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?
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.
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.
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.
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.
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.