spinofflive
An at-home rapid antigen test, or RAT, for Covid-19 (Photo: Getty Images)
An at-home rapid antigen test, or RAT, for Covid-19 (Photo: Getty Images)

SocietyNovember 15, 2021

Free rapid testing could be the nudge needed to stop the spread this summer

An at-home rapid antigen test, or RAT, for Covid-19 (Photo: Getty Images)
An at-home rapid antigen test, or RAT, for Covid-19 (Photo: Getty Images)

DIY testing kits are set to make a big difference to our fight against Covid – but the key to their success will be making them available for free, argues Rosie Collins, economist from Sense Partners.

New Zealand is swiftly moving to a suppression strategy. That means Covid is in the community, but we are still using some safety measures to slow the spread. This is to buy time for vaccination and mostly to avoid overwhelming our overstretched health system.

To suppress the virus effectively we need to quickly roll out rapid antigen testing (RAT), an easy and quick self-administered test. The alternative, the PCR brain-scrape currently in use, is time consuming, only available at a testing centre, and perhaps worst of all, requires talking to other people – all reasons why someone might avoid being tested if they’ve only briefly been at a location of interest or are experiencing just a mild sniffle

Making at-home testing easy to access is the kind of “nudge” policy we need – it reduces the “sludge” of a test taken in the company of strangers, where results take more than a day to come back.

What is RAT & why use it?

Rapid antigen tests are nasal swabs taken at home which return results in about 15 minutes. They cost about $10-15 each, compared to $130 for a PCR test that goes to a laboratory.

They are less sensitive than PCR tests, which made them less useful during our elimination phase when every case needed to be picked up.

Now that Covid is circulating more widely, we need to make it easier for people to get tested more frequently. The chance of being exposed has ballooned. No longer does the risk of exposure happen just a couple of times a year, like when that guy from Sydney had his holiday in Wellington in June. Vigilance is needed daily.

Singapore, Australia and the UK have already rolled out RATs. A culture of regular testing means far more cases are being picked up. Sure, the less-sensitive RAT might not pick up that you have Covid on Tuesday, but if you test again on Saturday, or someone else from your home does, odds are good that you’ll find out soon enough.


Read more:

What is rapid testing and when is it coming to New Zealand?


Hidden cases

Because of our high vaccination rates, cases are now more likely to be asymptomatic while still going on to infect others. In the UK, 1 in 3 people with Covid reportedly are asymptomatic but infectious.

In Singapore, where 85% of people are fully vaccinated, 98% of cases show no or mild symptoms. Still, a third of their ICU beds are being used by Covid patients.

Our narrow ICU capacity means we’re going to be dancing this tightrope too.

Learn from others 

The challenge we face is making it easier to pick up more cases quickly to slow the spread of the disease. No one wants to make their kids, parents, or flatmates sick.

Here we can learn from others. In Singapore, every household received six free RAT kits in September, in preparation for the arrival of the delta variant. Additional tests can be picked up from vending machines around the city for those notified of potential exposure.

In Australia, rapid tests are available at supermarkets, 5 for $50. In the UK home testing kits are free. They’re encouraging people to test twice a week, as part of their usual routine.

A German pharmacy worker hold up rapid antigen test kits. (Photo: INA FASSBENDER/AFP via Getty Images)

Lean into convenience 

“Nudge” theory tells us we need to make it easy for people to do the right thing, in this case to get tested.

If the process is a bit of a hassle, in contrast, then it is “sludge” design. When there are barriers to people getting tested, it is easier to accept on some level why people don’t, and it can lead to a lax testing culture.

When it comes to testing, we want as little “sludge” as possible to set good social norms.

RATs in every home

Last month I couldn’t get tested at either of the two doctors on my road, so the only choice was to walk 40 minutes each way to a testing centre. I don’t have a car, and Uber is not an option for people who suspect they may have Covid. After a PCR test you must isolate, sometimes for multiple days, while awaiting results.

It’s a lot of hassle and it’s time consuming, so much so that most people won’t be tested regularly on the off-chance they are positive but asymptomatic (and in fact usually can’t be tested under current rules).

It also doesn’t work if you live out of town, don’t trust public institutions, or aren’t able to drive to a testing centre.

When I was feeling under the weather it would have all been so much easier if there were home kits available. Free tests in the mailbox, in supermarkets, and in vending machines would all make a real difference as we head into the summer, when more of us will be moving around.

With free, and freely available, rapid testing it’s easy to test yourself simply as a precaution. I would love to check that I don’t have Covid before visiting my 80-year-old nana. Instead I have to gamble that I’m not positive but asymptomatic.

Get going 

Fighting the pandemic without all the tools in our toolbox doesn’t make much sense. Human behaviour means that if we want testing to be a part of our suppression strategy it needs to be as easy and painless as possible in every way.

If we don’t succeed in suppressing the spread, our hospitals are going to become overwhelmed and we will be looking at new restrictions and a stop-start summer.

The UK hasn’t got much right on Covid, but its antigen testing policy is gold. Free, widespread, and regular rapid testing is the way to go. Suppression will be a bust without it.

The sooner the RATs hit our streets the better.

Keep going!
Photo: Getty Images; additional design by Tina Tiller
Photo: Getty Images; additional design by Tina Tiller

SocietyNovember 15, 2021

How to help your kids get used to face masks in schools

Photo: Getty Images; additional design by Tina Tiller
Photo: Getty Images; additional design by Tina Tiller

As children in level three areas head back to school this week, those in year four and above will be required to wear face masks, as will their teachers. While it’s natural for parents to worry how this will impact kids, save yourself the stress, writes child psychologist Dr Emma Woodward.  

Good social skills are something we all want for our kids. The ability to connect with others, engage in conversation, practise attentive listening, make friends, and generally be able to function well in social situations are some of the most important skills our kids will learn while at school. 

Throughout their development, children learn to recognise many different facial expressions. In addition, they have to learn labels for them – like, “happy”, “sad” and “afraid”. Many of our social and people-reading skills flow on from recognising these facial expressions. 

Kids’ ability to decode facial expressions has been shown to link with their social, academic and emotional outcomes. Reading the emotions of other individuals from their facial expressions is an important skill in managing social relationships, and the ability to form and sustain relationships is integral to good mental health and wellbeing. As such, children with stronger face-reading skills may find it easier to make friends at school as they can effectively read and respond to emotional intent. They also tend to perform better academically. 

It seems natural, then, that the thought of face masks being worn in primary schools is intimidating for some parents. It’s an unknown quantity in our society: so is it fair to question what the impact of face masks, and my child not being able to read facial expressions as easily, will have on their overall development and school experience?

Long story short, no – if you’re worried that your child’s development will be negatively impacted because of the introduction of face masks in schools, save yourself the stress. School is important for peer-to-peer social interactions, but most kids will still have ample exposure to facial expressions and cues through the faces they’re surrounded by at home. Most important to your child’s social development is a happy and settled bubble.

Additionally, while facial cues are important, when you’re reading the emotions of other people, you don’t focus exclusively on their facial expressions. You rely on a variety of information, including tone of voice, body language, and other contextual cues. For most kids, once face masks are explained and demystified, it’s not going to be an issue (see further down for a structure to use).

For the most part, I would recommend taking a deep breath and feel reassured that you can take any of the hyperbolic commentary swirling around at the moment with a grain of salt. 

A place we should be turning our attention to on the topic of face masks in schools, however, is accessibility – and how this change will impact neurodiverse children. Neurodiversity refers to variations in the human brain meaning that ​​neurodiverse people experience and interpret the world in unique ways. ASD and ADHD are two common examples of neurodiversity.

For neurodiverse kids, recognising emotions, facial expressions and other emotional cues (like tone of voice and body language) can be much more of a challenge. Expressing and managing their own emotions is often hard enough, let alone understanding and responding to other people’s emotions. You add a face mask into the mix for a neurodiverse child, and you may start to see some behaviour changes – not only because they might be confused and have trouble understanding what’s going on due to the additional cognitive load it places on them, but also because they may be scared or anxious.

The same goes for Deaf children and those with a hearing impairment. For virtually all Deaf children and youth, including those who use sign language, the ability to see someone’s face clearly is important for lip-reading, understanding facial expressions, and understanding non-verbal communication. Face masks can obscure speech, making it harder to use any residual hearing. 

So, how do you approach the accessibility issue of face masks in schools? As our neurodiverse children and children with disabilities are already more likely to have barriers to education, it’s important that we address any potential accessibility issues that face masks may present inclusively and proactively. We need to consciously adapt our approach and develop skills for communicating effectively in a masked world. This starts before they return to school, so talk directly to your child’s teacher about their needs so you can form appropriate plans together.

Once any adaptations have been considered and implemented, it is important that we support and involve our children to understand how and why school might look different. We need to find out what their concerns and questions are (such as what teachers are doing to support them), and how they can ask for extra support should they need it. Preparation is key and one way we can do this – for neurodiverse and neurotypical children alike – is through the use of social stories.

Social stories are short descriptions of a particular situation, event or activity, which include specific information about what to expect in that situation and why. Created by Carol Gray in 1991, social stories are commonly used to help neurodiverse kids understand how others might behave or respond in a particular situation, helping them to cope with changes to routine or unexpected situations. They can help neurotypical people to understand the perspective of a neurodiverse person and why they may behave or respond in a particular way. 

Social stories present information in a literal or “concrete” format, which aims to improve a child’s understanding of a previously difficult or ambiguous situation. Providing structured information about what might happen in a particular situation, and some guidelines for ways of behaving in these situations, helps to reduce anxiety and increase compassionate responses from others.

An effective social story is situation-specific and has a clear goal, defined from gathering information about the situation and tailoring the text to match. For example, the goal may be to teach a child to expect to see their teacher wearing a face mask at school. Gathering information consists of asking several questions about the situation you want to describe in your social story, such as: Where does the situation occur? Who is it with? How does it begin and end? Finally, the story should be tailored – answering six questions: where, when, who, what, how and why. Here’s an example of a social story you could use to speak to your neurodivergent (or neurotypical!) child about face masks in schools: 

  1. When we go back to school, I will get to see my friends. I’ll get to see my teacher and play all my favourite games again. 
  2. To help keep me safe from getting sick, my friends and my teacher will be wearing face masks. That means I won’t be able to see their mouths. 
  3. But they won’t look scary – and their faces still look the same underneath the mask! 
  4. If I don’t understand what my teacher wants me to do, I can ask them for help. 
  5. If I can’t hear my teacher, I can ask them for help. 
  6. I can ask for help by….

It’s also important to note that some children will have medical exemptions that prevent them from wearing masks. A one-size-fits-all approach never reaps much benefit, and we’ll need to recognise that what suits “everyone” might not suit a neurodiverse child. Primary school-aged children like to flex their developing senses of moral justice – noting when things aren’t fair is a key example of this – so conversations will need to be had with our kids about how most of their peers will be wearing face masks, but not everyone will be. And that’s OK. 

Parents have had an exceptionally tough time over the past 18 months, with the work-and-kids juggle often feeling impossible to balance. For most kids, heading back to school with masks won’t be an issue. Neurodiverse children and those with disabilities may require tools such as social stories to help ease the transition. However, most importantly, we need inclusive consideration to enable full participation and achievement for all.

And if you’re a worried parent who’s made it this far – relax, no doubt you’re doing a wonderful job despite it all.