Testing remains paramount despite vaccine rollout, and we must improve it
Kevin Hrusovsky, CEO and president of Quanterix, and founder of Powering Precision Health, explains, from a U.S. standpoint, why testing remains paramount in controlling the spread of COVID-19 despite the vaccine roll-out.
Although the recent emergency use authorisations of the Pfizer-BioNTech and Moderna COVID-19 vaccines have brought some much-needed good news, the U.S is currently reckoning with the deadliest wave of the pandemic yet. Vaccines are finally starting to roll out to priority populations, but the virus is spreading faster than ever, killing thousands of Americans daily. It will be months before enough people are inoculated to achieve herd immunity, and emerging variants may prolong this timeline. Amidst these unknowns, testing remains paramount to curbing the spread and protecting the highest-risk members of society. However, despite its importance, testing has struggled to keep pace with patients, with results coming into question or being received long after infection and spread. It is clear there is still much work to be done in this arena.
Even as vaccines roll out, it's critical to continue the measures that can limit the toll: mask-wearing, social distancing, handwashing, and regular testing. This is where the scientific community has been applying considerable resources – and witnessing unparalleled innovation. We are constantly redefining our own testing strategies to address the ongoing challenge of false positives and negatives that pervades the current testing infrastructure. As it stands, the majority of today’s tests can only accurately detect the virus once it is active and an individual is contagious. By the time their results are received, they may have infected those close to them. These numbers go up considerably in the case of asymptomatic carriers, who may infect a swath of people unknowingly.
It is imperative that we mature testing options that can see the virus as it is incubating and provide patients with results they can act upon before symptoms or spread occurs. This is becoming achievable through highly sensitive biomarker technologies that can measure and quantify the virus with never-before-seen accuracy and specificity. The ability to measure and quantitate biomarkers indicative of COVID-19 at its earliest stages is a critical component of a truly effective testing infrastructure. Seeing the infection earlier and pre-symptomatically, with exquisite sensitivity and specificity, serves as an essential step in confidently moving our national testing capacity forward.
The other component of our testing infrastructure that we must continue to improve is sample capture. Today, the most reliable form of testing is the nasopharyngeal swab, which lifts a sample from the back of the nose and throat. This procedure is invasive and requires a medical professional to administer, necessitating the use of precious and limited PPE as they must get close to a patient’s face. Saliva swabs are easier to perform and more comfortable for the patient, but they increase the chances of a false result if the virus is in its earliest stages. The ability to employ non-invasive capillary sample or dried blood samples that can generate results on par with nasopharyngeal swabs is poised to become a game changer in the year ahead. Such samples could be easily collected right from the comfort of someone’s home on a regular basis, making the process easier and more convenient without sacrificing on performance.
As we unlock higher degrees of sensitivity and precision quantitation through unprecedented technological advances, we will be able to empower access to testing for a wider portion of the population, enhance reliability of results even as sample types become less invasive, and create convenience through homecare sampling options. These elements are critical to establishing the robust testing structure necessary to defeat COVID-19, and they may also have long-term ramifications for the proactive healthcare paradigm of the future. Imagine being able to monitor for and diagnose all manner of diseases, from cancer to Alzheimer’s disease, early through a simple, routine, at-home blood test. The potential to test as seamlessly and regularly for intractable conditions as we do for blood pressure or cholesterol today is, quite literally, at our fingertips.
Even as vaccines disseminate across the country, testing will remain a facet of society for the foreseeable future. Done correctly, we can get the world back on its feet sooner and lay the foundation for a precision health testing network that can support us for years to come.