As all of us absorb some of the more troubling aspects of the recent government announcements, we might not be able to avoid a sense of déjà vu. Just like at the end of March, the government is making decisions very quickly that will have a sizable effect the British public. Even more so, the government is pursuing the same line of response that they pursued back in March, leading some to question how far we have really come in our understanding of how to deal with the global COVID-19 pandemic.
Over the last few weeks, however, there have been a number of breakthroughs in the scientific community. These revelations concern the sensitivity of rapid testing, a topic that has been hotly debated in the months since lockdown began. For many, the fact that rapid tests were unable to detect antibodies and viral material below a certain threshold was a fatal flaw, further confirming the predominant use of PCR testing which can detect below this threshold.
The problem lies in the fact that PCR tests – like those available on the NHS – take at least 48 hours to return a result. Given that the government advises those with symptoms to stay at home, this might mean that the patient misses two days of work at the least, which, as infections rise again, could threaten the financial stability of those already hit hard by the pandemic. Similarly, those interested in travelling might have to postpone or even cancel their plans if they experience symptoms at an inopportune time. Clearly, there is an incentive here for Britons to simply take their chances, to keep functioning in ignorance by not applying for a test or to apply for a test but make no adjustments to their behaviour while they wait for the results. In both cases, the delay inherent in PCR testing poses a problem for mitigating infection rates.
But, since rapid tests are not as sensitive as PCR tests, we have no other option but to continue with this line of response, right?
Well, Harvard immunologist Dr. Michael Mina has a strange yet simple answer (which he lays out clearly and concisely in a recent New York Times article): what if rapid tests are just insensitive enough to miss non-contagious or non-immune individuals who nevertheless have some tiny amount of viral material or antibodies? Put another way, what if a positive result from a rapid test gives us all the information that actually we care about: are we infectious/immune or not?
Dr. Mina would answer in the affirmative. He does not dispute that rapid tests are less sensitive but still holds that they are more useful that PCR tests, since we are not interested in detecting any and all amounts of viral material or antibodies but only those amounts which make a patient contagious or presently immune. So, why are we being so sensitive? Rapid testing offers the British public the power to make informed decisions at the pace of their lives. PCR testing interrupts their lives to give them information that they don’t need.
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