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“It’s easy for people to despair, but the hope is even greater,” Theodor Fontane once said. In the coronavirus debate, new hopes also appear regularly, most recently so-called rapid tests.
Winter is coming. The number of infections is increasing. And the federal government fears that infection chains will soon no longer be smoothly traceable. Tests that tell you after 15 minutes whether you have been infected with the coronavirus or not are considered a possible way to get through the cold season without more drastic measures.
The question many researchers are asking today goes something like this:
What if …
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… the majority of German citizens …
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…any other day…
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… does a rapid antigen test and …
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… stay home if the test result is positive?
Studies suggest that this would be an extremely effective strategy, when combined with a face mask, hand washing, keeping your distance, and a follow-up technique. The activist network Rapidtests, which advocates this anti-crown strategy, has evaluated seven calculation models (1, 2, 3, 4, 5, 6, 7) that simulate the corresponding effects.
The results initially give hope:
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If three-quarters of the population were tested every three days and positive people were immediately isolated, the number of infections should drop by as much as 88 percent, according to an internal document that is available to SPIEGEL.
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Even if only one in two people took an antigen test once a week, the number of infections could be reduced by as much as 42 percent.
The main explanation for the strong effect is as follows: Currently, tests are mainly performed on people who have symptoms or who have been in contact with an infected person. We now know that we are often very infectious a day or two before symptoms start. So people can infect others without knowing it at the time when they are most infectious. Periodic mass testing could prevent it.
They also have another effect: if it takes several days, as before, until the result of a PRC test is available, many of the examinees may remain in quarantine for nothing. That should change with mass antigen testing too.
“Lockdown ohne Lockdown”
Rapidtests notes that some of the studies cited are so-called preprints, which means that their factual accuracy has not yet been officially verified. However, activists stylized mass rapid tests it is already a panacea. They look like a “blockade without a blockade”, they advertise. “Rapid tests can restore our freedom.”
Those primarily responsible for rapid testing are volunteer virologists, physicians, and IT experts who simply find antigen testing useful and are therefore committed to it. However, two members of the network work at Bosch and Roche, in other words, at corporations that can benefit from a rapid testing boom. The network emphasizes on its website that the two did not seek any personal gain through their engagement.
In the field of research, which promotes rapid tests, in some cases there are similar cross-connections. For example, scientist Daniel Larremore, who is a public advocate for rapid tests, is a consultant to antigen test manufacturer Darwin BioSciences.
In view of the home office chaos, existential concerns, complicated anti-Corona school rules, and exhausting discussions about masks, many people shouldn’t care. If the quick tests were a “Star Wars” movie, they would probably be Part IV: “A New Hope.”
The only question is to what extent can the computational utopias of scientists be realized. In reality, there are at least three major hurdles to testing some 61 million Germans every three days.
1. Impractical self-tests
Rapid mass tests would require a very high level of discipline on the part of the population. Because until now a throat swab was required for the evaluation of rapid antigen tests. In Germany, however, currently only medically trained personnel can do this.
Anyone who has ever had a corona test can imagine why – the swab must be inserted very deep into the throat to obtain a sufficient amount of virus for the test. This can cause an uncomfortable gag reflex. So the question is how many people would get a proper throat swab of themselves.
Therefore, scientists are investigating home tests that work with saliva or gargle samples. These could actually increase the number of rapid tests at some point, but are currently not reliable enough to be used.
As long as the professionals still have to work, the massive tests are probably utopian. Because trained personnel are already reaching their limits with PCR smears. There are about a million of these each week, a fraction of the antigen tests required in studies.
Now you can save the trip to the lab with rapid tests, as they can be tested on test strips right on site. Therefore, it could test more than a million people a week, but not 61 million Germans every three days.
2. High cost
Massive rapid tests would also be comparatively expensive. At the moment, manufacturers continue to keep a low profile with prices for antigen testing in Germany. The American pharmaceutical Abbott announces a rapid test for five dollars (4.25 euros). That means: if you analyze three-quarters of the population every three days, it would cost around 2,600 million euros per month, or 42.50 euros per citizen analyzed.
The government would probably have to pay that. Because health insurance companies currently only conduct ad hoc testing. Compared to the gigantic rescue packages that the government had to put together due to the first crown blockade, 2.6 billion euros a month would be comparatively cheap: at that time, depending on how it is calculated, much more than 100 billion euros were mobilized. euros. If antigen tests are ever to be mass produced, prices could also drop significantly thanks to so-called economies of scale.
However, the federal government is likely to only invest billions in massive rapid tests if it deems them reliable enough.
3. Uncertain test results
And, as Rapidtests activists also admit, the third obstacle: although some manufacturers, such as Roche, indicate a sensitivity of more than 95 percent, but only if there is a sufficient amount of virus. This means that rapid tests are unlikely to detect infected people with a lower viral load. Therefore, a positive result is very likely to be correct; a negative one is only partially significant.
Epidemiologists like Michael Mina from the Harvard TH Chan School of Public Health are of opinionthat lower reliability doesn’t matter if you test enough people often enough. Even if the last and penultimate test, which you did a few days ago, was negative, you can at least be relatively certain that you don’t have a crown.
But in combination with hurdle number one, the difficulty of testing yourself, there are justified doubts as to how much you can currently rely on massive rapid tests.
conclusion
Mass antigen testing does not appear, at least for now, to be a panacea, a strategy for a non-blocking blocking effect. First, they must be more reliable, more practical for autonomous users, and ideally also more cost-effective. However, they can make a complementary contribution to containing a pandemic.
That is, when quick decisions must be made, such as in emergency rooms. Or if you want to increase security in facilities with high-risk patients, such as nursing homes. Potentially highly infectious people could then be found and, for example, denied entry to minimize super-spread events.
This is exactly what the federal government intends to do with its rapid tests in clinics and nursing homes. Health Minister Jens Spahn (CDU) wants to flood hospitals, nursing homes and other risky facilities with rapid tests starting in mid-October. He believes these “have now provided relatively reliable results,” he said. Its use “considerably reduces the risk of infection.”
Everyone else has to continue behaving as before: keeping their distance, hand hygiene, daily masks.
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