Opinion: Antigen testing has some serious problems. Done right, it could reshape the future of health care

The Omicron variant of SARS-CoV-2 has renewed attention on Covid-19 antigen test kits. They are in high demand across the United States, and many Americans are having trouble getting them, prompting President Biden to announce that the White House will buy and ship 500 million rapid tests for free beginning in January.

The untold backstory here is that many people are growing accustomed to simultaneously serving as doctor and patient. Before the pandemic struck, the idea that millions of people would administer tests on themselves at home to determine whether they had a life-threatening illness seemed difficult to imagine. Today, it’s part of daily life.

While home-based antigen tests have made a questionable epidemiological contribution to tracking and confronting the pandemic, the real value they present goes far beyond Covid-19. If people trust their results, the ultimate outcome of the U.S. government investing an expected $50 billion to subsidize at-home testing may spark movement on many fronts that radically decentralizes health care and changes what Americans expect from and how they access care.

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The current discussion around antigen testing is naturally focused on the availability, cost, and efficacy of tests. Trust is another big issue. The rush for Food and Drug Administration approval may have backfired, undermining trust in the tests for some and creating a false sense of security for others.

Still, as Americans come to value rapid home testing for Covid-19, I believe this will usher in a new era of health care in which people feel comfortable testing for a variety of conditions at home because of their positive experiences during the pandemic.

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Just a few years ago, trying to engineer a shift like this would have seemed like a far-off dream requiring years of education, billions of dollars, and a dramatic change in mindset. It is astounding that this transformation appears to be taking place with relative ease.

Antigen tests are just the start. The public is increasingly familiar with — and has come to expect — tools that allow access to health care on their own terms, such as at-home tests for everything from strep throat to food sensitivities, FaceTime calls with their physicians, and prescription medicines delivered to their doors. That expectation is not going away anytime soon. The dilemma that health tech companies now face is finding ways to take advantage of the positive aspects of this trend while guarding against the challenges created in its wake.

My company, Healthy.io is, for example, working on applying this approach to chronic kidney disease. We call it “health care at the speed of life” because it means people will be able to take lifesaving medical tests in their own homes, when it is most convenient for them, without having to find their way to a lab or clinic or doctor’s office.

This is consistent with the key lessons of the U.S.’s massive experiment with at-home antigen testing. Specifically, everyone should have access to key tests, not just those who can afford upfront costs. Otherwise, the new system will only reinforce the shortcomings of the one it replaces.

At-home tests must adhere to high clinical-grade standards. To have any diagnostic value, patients and practitioners alike need to believe that the tests are as effective and as reliable as those used in medical offices.

For the at-home testing revolution to truly benefit patients, it must also tackle systemic issues confronting the health care system. As Covid-19 home testing has shown, if a test exists but is too expensive for the people who need it most, it will simply reinforce existing inequities in health care.

The pandemic has forced Americans to address their health care needs in new and innovative ways. To their credit, they’ve done so with gusto and determination. We now have a golden opportunity to rewrite the rules of the game in health care. That must be done today, and in the right way, or it will be lost tomorrow.

Yonatan Adiri is the founder and CEO of Healthy.io, a company working to transform the smartphone camera into a medical device.

Source: STAT