1/ An important thread on:

Why the 1 million Abbott BinaxNOW tests per day are not enough

Why we need 20 million tests per day

Why several companies could produce millions of tests per day but are choosing not to, due to regulatory uncertainty and lack of gov support.

We could likely re-open schools if we combine masks, social distancing, and ventilation with 2x per week rapid testing.

To test all 35 million K-8 students, we would need 20 million tests per day.

The Abbott BinaxNOW was recently approved for prescription use. It can currently be produced at about 1 million per day, far short of what we need.

On the inside, the Abbott BinaxNOW is a paper strip. But it's encased in a larger cardboard cassette, which is a huge bottleneck slowing down production.

It's possible to get much higher throughput by just producing the paper strip that comes inside. We've heard as much as 10x throughput. Doing so would also bring down the wholesale price to as low as $0.20.

So why not just produce these paper strips?

The conventional answer is that people often don't use the paper strips correctly.

And it's true, usability is a real problem.

The good news though is there are solutions!

One solution is to pair the paper strip with a smart phone app. When you take a picture, the app can read the test correctly and can confirm that it was done properly.

The other solution is to pair the paper strip with a reusable plastic cassette. You'd only have to buy the cassette once. Like BinaxNOW cardboard cassette, a plastic cassette would help with usability.

These solutions will likely bring the clinical (in-practice) sensitivity of these tests up to the level of the BinaxNOW. But even if they only bring up the sensitivity to 90% of the BinaxNOW, that's easily worth the 10X gain in volume!

Multiple companies can each produce multiple millions of these simple paper strip tests. But they are *choosing not to* because of regulatory uncertainty and fear that their factory investments won't pay off after the pandemic goes away.

When companies can't afford to invest in pandemic-solving tech, it's the role of the government to step in and provide financial support and regulatory clarity. Visit http://rapidtests.org  to support these tests.

Special thanks to @michaelmina_lab @sikeslab @Kevin_P_Nichols.