Contributed Commentary By Phil Groom
April 23, 2020 | As the coronavirus pandemic continues, world governments and health agencies are rushing to buy large quantities of laboratory and portable rapid testing kits.
Diagnostic testing is being seen as the key to slowing the outbreak, as it reveals invaluable information about how the virus spreads and allows authorities to more accurately predict how it will spread in future. Using these data, governments can take informed steps to implement targeted interventions and better protect public health.
The approach has already been shown to have an impact in areas such as Hong Kong, Taiwan, Singapore and South Korea, and has been endorsed by the World Health Organisation, whose director-general urged countries to step up testing, saying they “cannot fight a fire blindfolded.”
Mass population testing, followed by contact tracing and quarantining, is being held up as the most likely way that countries will be able to ease lockdown restrictions. But there is some way to go. Currently in the United States, for example, there are around 120,000 samples being tested each day, according to the Centers for Disease Control and Prevention. Some experts have claimed that as many as 20 million to 30 million people will need to be tested each day before things can get back to anywhere near normal.
A closer look at the science and technology behind some of the rapid testing kits currently available reveals most of them are not specific nor sensitive enough to detect the novel coronavirus, and the laboratory PCR kits—the current frontline standard—are less than ideal. They can take many hours to return results, can only be performed in a lab by trained experts, and can be expensive.
So, while useful, the most widely used tests are not entirely fit for purpose and offer little support to most governments’ mitigation strategies of ‘flattening the curve’ (i.e. keeping cases at a manageable level). The long incubation period of Covid-19 also means a person can have the virus active in their system long before they start showing any symptoms, if they show symptoms at all.
Currently, there isn’t a mass-produced, affordable rapid test specific to coronavirus that shows whether someone has the active virus and is infectious. Lateral flow has now become one of the preferred testing methods thanks to its portability, ease of use and its ability to deliver rapid, lab-quality results. Many companies and consortia are racing to become the first to produce a working and accurate lateral flow assay for Covid-19.
Imagine Integrating Real-Time Disease Mapping With The Right Diagnostic Test.
However, testing is only one piece of the puzzle when it comes to the Covid-19 outbreak. If we are to stand a chance of properly combatting this pandemic, mitigating the effects of the outbreak and ‘flattening the curve’, we need to go beyond just testing. The visual interpretation of epidemiological data in real-time is critical.
There are already various online maps tracking the coronavirus outbreak, but none of them are real-time. As useful as these are, they are largely reactive, relying on information being passed on from various local, national and international authorities. With the limitations of current testing methods, there is no way we can be certain the information is accurate, and we have no insight into the health status of the population which has not yet been tested. This information gap was further exemplified last week, when China retroactively raised the death toll in the city of Wuhan by 50%.
To really make a difference we need to capture the test result data at the point of testing, manage it in the cloud and then geo-map the results visually. Imagine how valuable a point-of-care diagnostic test could be during this and future disease outbreaks when it is connected to the cloud and collects and reports data to all stakeholders in real-time. Authorities would be able to put in place timely measures to slow or even stop the spread of infection and prevent further transmission. That would be a powerful tool.
While it is reassuring to see efforts and resources being put into developing rapid diagnostic tests, particularly point-of-care tests, this outbreak highlights the urgent and apparent real-world need for digitally connected, data-driven rapid diagnostic solutions.
Harnessing digital technologies combined with the power and accessibility of the cloud and integrated with the appropriate rapid diagnostic test should become the norm in fighting public health threats of a global scale.