| April 13, 2020 12:00 AM
Ordinary people have been doing extraordinary things these days, but the federal government keeps underperforming. The government’s failure to make COVID-19 tests widely available is a prime example. Despite broad consensus on the need for COVID-19 testing, the number of those tested is far behind where it should be.
It’s time for something bold. President Trump needs to invoke the Defense Production Act to get large, capable companies to develop, manufacture, and widely distribute COVID-19 tests. Home tests, produced with consistent high quality, can augment existing testing approaches, enabling people to test without leaving home. They maximize efficient utilization of testing capacity, are more cost-effective than “brick and mortar” testing centers, can be deployed efficiently to where testing is most needed, and can be economically produced in scale. The government can provide them easily and economically to every person in the United States who wants to be tested.
Two types of COVID-19 home tests are needed: first, tests for the virus to detect current infection, so that people can self-quarantine, and second, antibody tests, to determine who is immune and can safely go back to work and school. And there are two ways to deliver home tests: mail-in, where specimens are collected at home and sent to a lab for testing, and rapid tests, such as home pregnancy tests, where results are immediate.
COVID-19 mail-in tests can be developed, validated, and produced quickly. The Food and Drug Administration has already approved home self-swabbing for COVID-19 virus tests, but currently, swabs must be dropped off at a testing center. Instead, swabs could be sent via FedEx. Similarly, a mail-in antibody test could use a fingerstick blood sample. I founded the Johnson & Johnson company which developed the first home test for HIV. We validated the same type of sample for our FDA-approved mail-in home HIV antibody test.
Self-collected samples would be sent via a purpose-designed prepaid mailer to the FedEx central hub. FedEx would then route specimens to a network of test facilities based on their capacity, maximizing efficient utilization of testing. Results and medical guidance would be obtained from home.
A rapid home COVID-19 antibody test can also be developed quickly. A rapid fingerstick COVID-19 antibody test was just approved by the FDA for lab use; such a test could be adapted to home use, and rapid home tests are very cost-effective. Home pregnancy tests, with digital readers for easy test readout, typically sell to retailers for less than $1. Fortunately, American companies lead the world in rapid home testing technology.
For example, no company sells more home pregnancy tests worldwide than Procter & Gamble, whose tests are made through a joint venture with Abbott; Abbott is already a leader in COVID-19 point-of-care testing. Home testing is a mature, low-margin business, and companies naturally try to maximize financial returns. But Trump needs to urge companies such as Procter & Gamble and Church & Dwight (another home test manufacturer) to get into the COVID-19 home testing business right away.
It will take time and resources to develop and produce COVID-19 tests. The lesson of the dismal initial attempt at producing tests from the Centers for Disease Control and Prevention is that developing and producing tests in scale of consistent high quality is not as easy as laypeople (or even some professionals) might believe. That’s why it’s essential for Trump to act now and convince companies with experience in developing home tests that making home COVID-19 tests now needs to be their priority. Once home tests are developed, approved by the FDA and manufactured in quantity, the government can widely distribute them, thus saving lives, giving people peace of mind, and helping to restore the economy.
Elliott Millenson founded the Johnson & Johnson company that developed the world’s first home HIV antibody test.