Thread by @DrEricDing

📍BEST RAPID ANTIGEN TEST. This is the super awesome, very accurate, cheap $5, rapid antigen Abbott PanBio #COVID19 test used to find active infectious virus (& recommended by the renowned @michaelmina_lab).

SO WHAT’S THE DAMN PROBLEM?

➡️It’s not FDA approved in US yet. 🧵

https://twitter.com/michaelmina_lab/status/1328957535395729410

2) it is very useful for rapidly finding and isolating contagious #COVID19 cases.

📌For patients suspected of current COVID-19 infection.

📌High performance rapid test enables immediate treatment or isolation measures to minimize transmission.

3) 📌Patient-friendly nasal or nasopharyngeal sample collection types.

📌Accessible, large-scale testing helps contain the virus spread.

(FYI: I do *not* own any Abbott stock/equity, nor compensated in any way. I have not spoken to anyone from Abbott).
globalpointofcare.abbott/en/product-det…

4) Now it’s not 100% perfect but comparing nasal PanBio rapid antigen test vs Nasal PCR #COVID19 test:

📌Sensitivity 98.1% (99.0% for samples with higher viral load PCR Ct<=33)

📌Specificity 99.8% (ie 0.2% false positive)

(Sensitivity is 91-94% vs deep nasopharyngeal PCR).

5) Then again, a PCR test isn’t perfect either. And hence testing is also critically about the timing. But the key thing is that rapid antigen tests finds people who they are *most infectious* & carrying active virus, according to @michaelmina_lab. This is why we need it so bad.

6) “The point is to use these tests frequently so people are likely to know their status early, before they transmit to others. It is frequency and speed to get results (not absolute sensitivity) that should take center stage in public health screening program to stop outbreaks”

7) “This program doesn’t require the entire population to participate. Even if half of the community disregards their results or chooses to not participate altogether, outbreaks would still be turned around in weeks.” google.com/amp/s/time.com…

8) What about false positives? “With every pack of 20 paper strip tests sent to a house, 3 extra confirmatory tests (orthogonal antigen tests) will be included. When you test positive, you immediately use confirmation test at home, & if confirm positive, you stay home & isolate.”

9) What if tests aren’t sensitive enough compared to PCR? ➡️“This simply is not true—a misunderstanding. These tests are incredibly sensitive in catching nearly all currently transmitting virus”

➡️ “confirmatory rapid tests can bring the specificity to >99.9%” or higher.”

10) Basically we need cheap rapid tests, we needed it yesterday. The test has been successfully approved in Europe. The US govt needs to approve the test via EUA, and then ramp up production & distribute the tests to millions. That is the best way to get epidemic under control.

11) BOTTOMLINE: Bring on these accurate and cheap rapid antigen #COVID19 tests. Time is of the essence. Lives are of the essence. Our economy’s survival and health is of the essence. We need leadership on this immediately.

12) Although FDA just approved a different at home test, the Lucira COVID-19 All-In-One Test Kit is a molecular (real-time loop mediated amplification reaction) single use test, it needs prescription and slower and lower sensitivity and specificity. fda.gov/news-events/pr…

13) that said, it’s good but it’s not the same as the mass cheap rapid antigen approach recommended by @michaelmina_lab and @RanuDhillon. The new FDA approved LAMP test also needs a battery 🔋 in each kit & not nearly as fast or cheap as a paper strip rapid antigen #COVID19 test.