Why Researchers Believe a 'Crappy' Coronavirus Test Can Help Fight the Pandemic

Depending on where you’re located, getting a coronavirus test may not be so simple. It can take days or even weeks to get results, leaving people unsure of their status and potentially transmitting it to others.

Some health experts are now arguing that the country’s insistence on accurate tests that take time to process may actually be counter-productive in controlling outbreaks. They’d like to see a “crappy,” less sensitive test that trades accuracy for being inexpensive, widely available, and able to produce results quickly.

In an op-ed in The New York Times, Boston University economics professor Laurence J. Kotlikoff and Harvard T.H. Chan School of Public Health assistant professor of epidemiology Michael Mina say that at-home tests that use saliva are inexpensive to produce and can be distributed on a scale that makes daily self-testing possible.

The Food and Drug Administration (FDA) has not yet approved these tests, which use paper strips to indicate infection, owing to the fact they’re not as sensitive as the polymerase chain reaction (PCR) nasal swab tests and often give false negative results. But according to Mina, that’s not the whole story.

While it’s true simple paper tests that change color after just 15 minutes are less accurate overall, they do a reasonably good job when large amounts of virus are present and when a person is likely to be most contagious. And because the tests can be taken frequently—even daily—a person stands a good chance of identifying an infection. Positive results could also be confirmed with the usual nasal swab test.

Under most circumstances, a person going to a drive-up or walk-in coronavirus testing site may be evaluated only once. With paper tests, their status can be assessed daily, allowing for early intervention and isolation so they don’t spread the infection to family, co-workers, or classmates.

The test could even be government-subsidized and distributed, Kotlikoff and Mina say, absorbing the $1 to $5 cost per test to allow for monitoring in real time. Instead of the current structure, which sees only one in 10 people likely positive for the virus being tested, the paper tests could do a reliable job of providing data for the rest of the population.

“As long as you’re using the test on a pretty frequent basis, you will be more likely than not to catch the person on the day they might go out and transmit,” Mina told NPR. “And they’ll know to stay home.”

Companies like E25Bio have developed such tests, but when or if they will obtain FDA approval remains to be seen.