Can Humankind win the war against COVID-19?
The Current Problems of COVID-19 Testing
What are the problems or shortcomings of COVID-19 testing that make it a less effective tool in fighting the COVID-19 pandemic? There are three:
Accuracy of Test
A false-negative test result (i.e. infected but not detected by COVID-19 test) is worse than no testing. A person with a false-negative test result may unknowingly go on to infect many people.
A false-positive test result is not good either, although a false positive result causes less harm than a false negative result.
It is widely recognised polymerase chain reaction (PCR) tests are highly accurate in the high 90% plus range, and 99% under ideal conditions when properly conducted by trained medical professionals. Rapid antigen tests are reported to be less accurate at around 93%.
At-home tests are even less accurate because individuals collect the test samples themselves, not trained medical professionals.
Turnaround Time of Test Results
To conduct COVID-19 testing we generally require the availability of test kits, trained test personnel with personal protective equipment (PPE), a test laboratory to support the test analysis, and other logistics.
Turnaround time of test results can range from 1-2 days to more than a week depending on test laboratory capacity. In the USA, it has been reported the median test result turnaround time to be 4 days and a lot of times test results come in as late as 10 days after testing.
Long turnaround time diminishes the benefits of testing. A person, if already infected, can infect other people while waiting for test results if that person does not quarantine at home and continues to go to work or interact with other people in the community.
Testing Capacity and Cost
Testing capacity and testing costs are closely related. Current COVID-19 test methodologies involve the availability of test kits, trained test personnel with personal protective equipment (PPE), and test laboratory to support the test analysis. Setting up a testing facility involves arranging for a huge amount of logistics. It has been reported each COVID-19 test can cost up to US$100.
Many innovative companies are working hard to improve COVID-19 test accuracy, reduce turnaround time for test results, increase testing capacity, and bring down per COVID-19 test cost.
The Required Outcomes for COVID-19 Testing
Can COVID-19 testing be just like a litmus test? That would be a dream COVID-19 testing technology breakthrough. However, that would probably be too much to ask for even in a dream.
We shall set the test requirements as below:
- Test results available in real-time (i.e. instantly or almost instantly within 5-10 minutes)
- Test accuracy of 99%
- Per test cost of $5 or less
- Time taken for each test in 5 minutes or less, consequently test capacity per test station in hundreds per 8-hour day and more if run longer hours
What if there is a New COVID-19 Test Technology That Delivers The Required Outcomes?
What if an innovative company has a technology breakthrough and gives us a new COVID-19 test technology that would involve no reagent, no swab, no laboratory support required, and no PPE?
What if the new COVID-19 test method would involve only collecting saliva samples from the person being tested by spitting into a test sample collector?
What if the new COVID-19 test method would involve examining saliva samples using a transmission electron microscope to identify the COVID-19 virus using Artificial Intelligence (AI) and Machine Learning (ML) technologies?
What if the new COVID-19 test method could generate hundreds of transmission electron microscope images of the saliva samples that would allow AI and ML to identify the COVID-19 virus even at a very low count in the saliva samples? It would mean that even if a person was asymptomatic, the infection could be detected as long as the COVID-19 virus was present, even at a low count, in the person’s saliva sample. Test accuracy ticked.
What if the new COVID-19 test method could automate saliva sample collection so test personnel could be shielded from persons being tested without any close contact? It would mean test personnel would be in a safe zone and would not need full PPE.
What if saliva samples could be discarded in a contamination-safe way after testing? What if the saliva sample collection machine could be disinfected frequently to prevent cross-infection of persons to be tested?
What if AI and ML software and database could turnaround test results almost instantly by comparing transmission electron microscope images with AI and ML database images without test laboratory or logistics support? Test turnaround time ticked.
If we have all the ticks to all these what-ifs, the per-test cost would be very low and the test capacity could be in hundreds per transmission electron microscope machine per 8-hour day.
Then this would be a dream COVID-19 testing technology breakthrough.
What Would a Dream COVID-19 Testing Technology Breakthrough Bring?
The abundance of accurate COVID-19 tests at low cost would make COVID-19 testing an effective and powerful tool, other than the COVID-19 vaccine. No reagent, no swab, no extensive test personnel, no PPE, and no test laboratory support would be required. The test would not be invasive and people would be happy to be tested. The test machine would screen out infected people in real-time.
What would then happen?
COVID-19 Free Zones
COVID-19 Free Zones would be set up at hospitals (i.e. non-COVID-19 hospitals), aged care facilities, border control points such as airports and seaports, and for essential services staff and their workplaces. Every staff and visitor would be tested to be COVID-19 virus-free before entry into COVID-19 Free Zone daily. Every piece of luggage, good, and the personal item would go through a disinfection gate disinfected by a disinfectant spray robot and UV-light disinfection machine before entry into the COVID-19 Free Zone.
COVID-19 Surveillance Zones
COVID-19 Surveillance Zones would set up in schools, at major transport hubs, in large factories and offices, and shopping malls. These test machines would be regularly deployed to pick up and screen out infected persons from infecting other people in the community. Close contacts of infected persons would be tested immediately as well. There would be no waiting required because the huge test capacity would allow for testing to be conducted.
We know now asymptomatic transmission in the community remains a major challenge for many nations dealing with COVID-19 outbreaks. Setting up COVID-19 Free Zones and COVID-19 Surveillance Zones supported by an effective COVID-19 testing tool would reduce the COVID-19 community transmission.
Last Words
Well, this dream COVID-19 testing technology breakthrough is a dream now. However, reality always starts with a dream. One day some innovative companies will make the technological breakthroughs to win the war against COVID-19.
We should be optimistic that the humankind can and will win the war against COVID-19.
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