Not All Rapid Antigen Tests Are Equal!

Please do NOT assume metrics same across tests

Some work amazingly well to catch contagious virus. Some not

If you hear a rapid test isn't working well, dont assume its same for all of them

It's not
Rapid antigen tests must catch virus on a paper strip

To catch virus, test manufacturers use ANTIBODIES (yes, antibodies like the ones in your immune system) to catch the virus

They make the antibodies and embed them, in a line, on the paper strip.

Thus a line forms if +ve

Antibodies can come in all shapes and sizes (sort of)

Point is, some antibodies are much more specific and strong binders than others

Some are just... sticky. Some much more directed.

Some grab the virus more tightly - these may be used on the more sensitive rapid tests

Moral of this little tutorial is... rapid antigen tests are not all created equal and they are generally only as good as the antibodies selected (usually discovered by sequencing an infected persons B cells) and printed on the paper....

Some newer rapid antigen tests are a bit (or a lot) better than some that came out many months ago

For the newer ones, companies have simply had more time to sequence more people's B cells and dig deeper to find better, stronger, more specific antibodies for the test

Lots of publications now have looked at the differences

So, If you're in a position to decide on a rapid testing program for your city, state or country - don't assume one test is same as the next. Simply put, and like everything in life, they simply aren't. :)


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More from @michaelmina_lab

18 Nov
For anyone wondering what a best-in-class rapid antigen test looks like. This is the @AbbottNews PanBio rapid antigen test.

If you lift up the plastic top (which is cheap) it is a simply paper strip (that white part with the red line)....

These are exceptionally cheap w/ very good accuracy to detect people when they are carrying infectious virus

Extremely easy to use
Simple design

I suggest a model where you reuse the plastic shell (like contact lenses) and just change the paper strip. Simple.

It is really unfortunate though that this particular test is NOT sold in the US. It is sold outside of the United States.

Nevertheless - this is to show that THESE TESTS EXIST.

The US Government should be making them in the 10's of millions daily.

Instead, Americans are dying
Read 4 tweets
18 Nov

• NO lockdowns
• NO waiting for vaccines
• Reverses cases in weeks

A true public health approach focused on the ppl

To end the public health *WAR* we are in.

RAPID At-Home COVID Testing for All
This Plan works WITH the people and meets them where they are.

It works WITH all the other public health approaches we are already taking - it does not replace them

It is bold and and ambitious - and addresses the fact that we are actually in a war with a virus...

It is time the government STOPS the nonsence of treating this like scattered medical problems to be addressed medically

We MUST address the pandemic as a public health problem - with the RIGHT TOOLS - only then will the medical issues resolve

Not the other way around

Read 15 tweets
16 Nov
VACCINES can work!

Another #COVID19 phase 3 vaccine trial reports awesome results. This time, an estimated 94% efficacy

95 COVID19 detected: only 5! in the vaccine group and 90 in the placebo

But like Pfizer results - need to take w caution... WHY?

First, the amazing efficacy from phase 3 at this point for both @moderna_tx and @pfizer vaccines - both mRNA vaccines - is EXCEEDINGLY ENCOURAGING.

These results show that these vaccines are eliciting the correct antibody bases responses to stop symptomatic infection!

What I am worried about is the time scale of the trials thus far:

The leading vaccines are presenting the spike protein to the human immune system. This makes sense! Immunize against spike and stop virus entry into the cells.

Read 13 tweets
15 Nov
My brother is an amazing soul.

When the pandemic started and schools shut down, kids in Saratoga Springs,NY who relied on free school lunches for food, lost those lunches.

He, with his rather small deli in upstate NY started making free sandwiches for the kids.

Now this...
And this was the message.
This 👆is how we work together as a society to pull through this pandemic. This is encouraging and hopeful and shows off the best that humans can be.
Read 5 tweets
15 Nov
@elonmusk Great question! It’s more complex question and depends on why the test is being used - ie: do you want to know if you are currently contagious/risky to others or if you have any remnants of RNA? The difference may sound trivial but it is massive

@elonmusk If the question is "Am I currently infectious right now when the swab is collected" then on *most* instruments/labs, data suggests a Ct value somewhere around 30 or below is needed. (Different instruments/labs are different - but that's a decent generalization)...

@elonmusk If the question is "Am I becoming infectious" then even if you have a high Ct value... say 38... then it's important to test again the next day. If you go to 28, then you better stay put, you're likely infectious for the next 5-8 days or so...

Read 10 tweets
14 Nov

Rapid Antigen tests work v well!

Not all are same - Some much better than others

This paper is a masterclass of how to study AND interpret the use of #COVID19 rapid antigen tests!

Best study IMO to date of how to think about these tests…
The paper 👆by one of the leading groups in the world on #COVID19 testing @c_drosten.

The paper supports precisely what we have shown in our research for these tests to be used as powerful public health screening tools to slow/stop outbreaks…
The paper evaluates multiple antigen tests and finds a wide variety of specificities and analytical sensitivities

Drives home message that not all antigen tests are the same! These tests use antibodies to capture the virus and these will induce potentially major differences

Read 11 tweets

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