‘Game changer?’ Florida eyes rapid and sensitive coronavirus test that just hit market
A new COVID-19 test approved by the Food and Drug Administration on Wednesday could dramatically improve and expand rapid testing for the disease in Florida, according to the state’s testing czar.
It’s unclear when they will be available. The U.S. is purchasing 150 million of the tests at a cost of $750 million, President Trump announced Thursday, a move that will boost the nation’s capacity for rapid testing.
But Jared Moskowitz, the state’s emergency manager, said they will change the testing landscape in Florida.
“There are tests that are as sensitive, and there are tests that are as quick,” he said. “The key is that most of those have not been combined, quick and the sensitivity together. That’s the game changer.”
The nasal-swab test, called BinaxNOW, is priced at about $5, a fraction of the cost of the tests Florida currently uses to diagnose the illness, which can range from $50 to $120 each for the state to run. The test is about the size of a credit card and can return results in about 15 minutes.
It also does not require lab equipment or personnel to process — meaning it could eventually be used to test students returning to school, people evacuating to hurricane shelters, workers going back to the office and sports audiences.
Abbott said it is pairing the test with a mobile phone app that can be scanned like a digital “boarding pass” to enter places where people gather.
Though there are drawbacks — the test is only approved for use in cases with symptoms so it won’t catch asymptomatic disease carriers — Moskowitz has already had several phone calls with Abbott, and said he plans to go after the new tests “aggressively.”
By late afternoon, after continued conversations with Abbott, Moskowitz learned that the entire first year’s supply of the tests had been purchased by the federal government. He said he’d already spoken to Gov. Ron DeSantis about securing the tests, and that this meant Florida wouldn’t have to pay for them at all.
Florida currently uses two types of tests. The molecular, or PCR test, is highly sensitive and requires healthcare workers to administer and a lab to process results. It involves a nasal or throat swab and can cost the state of Florida as much as $120 for one test.
A quicker test, which measures for a protein of the virus called an antigen, is less sensitive but can be self-administered. It also is done through a nasal or throat swab, costs about $50 for the state, and requires a lab to process results.
But the antigen tests have limited sensitivity, meaning a negative result has less weight because the test is more likely to have a missed infection.
The new Abbott test, which can produce results in less than 15 minutes, was measured to have a 97% sensitivity for people with symptoms, meaning it would catch 97 out of 100 infections.
But the test isn’t available for people without symptoms because it hasn’t been tested enough in those cases, due to the difficulty of identifying silent carriers of the virus.
That means the test can’t be used for the type of frequent screening of asymptomatic people that public health experts like Michael Mina of the Harvard T.H. Chan School of Public Health have been calling for. It can’t be used at home or with as much convenience as might be necessary to block or drive down transmission rates.
But Mina said he was nonetheless enthusiastic about the test because of its low cost and near-immediate results, which would shorten turnaround times and be more likely to catch people who are still contagious.
“This isn’t necessarily the test that is going to open up frequent testing at the population level ... until a vaccine comes along,” Mina wrote on Twitter. “But this is a great start to get this type of test into use for evaluation to eventually get us where we need to be.”
Amesh Adalja, a physician and infectious disease expert, and a senior scholar for the Johns Hopkins Center for Health Security, said faster and reliable test results will lead to better case investigation and contact tracing, which in turn will help contain outbreaks. Contact tracing is when public health workers try to find those people who may have been exposed to an infected person, test them and isolate them if needed to limit spread of the disease.
“The easier the test is and the more rapidly you can get results that are actionable, the better you can get control of the pandemic,” he said.
Adalja said there is still no ideal test.
“You need a test that’s going to be able to tell someone if they’re contagious or not so they can decide what activities to take,” he said. “That’s going to be a home-based test ... something very simple.”
Until then, Moskowitz said the Abbott tests are a step forward because their low cost, ease of use and accuracy will allow Florida to continue testing for the long term at much lower cost.
“The state of Florida spends millions of dollars a day on testing,” Moskowitz said. “At some point that spending is not sustainable. ... This is a game changer in that it can keep testing available, accessible, quick and easy and yet keeps it affordable so the state can continue testing.”
This story was originally published August 27, 2020 at 5:56 PM.
