Read on Twitter
HUGE. **Rapid** 15 min tests approved by @WHO—a bold & right step for #COVID19. Akin to home pregnancy tests, rapid antigen tests better than PCR where labs scares & lag is long. Rapid tests are cheap & identifies *infectious* cases & fast isolation. Game changer for pandemic! 
https://twitter.com/alinouriphd/status/1310626435061690371
https://twitter.com/alinouriphd/status/1310626435061690371
2) Rapid antigen testing is described as “The plan that could give our lives back”. Leading advocate is Harvard epidemiologist Dr Michael Mina @michaelmina_lab. He believes if we need to deploy millions of antigen tests to epidemic hotspots. https://www.theatlantic.com/health/archive/2020/08/how-to-test-every-american-for-covid-19-every-day/615217/
3) For those needing a background, unlike PCR tests which tests for the RNA genome of the coronavirus, the antigen tests for protein parts of the virus. PCR slightly more sensitive but PCR often finds RNA 
fragments of non infectious virus pieces even when later can’t transmit.
fragments of non infectious virus pieces even when later can’t transmit.
4) But advantage of antigen test is not only is it fast (<15 min) and cheap ($5 or less, hopefully $1 when mass produced), and not require delicate logistics of sending to a lab and waiting for days or even a week... but think of use by masses and resource limited settings.
5) Currently, WHO only approved for low and middle income countries where resource low. And US FDA has only approved Abbott’s BINAXNOW via an EUA. Weird thing is HHS bought up all 150 mil rapid antigen tests—for entire 2020. But very unclear deployment. https://www.hhs.gov/about/news/2020/08/27/trump-administration-will-deploy-150-million-rapid-tests-in-2020.html
6) The other odd thing is that FDA’s EUA approval for antigen test BINAXNOW is only for symptomatic. But HHS Asst Sec Brett Grior also endorses using it “off label” for asymptomatic as well. I don’t disagree per se, but it’s ironic HHS asst sec goes around FDA’s EUA intent. 
https://twitter.com/hhs_ash/status/1300146630201610240
https://twitter.com/hhs_ash/status/1300146630201610240
7) To be clear, people without symptoms of #COVID19 often have similar viral loads as symptomatic people, and both can be infectious. That’s why @michaelmina_lab endorses using antigen tests for ‘screening’ as well for testing anytime—not just diagnosing overtly sick patients.
8) That said, “clear evidence that “Abott didn’t just have symptomatic diagnostics in mind here, but also screening of asymptomatic people.” Symptomatic people are much more likely to have the virus, decreasing the chance of a false positive...”
9) “... For asymptomatic people, even in an area with lots of infections, Andersen worried that Abbott’s test isn’t accurate enough, and would generate many false positives.” https://www.theatlantic.com/science/archive/2020/08/abbott-covid-19-rapid-tests-trump/615826/
10) But there are “solutions to increase specificity. For example, a future version of the test could look for two viral targets. Or two tests could be packaged together, one of which would be a slightly more expensive test that you’d take if you got a positive on the first.”
11) Dr @michaelmina_lab calls this multi test confirmatory approach “orthogonal” testing—using a PCR test as followup or even a DIFFERENT antigen test (yes, you can test for different antigens to the virus—lots of possible targets on a virus). Akin to an independent verification. https://twitter.com/michaelmina_lab/status/1297231253041709057
12) An analogy—think of it this way, if we want to find a hidden enemy submarine, is it better to drop one sonar buoy (PCR test) every 100 miles that reports weekly, or drop a 90%-as-good sonar buoy every mile that reports every 15 min? Latter of course. That’s antigen testing!
13) Besides WHO, airlines like @lufthansa has gotten into the rapid antigen test game, offering tests for passengers starting October. But at first for First/Business class passengers—which is SUPER LAME and nonsensical. If limited, it should be randomly or for economy pax first! https://twitter.com/drericding/status/1309362029254320129
14) BOTTOMLINE: the era of rapid cheap antigen testing is soon upon us, which would radically change the pandemic response and allow us to quickly isolate the sick and stop community transmission faster. But we need more/faster—& for FDA to approve antigen tests for ‘screening’.
15) Clarification about the other Abbot “rapid” test ID NOW touted in spring— a quicker PCR test but not cheap & it still needs a machine & lots of reagent cartridges, & not as accurate as other PCRs. The new rapid antigen lateral flow tests are akin to home pregnancy test.
