Surging International Infections Underscore Need for At-Home COVID-19 Multiplex Testing Options

By Ron Chiarello, PhD

As new COVID-19 cases in the U.S. decline to levels not seen since last summer and half of U.S. adults are fully vaccinated, many Americans are beginning to relax and look forward to a day when the pandemic is just a memory.

Unfortunately, we are unlikely to get there any time soon on a global basis, as many developing countries suffer from inequalities that prevent them from making anywhere near the progress the U.S. has achieved in fighting COVID-19.

The World Health Organization’s (WHO) recently published World Health Statistics 2021 report offers a snapshot of today as well as a glimpse of the future. At the time of the report’s release, global COVID-19 cases stood at 160 million and deaths at 3.3 million, with newly confirmed cases at an all-time high globally.

In the coming months, however, we are likely to see the rift between rich and poor countries widen, as “fair and equitable access to the vaccines is far from being achieved,” according to the WHO. As of May 1, just 20% of vaccine doses had been administered in countries with lower- and lower-middle incomes, while 80% went to countries with upper- and upper-middle incomes.

One sentence in the WHO report starkly lays out the challenge that the world faces as a result of inequalities between rich and poor countries: “The pandemic is entering a new phase characterized by a dramatic shift of its epicenter to the developing world, jeopardizing the world’s collective goal to end it and risking further setbacks to the entire sustainable development agenda.”

It is easy to allow positive COVID-19 trends in the U.S. to distract us from the reality that, bluntly, things are much bleaker across most of the globe. Because the global pace of vaccination is proceeding so slowly, we must explore new approaches to mitigate the pandemic. Today, at-home, multiplex testing is among the best options for managing the spread of the disease. Here’s why.

What is multiplex testing?
Multiplex testing refers to molecular tests that are capable of simultaneously detecting multiple targets from the same sample. These tests are generally used in forensic laboratories, clinical diagnostics, and life sciences research for a variety of functions, such as pathogen detection, forensic studies, and food analysis.

However, the ability to detect infectious diseases is how multiplex molecular testing can help manage COVID-19. Multiplex molecular tests feature several advantages over other alternatives, such as greater cost-effectiveness, higher throughput, more information with fewer samples, greater accuracy of data normalization, and time savings.

As it relates to COVID-19 and other infectious diseases, one of the strong points of multiplex testing is the ability to use the same sample and device to test for multiple conditions. There are likely to be other pandemics in the future, and properly designed multiplex molecular tests will be capable of assessing one patient’s sample for COVID-19 as well as “new” infectious diseases that threaten to create pandemics.

At-home COVID-19 testing: The state of play today
To control outbreaks and inform people of when they need to self-quarantine, it is critical that consumers gain access to convenient at-home COVID-19 testing options, including multiplex tests that detect a wide array of infectious diseases. The good news is that some over-the-counter tests that deliver at-home results in just minutes are already available to U.S. consumers as a result of a recent authorization by the FDA. The bad news—once again—is in the developing world, where these tests are likely some time away from being widely available.

Many of these authorized tests work by obtaining samples via nasal swabs, which are then inserted into a device that performs a point-of-care analysis, eliminating the requirement that users ship the sample to a lab for processing. Most of these tests produce results within 30 minutes, some even faster.

One important caveat is that most of these authorized diagnostics are antigen tests. This method of testing works well to quickly identify people who are infected with a larger amount of a virus, but the downside is that antigen tests are far less sensitive than molecular tests and more likely to lead to false negatives, according to a report in Popular Science.

A better alternative to expect in the future comes via at-home multiplex infectious disease tests that are performed via a device that connects to battery-powered smartphones. In developing countries, particularly, battery-powered tests will benefit geographic areas that frequently experience power outages and unpredictable service.

A recent report from Frost & Sullivan illustrates the future importance of smartphone-based, point-of-care infectious disease testing technology. Frost & Sullivan predicts threefold growth in the market between 2019 and 2024, with the emergence of cost-effective lab-on-a-chip and smartphone-based point-of-care tests, in addition to increasing reliance on less-invasive testing methodologies, expected to drive the market.

Mitigation for the developing world
Across the U.S., the prospects of emerging from the COVID-19 pandemic and returning to normalcy have never looked better. From a global perspective, however, that is hardly the case. Vaccines have barely made their way into many lower-income countries, and the rollout to these developing countries is likely to take years.

We aren’t going to vaccinate COVID-19 away any time soon, so we need to focus on mitigation strategies. Among the foremost of those strategies is to deploy across the globe quick, accurate, battery-powered multiplex molecular tests that will help citizens of developing countries return to some of the normalcy that Americans have already begun to enjoy.

Ron Chiarello, PhD, is founder, CEO, and chairman of the board of Alveo Technologies.