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As At-Home Coronavirus Tests Hit Pharmacies, What Role Can They Play In The Pandemic?

MARY LOUISE KELLY, HOST:

Bit by bit, more good news about where we are in the fight against COVID. As of this week, everyone 16 and over in the U.S. is eligible to get a vaccine. And you can now buy a relatively low-cost rapid test for COVID. You take it at home, no prescription needed. Michael Mina is a Harvard epidemiologist who has been pushing hard for at-home testing. Professor Mina, welcome.

MICHAEL MINA: Well, thanks very much.

KELLY: As we said, you can now buy these at-home tests from your pharmacy. They may not be on the shelves, but you can get them for online orders. I want to clarify that these are antigen tests, and we often hear that it's the other kind of test, the PCR test, that's the gold standard. So how reliable are these at-home tests?

MINA: They are very reliable if the question that you're asking and the reason that you're taking the test is, am I infectious right now and a risk of transmitting the virus to other people? And if that's your question, then these tests are very, very accurate. They are not going to give you the information that tells you if you were infectious two weeks ago. The PCR test can give you that type of information, as well as letting you know if you are infectious today.

KELLY: OK. But in terms of just telling me I may be spreading the virus to others right now, these tests work. They're good.

MINA: These tests work exceptionally well for that question. Absolutely.

KELLY: Let's talk about the cost. I know when you first started calling for easy, at-home COVID tests, your hope was that they would cost a couple of dollars. This is the first one that's hit the market. It costs $12 to test. Is your hope that the cost will continue to come down?

MINA: Absolutely. I hope very much that the cost will get down to 1 to $3 per test. Right now in the United States, there's no market competition, so I hope that more tests will be authorized to either drive down the prices or that the government could subsidize the price of these tests. Using a test like this is a public health good.

KELLY: I do have to ask, do we still need a bunch of at-home tests? Now that more than half of Americans have gotten at least one shot and hopefully more will continue to get fully vaccinated, do we need a massive rollout of at-home tests?

MINA: I think the landscape has shifted dramatically in a good way. What we do need today is to have enough tests so that people can know if they have a reason to think that they might be infectious and want convenient access to a test without having to go and wait for days to get a result back from a PCR laboratory. There is still a role for that.

KELLY: I'm thinking of kids. I've got one at home who's too young to be vaccinated, and he's going to school. Is that an example of a group where this test might be really helpful?

MINA: Absolutely. We're going to see kids get their normal illnesses, and these tests are going to be crucial to enable parents and others to be able to know in real time whether their child has the virus or if they just have a regular childhood cold.

There's also going to be a major role come fall and winter. Should anything go wrong with the vaccines, we need backup plans. And thus far into the pandemic, we have had essentially no backup plans, and we've had over half a million deaths as a result. If new variants come around that get around people's immune systems, especially in elderly whose immune systems a year after they get vaccinated might be waning in terms of their level of protection, we want to be able to limit spread as much as possible. And these tests are our eyes to be able to see where the virus is and whether we're at a risk of spreading it to people who could become sick.

KELLY: I hear some frustration in your voice that this technology existed and that it's only now, at this stage of the pandemic, rolling out and going to be widely available if we want it in our homes.

MINA: Had these tests been rolled out in the middle of last year in large numbers, we could have potentially seen hundreds of thousands of fewer deaths by preventing the surges. And instead, we had a lot of testing where nearly all of it was effectively useless to help slow spread. But we can't roll back time. And so I hope that in the future, we develop the regulatory framework that would enable tests to be considered in the context of public health versus medicine and that the speed of getting them authorized would be commensurate with the danger and risks posed by the pandemic upon us.

KELLY: Michael Mina is an assistant professor of epidemiology at Harvard T.H. Chan School of Public Health. Thank you.

MINA: Absolutely. Transcript provided by NPR, Copyright NPR.

Mary Louise Kelly is a co-host of All Things Considered, NPR's award-winning afternoon newsmagazine.