In its fiscal and economic update on Tuesday, the government proposes to give the money to Health Canada and the Public Health Agency of Canada, so they could continue supporting provinces and territories “in securing the rapid testing supplies they need to keep Canadians safe and healthy.” The money would also go towards expanding testing programs in schools and workplaces.

The fiscal update shows the funds earmarked for the 2021-2022 fiscal year only.

The federal government says as of Nov. 26, Canada has bought 94.9 million rapid tests and distributed 85.9 million of them to provinces, territories, and Indigenous communities, “free of charge.”

While rapid tests – which can provide results in about 15 to 20 minutes and don’t need to be sent to a lab – are useful in detecting COVID-19, experts warn they’re just one of “many layers of protection” and should not be used to replace vaccines.

They are also not as accurate as PCR (polymerase chain reaction) tests.

COVID-19 THERAPEUTICS
The government is also proposing to spend up to $2 billion over two years to procure new treatments for COVID-19, including antiviral drugs that could help keep patients out of the hospital.

Earlier this month, the federal government signed deals with Merck and Pfizer to buy their antiviral drugs, pending Health Canada approval of the products.

The economic and fiscal update document earmarks $1 billion for additional COVID-19 therapeutics procurement in the 2021-2022 fiscal year, and another $1 billion in 2022-2023.

original article

On Dec. 2, 2021, President Joe Biden outlined a series of actions to respond to the COVID-19 pandemic, including making at-home COVID-19 rapid tests eligible for reimbursement by private insurance. Along with vaccination, testing remains one of the most effective ways to track and reduce transmission of SARS-CoV-2, the virus that causes COVID-19.

Even though COVID-19 testing has become part of most people’s everyday conversation, many people still have questions about the difference between antigen and PCR tests, including when and how to use them.

I’m a molecular biologist based at UMass Chan Medical School. Since April 2020, I’ve been part of a team working on a National Institutes of Health-funded program called RADx Tech to help companies develop rapid tests to detect when a person is infected with COVID-19.

How rapid antigen tests work
Rapid antigen tests are designed to detect a portion of protein – known as an antigen – of SARS-CoV-2. First, you take a sample from your nose or mouth with a swab, as directed. You mix the sample with liquid that breaks apart the virus. You then apply the liquid to a test strip that has antibodies specific for SARS-CoV-2 painted on it in a thin line. Antibodies are Y-shaped proteins that recognize and bind to foreign substances such as antigens. If the antibodies bind to the virus proteins, or antigens, a colored line appears on the test strip, indicating the presence of SARS-CoV-2.

These tests are convenient because they are easy to use and provide results quickly, typically within about 15 minutes. Another benefit is that antigen tests can be relatively inexpensive, at around US$10-$15 per test. In contrast, PCR tests usually require laboratory equipment and technicians, take 12 hours to several days to get results and cost $100 or more, though there are many ways to get these tests free of charge.

In his announcement, President Biden also discussed plans to distribute 50 million free tests to community health care providers for people without insurance. People should check their local media outlets for information about when free rapid tests become available. In Colorado, free rapid tests have been available to families with school-age children for months. Be prepared to act quickly: In late November, 100,000 people signed up in less than 24 hours for free antigen COVID tests in New Hampshire.

As of early December 2021, the Food and Drug Administration has authorized about a dozen rapid antigen tests for SARS-CoV-2, which means these tests meet certain standards for performance and accuracy.

When to use rapid tests
If you have any symptoms of COVID-19, regardless of whether you’ve been vaccinated, you should get tested right away with either a PCR or antigen test.

SARS-CoV-2 can spread very easily, even if you don’t have symptoms. The faster you can determine if you have COVID-19, the sooner you can isolate yourself, which helps prevent transmission to others. Early testing is also critical because new drugs like those from Merck and Pfizer are most effective if given early in the course of infection, soon after symptoms appear.

If you get a negative antigen test but still feel sick, it is possible that you received a false negative test. Isolate yourself away from others and contact your health care provider to discuss your symptoms. If you get a positive test, you should isolate yourself at home and contact your health care provider as soon as possible.

If you don’t have symptoms but have had close contact with someone with COVID-19, what to do depends on your vaccine status. If you’re fully vaccinated, the CDC currently recommends that you wait five to seven days after your exposure and then get a PCR or rapid antigen test. If you’re not fully vaccinated, get tested right away. If you don’t develop symptoms, you should still get retested five to seven days after your exposure.

Like many respiratory viruses, it takes several days for SARS-CoV-2 to build up in your body after exposure. During this early phase of infection, the amount of viral protein is relatively low, and a rapid test may not detect your infection. This is why serial testing over multiple days, with at least 24 hours between each test, is recommended for many antigen tests. Rapid antigen tests are most often accurate when a person is infectious, because that is when the highest amount of virus is in the respiratory tract.

Studies have shown that serial antigen testing – typically two to three tests in one week – is on par with a single PCR test. Remember that a test is only a snapshot of your SARS-CoV-2 status at the time of the test. It’s possible, especially with antigen tests, to test negative during the early stages of infection.

The future for at-home COVID-19 testing
Despite all that we researchers have learned, there is still more to understand about the best way to use rapid tests. Our team is conducting several studies to fill these gaps.

One question we are studying with a program called STOP COVID-19 is how people use home tests when their infection risk is low versus high. For instance, someone who wears a mask indoors and does not eat out at restaurants may be considered low risk, while someone who is not vaccinated and gathers with many people without masks is considered high risk. We are also interested in knowing whether people will adhere to a testing regimen when they have an exposure, and whether they will share their home test results with their local department of public health.

Another major question our team is studying is: How do antigen tests compare with PCR tests when it comes to detecting COVID-19 in people who are positive but have no symptoms? A separate nationwide study called Test Us at Home is generating important data that will help us answer this question in the next few months.

Rapid antigen tests are a welcome tool in society’s fight against the COVID-19 pandemic. When used properly and in combination with other tools such as vaccination, mask-wearing and good hygiene, these actions can help limit the spread of SARS-CoV-2 this holiday season.

original article

One year ago this week, the Food and Drug Administration had just authorized the first at-home test and the first monoclonal antibody treatment, and there were no authorized vaccines. Hotspots flared across the nation as different states took different approaches to curbing the virus by requiring masks and limiting public gatherings.

It doesn’t fully make sense for the U.S. to be in this position today when we have an ample supply of safe and effective vaccines, we know how the virus spreads, and we understand the effectiveness of masks and distancing in limiting infection.

In many ways, the country is making progress. The fact that nearly 10% of children between the ages of 5 and 11 were vaccinated in the first two weeks they were eligible is heartening. Nearly all people who are hospitalized with Covid-19 are unvaccinated, underscoring the protective effect even for those with breakthrough cases. Yet disappointingly low vaccination rates in many areas means the virus retains its hold on the country. To end this pandemic, we must continue increasing vaccinations.

Unfortunately, increasing the number of Americans who are fully vaccinated is likely to be a slow process. Making reliable Covid-19 testing more widely available and better reported can help in the interim.

To improve a national Covid-19 testing strategy, it’s essential to distinguish between the various needs for testing and figure out how to meet them. First, as hospital emergency departments and doctors’ offices once again become crowded with people with respiratory illnesses, it is vital to distinguish those with Covid-19 from those with influenza or other respiratory diseases. Second, Covid-19 infection must be identified early in those who are at high risk of serious disease in order to respond with interventions such as monoclonal antibodies or the promising new antiviral pills the FDA is evaluating. Third, routine screening and surveillance testing must be increased across many settings and populations to identify new outbreaks. Fourth, it must be easy and affordable for every American to test themselves regularly to make family gatherings, social events, and a return to pre-pandemic activities safer.

In October 2020 — before vaccines and before the surge of the Delta variant — the AAMC Research and Action Institute, with which we are both affiliated, released its estimate for the number of daily Covid tests needed: more than 8 million tests a day. Yet as the virus surged through the nation once again through the fall and winter of 2020, there were never more than 2 million tests a day reported.

Today, the number of tests being conducted each day is unknown.

The availability of at-home tests has increased, but access to them is hugely variable and when individuals test themselves, the results are rarely reported to state or national public health authorities. Both of these problems must be fixed. Rapid tests have been difficult to find in many areas of the country and at most retailers cost $25 for two tests that are designed to be used by one person 36 hours apart.

While it’s a good idea to make a multigenerational gathering safer by testing everyone, testing 12 people on Thanksgiving morning is cost-prohibitive for most families, even at recently discounted prices. And a test that gives rapid results at home doesn’t require the intervention or knowledge of anyone other than the person taking the test. So unless someone seeks medical care for their symptoms or infection after testing positive, that positive result typically won’t be captured in the Covid-19 testing totals reported daily by the Centers for Disease Control and Prevention. Without knowing the scope of new cases identified by positive Covid tests, it’s impossible to understand with precision how progress is being made against the pandemic.

It will never be enough to know the number of tests that are made available or used nationally. It’s also important to know where they are being deployed and how they are being used and reported. For instance, use of 75 tests could mean one family testing each of three children weekly for the school year; one wedding where all guests are tested before entering; or 10% of the students in a large elementary school tested once. Only in the third scenario are the results likely to be reported to state public health officials.

Testing must be seen as a coordinated public health measure, not just something done to diagnose Covid-19 cases or for individuals wanting to clear themselves for travel, theater, and social events. To get through this winter, the U.S. will need more widespread and purposeful deployment of tests. Without a systematic testing strategy and local results of those tests, public health interventions such as masking, distancing, and travel recommendations cannot be effectively deployed.

The Biden administration’s announcement that it is expanding testing is a positive step. Now public health officials need a roadmap for increasing the number of available tests, clarifying how those tests are deployed, and ensuring that Americans have access to testing for the foreseeable future.

Understanding the scope of testing requires having a better idea of how tests and testing supplies are being distributed. Statistics describing the number of tests run or tests made available should clearly differentiate between those available to individuals for commercial purchase; those used in clinical labs; those purchased by companies to test their own workforces; those used for screening in academic institutions, public school systems, or other high-risk areas; or those used by hospitals and medical centers for diagnostic purposes.

Every American should have ready access to affordable or even free at-home tests and should also have clear, consistent guidelines on how often to test and what to do with a positive result. There is no uniform guidance or process on how to report infection. These gaps must be filled.

If living with the new normal means living with Covid-19, the U.S. should not be taking a haphazard approach to testing.

original article