THREAD!
I am exceptionally excited about this real world experiment to bring free at-home rapid tests to two large US communities.

Terrific leadership and scientific policy implementation from our @CDCDirector and @NIH!

1/x
nytimes.com/2021/03/31/hea…
We know that frequent accessible testing with rapid results can be a critically important tool to slow transmission, keep R<1 and prevent surging cases. Why? because anyone can be exposed to the virus and not realize it until after they have become infectious.

2/x
I hope this new initiative will demonstrate the effectiveness of accessible, frequent at-home rapid testing and subsequently inform national policy to make at-home rapid testing available to all Americans without a prescription (and ideally for free!)

3/x
Importantly, the announcement of this public health effort by @CDCDirector @NIHDirector @NIH is entirely in line w the recent updates on rapid screening tests from the @US_FDA, guidance from the @CDCgov and objectives set forth by the @POTUS administration.

4/x
Although #COVID19 Vaccines are clearly our primary objective to help rid us from the grip of this virus, multi-pronged strategies are needed to further mitigate spread and keep outbreaks from becoming surging cases as we roll out vaccines.

5/x
Empowering individuals with knowledge of their infection status on a routine basis, equitably, easily and in the privacy of their own home is absolutely crucial and is one of the most powerful yet least exploited tools we have to combat infectious diseases like SARS-CoV2.

6/x
I’m thankful for our @NIHDirector, Bruce Tromberg, Rachael Fleurence and so many others @NIH for brining this program to life for the US and the world to learn how we can best combat these viruses today and in the future.

7/x
We and others have studied and written about potential strategies like this to combat this virus. I’m grateful that we now have all of our government agencies aligned on what the science says - frequent rapid testing is crucial to mitigate spread of this virus in a pandemic

8/x
Here is a thread about how we viewed something like this to work on a national level. The current program will help further inform this!

9/

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More from @michaelmina_lab

23 Mar
Thread: NEW Rapid Test Research!

Population-wide Rapid testing over a two week period of time (Rapid Ag testing of ~50% of population each weekend for two weekends in a row) PLUS subsequent quarantines led to ~70% reduction in prevalence.

1/x

science.sciencemag.org/content/early/… Image
Figure above shows the relative reduction in prevalence that occurred - which was consistently substantial across the regions where the population wide rapid testing was performed. Centering around 58%. Compared to what would have happened, the effect was even greater (70%)

2/x
The authors used mathematical models to help understand if the effect noted was due solely to tests, solely to the isolation and quarantines imposed or to both.

They found very strong evidence that it was the overall program - the rapid testing PLUS the behavioral changes

3/x
Read 8 tweets
17 Mar
THREAD: Statement on new FDA guidelines for Screening programs

Today FDA announced new guidelines for screening programs (i.e. testing asymptomatic individuals frequently to detect positive cases before they spread to others).
fda.gov/news-events/pr…

1/x
While this appears to be good news and a positive step forward to increasing regular testing for public health, we still don’t have a full understanding of how to interpret these guidelines.

There are a few details that we are trying to get clarification on from the FDA.
2/x
For Ex:

1) Does this allow schools to implement a screening program without a CLIA waiver or prescription? (both barriers to testing)

2) Will FDA designate previously approved tests for screening purposes or will the test developers need to apply for a screening claim?

3/x
Read 7 tweets
10 Mar
THREAD:

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.

1/x

bloombergquint.com/onweb/citi-deb…
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.

2/x
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.

3/x
Read 7 tweets
3 Mar
Short thread:

When things work well, they are unnoticeable to the public.

This is especially true of public health efforts. When public health efforts work, they go unnoticed. As in policy, boring is better in public health.

1/x

theatlantic.com/ideas/archive/…
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.

2/x
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.

3/x
Read 8 tweets
28 Feb
Interesting fact

I’ve not been PCR tested-Yet I helped start what is now the highest (?) throughput PCR lab in the world

Wouldn’t know where to sign up / don’t have time to stand in line for a test w results days later

I do have access to simple rapid at-home tests, 2x/wk

1/x
I’m not special. If I don’t have time to stand in line, millions and millions of others do not have time to do this.

If I’m not readily aware of how to sign up - millions of others aren’t. Sure, Google will tell me, but not everyone can just figure it out.

2/x
Testing is simply not equitable in the US and access is limited

Nearly 65% of Americans have never been tested. Not bc they don’t want to, but bc it’s not simple. Testing is a public good - we must make it simple!

At-home tests will improve equity and our public health response
Read 4 tweets
26 Feb
THREAD: NEW INFORMATION!

A first of its kind national survey out today from @CCDD_HSPH @TheCOVIDCollab and @HartSurveys on at-home rapid testing

What did we learn?

86% of Americans are willing/eager to use at-home rapid tests – BUT awareness of rapid antigen tests is low

1/x
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.
Read 11 tweets

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