There was exciting news that broke late yesterday. The FDA has issued Emergency Use Authorization for Abbott Labs’ $5 rapid COVID-19 test. This new test provides results in 15 minutes and pairs with a smartphone app to show a digital certificate confirming the date of the most recent negative test.
At first glance, this looks like it could be the breakthrough that could save the travel industry. It would also be a boon for live entertainment, restaurants and even would allow for large events without worry about getting sick or infecting everyone else attending.
Access to cheap, quick tests is one of the keys we need to unlock the door that’s keeping us from everything we want to do again. However, it’s only one key and there are several locks on the door.
If you think I’m just Mr. Negative and this test is exactly what’s needed to go back to the way things were, why is the stock market not rallying? The airline ETF (JETS) only up 3% today (YTD -48%) and a broader travel & leisure ETF (PEJ) is up just 2% (YTD -33%). So this news is obviously good for travel, it’s not going to springboard us back to where we were.
Here are several of the reasons that a rapid test alone isn’t enough to get people excited.
Skepticism
In the age of coronavirus, we’ve all been told before that a new breakthrough was going to turn things around. Back in March, Abbott Labs (the same company making this new test) was granted the same emergency use for its breakthrough rapid test. Just two months later, the FDA issued a warning because additional data showed that the test was only 80% sensitive for COVID-19. That meant it missed 1 in 5 positive cases. Not great when you’re trying to contain a pandemic.
Residents of the United States have been burned by testing results for the entire duration of the outbreak. At the start, there was a lack of tests and questions about their ability to accurately determine positive and negative results. Once people were able to get tested, there was an inexcusable delay in getting back results, making them meaningless.
We’re at a point where it’s possible to get tested and get results back from a lab but by now, people aren’t very trusting in the system.
Numbers Game
With this new rapid antigen test, BinaxNOW, Abbott claims a sensitivity of 97.1% and specificity of 98.5% from the completed clinical trials. This is much better than the 80% accuracy from their previous test. Abbott claims they can produce tens of millions of tests in September and up to 50 million tests in October. 50 Million.
With doing that many tests, there are still going to be 3% of the positive patients being told they’re negative. That would mean they’d be able to show a pass and might even be allowed into a foreign country. It would also mean that 1.5% of the people who are negative would show a positive result. A confirmatory lab test using the more sensitive PCR method would then be needed but until those results are back, they’d be expected to self-quarantine.
Finally, these test results aren’t good for very long. If you’re infected, it can take anywhere from 3 to 14 days for you to have enough virus to trigger a positive test. So if you were infected the day before your test or even the day after you get a negative result, it’s only a few days before you’d possibly test positive.
Ease of Testing
The benefit of getting a mass-produced, inexpensive, rapid test is undeniable. However, this leads to a new problem. Where are these tests going to be performed? The BinaxNOW test is a nasal swab test performed by a health care provider. This means you’ll have to go to a doctor, clinic, pop-up site or any other CLIA-waiver approved location to get your test done.
Opening up these locations isn’t as easy as it sounds. Many of them provide drive-up services but what if you don’t have a car? The current system puts many patients at a disadvantage to get tested. This will only exacerbate the disparity we’re already seeing with access to tests.
Consequences
At the moment, getting a positive COVID-19 test is a huge problem on many levels. For the people who are already experiencing symptoms, it means an extended quarantine and the fear that the condition will only get worse. Could you be one of the 0.68% of people who die once catching it? Are you more at risk or less depending on your personal health conditions and age?
There are also the economic issues that come along with being quarantined. If you’re asymptomatic and lucky enough to be able to work from home, you might not be affected that much by your result. However, if you’re one of the “essential workers” who have kept working in person the whole time, it’s a totally different story. If you’re lucky, you work for a company that will pay you while you’re home but there are no guarantees if you work for a small business or if you work for yourself.
When thinking about travel, some people believe that a rapid test will open up the country and the world to visitors again. But think of the other side of that story. You’ve booked a trip overseas to a country that requires a negative test 48 hours before your trip. You’ve paid for airfare, booked hotels and activities and when you get your results back, you come back as having COVID-19.
What happens now? There goes the trip but will you be able to cancel all of your plans just like that? All travel companies haven’t stated what their policies are if you have to cancel a trip due to a positive coronavirus test. Being able to cancel a trip without penalty will be needed before people will feel comfortable about booking any trip requiring a negative test result.
What Else Is Needed?
Testing alone will not solve the problem because of the limitations. The other main piece of the puzzle is going to be a safe and effective vaccine that’s used by a large part of the population. In the United States, there are just too many positive cases for us to keep the spread of coronavirus under control. Other countries around the world are having a different problem. While they suppressed the spread at the outset, they now have to deal with flare-ups due to the relaxation of the restrictions.
I’d honestly be glad to be dealing with the second problem but there’s nothing I can do about it living in the USA.
A vaccine will help everyone in the battle to control the spread of coronavirus worldwide. It will hopefully knock down the virus by giving it fewer hosts to infect. This is when we will see the most dramatic decrease in positive cases and subsequent hospitalizations and deaths.
Additional therapeutic options to help if you get sick are another smaller part of the solution which will give people more peace of mind.
Only then will we see the restrictions on travel start to be lifted and people start to feel safe about traveling again.
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This post first appeared on Your Mileage May Vary
