Today I am announcing a new massive public health research study - with @Citibank - to use and evaluate frequent at-home rapid testing. The study is evaluating how well workplace infections are prevented by frequent home-tests.
The study is evaluating whether rapid home-tests used ever M/W/F can successfully prevent workplace transmission better than current status quo of symptom screens and evaluates how well non-medical ppl can perform the tests on their own.
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The rapid tests - which aren’t yet EUA’d but are used globally and we’ve found to be very effective in pilots - are being introduced in conjunction with @LivePerson’s Bella Health app to provide AI-powered assistance to help people at home learn how to use the tests.
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If simple mobile tools like Bella Health and other apps can reliably help people to use these (and other medical devices) at home - it can pave way for a new generation removing need for $$ medical visits and increase equitable testing and increase the usefulness of tests
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My hope, overall, is that this large clinical / public health study will help build a roadmap for how we can keep economies and schools open even where vaccines don’t yet exist and in event of new resurgence of transmission in fall.
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I’m committed to helping us (society) not find ourselves having to distance from our loved ones for a year ever again. And I’ll keep working to identify creative avenues that prevent another year like the one we are emerging from. This study is part of that commitment.
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These types of tests are (remarkably) not FDA authorized for frequent use at home. (The study participants are aware and sign consent)
This study will hopefully help @HHSGov & @CDCgov see why it is important that these tests be defined as public health tools - not medical tools.
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Unfortunately, this fact, that when public health is working well, it is unnoticed, necessarily sets them up to appear like they are failing.
The only time the public thinks about successful public health efforts is when they falter at all, especially if faltering is rare.
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This happens all the time with the most successful vaccines... b/c the only time highly successful vaccines make the news (outside of a pandemic) is when a rare adverse event occurs. We simply don't report the constant daily successes of the best working programs.
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86% of Americans are willing/eager to use at-home rapid tests – BUT awareness of rapid antigen tests is low
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This week Congress is considering $46B for testing, including for rapid tests. What does America think about that?
85% of Americans want government to fund these tests & distribute them. Strong support for rapid tests across political spectrum: 94% of Dems and 74% of Repubs.
But support for testing doesn’t come at any price. Willingness to test at-home decreases as $ increases. At $25 (price of the only two currently EUA authorized rapid at-home tests), only 33% of Americans would test themselves regularly.
The tweet thread above by Denis Nash @epi_dude is terrific and contains lots of wonderful data!
For me, It highlights the need for us to re-evaluate what it is we are doing. When our actions weren't working to slow spread, should we have kept forcing the same actions?
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I worry that we get into group-think mentality and peer pressure is immense to "stick with the consensus"...
but when consensus is to stick to a failing test-trace-isolate as control, against our own warnings to our future selves... maybe we should've bucked the trend?
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Essentially, we created a barometer that gives the growth rate (or decay rate) of an epidemic based entirely on whether the distribution of viral loads in ppl at a single time in a population is averaging high (epidemic growing) or low (epidemic declining).
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This property of epidemics (when they are going up, detected virus loads are higher on average) has caused massive confusion.
The virus itself isn’t changing nor are the actual virus loads inside of individual people...
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I’ve spoken on sensitivity and why rapid Ag tests shouldn’t be compared to PCR
Nevertheless, we’re stuck comparing to PCR. So, to deal w this, “we” have taken to comparing rapid antigen tests to PCR results below specific Ct values that may represent contagious virus loads
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In many studies, Ct of <30 or <25 are considered to be likely contagious or “high virus”, respectively
HOWEVER this is bad. We must stop assuming this
Not all labs are the same
A Ct 25 in many labs may = a Ct of 18 elsewhere
This happened in Liverpool w Innova evaluation
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