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Marni Soupcoff: Government hand-holding is curtailing critical COVID testing
For testing to be widespread and frequent, it must be inexpensive and within easy reach. Grant individuals the autonomy to take care of themselves
Author of the article:Marni Soupcoff
Publishing date:Nov 19, 2020 • Last Updated 4 hours ago • 4 minute read
The U.S. Food and Drug Administration (FDA) has approved an at-home COVID-19 test kit made by Lucira Health. PHOTO BY NATHAN FRANDINO/REUTERS
The stubborn conviction that coronavirus testing regimes will only succeed if they are combined with major government hand-holding has been in evidence again this week. This time, it is the U.S. Food and Drug Administration (FDA) reminding us of the paternalism that still stands in the way of fighting the second wave of disease. On Tuesday, the agency took the welcome step of authorizing an at-home COVID test on an emergency basis, but insisted on requiring that people get a prescription from a health-care provider in order to get their hands on one of the kits.
The major benefit of at-home tests is that they are so simple and accessible, anyone can use them at any time, with no doctor’s appointments or waiting in line at clinics required. Have a sore throat and wondering if you should go into work? Nip into your bathroom, swab your own nose with a kit you’ve been keeping in your medicine cabinet, then within a half-hour, learn from a cute little cartridge whether you have coronavirus — and isolate or venture out into the world accordingly.
STORY CONTINUES BELOW
That benefit is dramatically constrained when regulators demand that medical sign-off is necessary for an individual to go through these steps. Have a sore throat and wondering if you should go into work? Find a way to get in touch with your doctor for a video or phone appointment that may take place some time in the next few days, hope your doctor can seamlessly get a prescription to a nearby pharmacy, then find a friend or relative who can go to the pharmacy to fill the prescription and pick up the test kit for you (after waiting in line behind all the other friends and relatives who have been sent to the drug store for the same reason). Or just go into work, because you cannot take a week off every time your throat is a little dry.
Paternalism stands in the way of fighting the second wave
The difference in these scenarios matters a lot because it is the difference between curbing or continuing community spread, which in itself is the difference between infected people staying home for a few days or everyone staying home for months (once things get so bad that the government resorts to returning to a lockdown). For testing to make a difference, it must be widespread and frequent. For testing to be widespread and frequent, it must be inexpensive and within easy reach. For testing to be within reach, regulators must be willing to do something that is fundamentally against their nature: grant individuals the autonomy to take care of themselves.
The FDA is not ready to give up that kind of control. Why? The rapid at-home test they have authorized is not toxic or scary or dangerous. A careless or reckless person could do themselves far more physical harm with a bottle of Tylenol than they could with the swab and cartridge. And the results are easier to interpret than the results of an at-home pregnancy test (the COVID at-home test cartridge literally lights up beside the word “positive” or “negative”).
STORY CONTINUES BELOW
Workers supervise the lineup at a COVID-19 testing centre in Judiciary Square, Washington, D.C., on Nov. 18, 2020. PHOTO BY MANDEL NGAN/AFP VIA GETTY IMAGES
The FDA may hope that by maintaining a prescription requirement it will maintain a handle on information. The federal guidelines say that people who use the at-home tests are supposed to report the results to their doctors, who are in turn supposed to report the results to public health authorities. But since public health authorities have not been able to keep up with contact tracing anyway, due to the explosion of cases, it hardly seems like a big deal if they are not informed of every single at-home result — a lot of infected people who would be flagged by at-home tests are people public health is missing altogether under the status quo, which is the point of widening the scope of testing to make it effective for screening.
The instinct in combating a public health crisis is to use top-down government control of a whole population, because individuals cannot possibly make any kind of difference on their own. Except that maybe they can. As Harvard professor Dr. Michael Mina said in a piece he recently wrote for Time, “At-home testing is not a publicly visible action. It is as private as brushing your teeth in the morning. Yet it will give even the most ardent anti-masker critical information about their status, which will help them make responsible choices for their family, friends and community members, and immediately help reduce the rate of virus transmission.”
Empowering people to go it on their own in this way is the best chance we have of beating coronavirus quickly before it does more damage.
• Email: soupcoff@gmail.com | Twitter: soupcoff
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Canada's Chief Public Health Officer Dr. Theresa Tam wears a mask as she waits to answer questions during a COVID-19 update in Ottawa on Nov. 3, 2020.
Marni Soupcoff: In the fight against COVID, Canadian health officials have been at the back of the pack
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Marni Soupcoff: Government hand-holding is curtailing critical COVID testing
For testing to be widespread and frequent, it must be inexpensive and within easy reach. Grant individuals the autonomy to take care of themselves
Author of the article:Marni Soupcoff
Publishing date:Nov 19, 2020 • Last Updated 4 hours ago • 4 minute read
The U.S. Food and Drug Administration (FDA) has approved an at-home COVID-19 test kit made by Lucira Health. PHOTO BY NATHAN FRANDINO/REUTERS
The stubborn conviction that coronavirus testing regimes will only succeed if they are combined with major government hand-holding has been in evidence again this week. This time, it is the U.S. Food and Drug Administration (FDA) reminding us of the paternalism that still stands in the way of fighting the second wave of disease. On Tuesday, the agency took the welcome step of authorizing an at-home COVID test on an emergency basis, but insisted on requiring that people get a prescription from a health-care provider in order to get their hands on one of the kits.
The major benefit of at-home tests is that they are so simple and accessible, anyone can use them at any time, with no doctor’s appointments or waiting in line at clinics required. Have a sore throat and wondering if you should go into work? Nip into your bathroom, swab your own nose with a kit you’ve been keeping in your medicine cabinet, then within a half-hour, learn from a cute little cartridge whether you have coronavirus — and isolate or venture out into the world accordingly.
STORY CONTINUES BELOW
That benefit is dramatically constrained when regulators demand that medical sign-off is necessary for an individual to go through these steps. Have a sore throat and wondering if you should go into work? Find a way to get in touch with your doctor for a video or phone appointment that may take place some time in the next few days, hope your doctor can seamlessly get a prescription to a nearby pharmacy, then find a friend or relative who can go to the pharmacy to fill the prescription and pick up the test kit for you (after waiting in line behind all the other friends and relatives who have been sent to the drug store for the same reason). Or just go into work, because you cannot take a week off every time your throat is a little dry.
Paternalism stands in the way of fighting the second wave
The difference in these scenarios matters a lot because it is the difference between curbing or continuing community spread, which in itself is the difference between infected people staying home for a few days or everyone staying home for months (once things get so bad that the government resorts to returning to a lockdown). For testing to make a difference, it must be widespread and frequent. For testing to be widespread and frequent, it must be inexpensive and within easy reach. For testing to be within reach, regulators must be willing to do something that is fundamentally against their nature: grant individuals the autonomy to take care of themselves.
The FDA is not ready to give up that kind of control. Why? The rapid at-home test they have authorized is not toxic or scary or dangerous. A careless or reckless person could do themselves far more physical harm with a bottle of Tylenol than they could with the swab and cartridge. And the results are easier to interpret than the results of an at-home pregnancy test (the COVID at-home test cartridge literally lights up beside the word “positive” or “negative”).
STORY CONTINUES BELOW
Workers supervise the lineup at a COVID-19 testing centre in Judiciary Square, Washington, D.C., on Nov. 18, 2020. PHOTO BY MANDEL NGAN/AFP VIA GETTY IMAGES
The FDA may hope that by maintaining a prescription requirement it will maintain a handle on information. The federal guidelines say that people who use the at-home tests are supposed to report the results to their doctors, who are in turn supposed to report the results to public health authorities. But since public health authorities have not been able to keep up with contact tracing anyway, due to the explosion of cases, it hardly seems like a big deal if they are not informed of every single at-home result — a lot of infected people who would be flagged by at-home tests are people public health is missing altogether under the status quo, which is the point of widening the scope of testing to make it effective for screening.
The instinct in combating a public health crisis is to use top-down government control of a whole population, because individuals cannot possibly make any kind of difference on their own. Except that maybe they can. As Harvard professor Dr. Michael Mina said in a piece he recently wrote for Time, “At-home testing is not a publicly visible action. It is as private as brushing your teeth in the morning. Yet it will give even the most ardent anti-masker critical information about their status, which will help them make responsible choices for their family, friends and community members, and immediately help reduce the rate of virus transmission.”
Empowering people to go it on their own in this way is the best chance we have of beating coronavirus quickly before it does more damage.
• Email: soupcoff@gmail.com | Twitter: soupcoff
Canada's Chief Public Health Officer Dr. Theresa Tam wears a mask as she waits to answer questions during a COVID-19 update in Ottawa on Nov. 3, 2020.
Marni Soupcoff: In the fight against COVID, Canadian health officials have been at the back of the pack
None
Marni Soupcoff: Government has asked you to sacrifice a lot — unless you're rich
VIEW ON NATIONAL POST
THIS WEEK IN FLYERS
np logo
© 2020 National Post, a division of Postmedia Network Inc. All rights reserved. Unauthorized distribution, transmission or republication strictly prohibited. 365 Bloor St East, Toronto, ON, M4W3L4, www.postmedia.com
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