Imagine a world where you could walk into any corner store, find a COVID-19 rapid test, buy it for just a few dollars, and know within minutes whether you are, or are not, contagious with coronavirus. You wouldn’t need a doctor’s referral to buy one. You wouldn’t need a lab technician to read the result. You wouldn’t even need to endure the deep (and often painful) sinus swab to get the sample.

There are places in the world where this scenario is already a reality; the United States is not one of them.

That’s not to say that rapid tests don’t exist in the U.S. Back in August, the U.S. government purchased 150 million rapid tests as a way to expand testing, but it hasn’t gotten very far in distributing them. Plus, the ones available for over-the-counter sale still need to be sent to a lab to be processed, many are expensive, and you often need a health provider’s prescription to get access to one.

According to Dr. Michael Mina, an epidemiologist and immunologist at Harvard Medical School and Brigham and Women’s Hospital in Boston, making rapid testing widely available could be the key to getting back to life as we once knew it — but seeing the U.S. hesitate over deploying wider rapid testing has been “dispiriting,” he said.

A rapid COVID test cassette from LabCentral
The tests are simple and work a lot like pregnancy tests
Sarah Leeson

Other countries, he said, are asking: “Why, America, can’t you get out of your own way and recognize that you have tools sitting right in front of you? You’re the most resourced country in the world, but you fail to recognize just how powerful the tools sitting in front of you are.”

Despite this, it’s possible that we may be seeing rapid tests on the shelves in the near future. A consortium out of LabCentral in Cambridge, Massachusetts is currently developing its own self-administered rapid test. It plans to have the tests available for sale everywhere in the U.S., possibly within weeks. The company has been using the rapid test to get its own employees back to the lab since September, and it has already caught asymptomatic COVID carriers — stopping outbreaks before they could even happen.

“It’s not the gold standard, but that’s OK,” said Celina Chang, vice president of science operations at LabCentral. “What we’re looking for is people with a high enough viral load that they’re actually shedding and infecting other people. And this can definitely detect that.”

Johannes Fruehauf, president of LabCental, imagines a future where you show up somewhere — whether it’s a flight, a work conference, or a wedding — take a test, get your result, and join the crowd without fear.

“We have all accepted that we will have to wait in line and go through a security screen at the airport so that we are not carrying knives or guns onto the airplane,” Fruehauf said. “And we subject [ourselves] to that because we enjoy the sense or the actual safety that this conveys upon every traveler.”

Alex Harmon processes tests in a lab
Alex Harmon processes rapid test samples as part of the study out of LabCentral. They are hoping to have these tests on the shelves for individual purchase in the near future.
Sarah Leeson

While these tests might get us a few steps closer to traveling or gathering again, they are not flawless. In one widely publicized example, there was a superspreader event at the White House’s Rose Garden in September. After guests tested negative with a rapid test upon arrival, they gathered freely (and closely) without masks. Later, at least 11 attendees — including President Trump — tested positive.

However, this is where the so-called “swiss cheese” model of protection could come into play. With layers of protections in place, from social distancing to mask-wearing and now even some vaccine administration, the cumulative effect of all of these practices can keep us safe — and rapid testing could be an important part of that picture, according to Dr. Joshua Schiffer.

The infectious disease specialist from the University of Washington is a champion of rapid testing, even if these tests aren’t perfect. In his eyes, we can’t let the perfect be the enemy of the good.

“There’s a number of different ways to attack this and to achieve success and very few of them are going to involve just a perfect solution that is foolproof,” Schiffer said. “Each of these strategies has holes, but if you apply all of them, fewer infections break through.”

Slovakia is one country that has demonstrated how effective rapid testing can be, using the method to stop outbreaks at large scale. Researchers believe Slovakia’s mass testing program, coupled with its strict quarantine measures, may have cut infection rates by as much as 60% in one week, which could turn the tide of the pandemic there.

Why aren’t rapid COVID tests being used widely in the United States then, given their success elsewhere?

Well, getting these tests into our hands might necessitate a paradigm shift for the U.S. health industry. According to Dr. Mina, allowing individuals to test themselves would be a significant departure from the current system of going to a doctor’s office to get screened, but he believes we shouldn’t let this stop us.

“This is a novel pandemic,” Mina said. “Somebody has to do it first.”

Sarah Leeson is Associate Producer with Innovation Hub.