Testing Technology Trends
The “Say Yes! COVID Test” program is providing millions of rapid antigen tests to four communities experiencing COVID-19 surges this fall
What is “Say Yes! Covid Test?”
Novel community-level prevention strategies that can slow the spread of SARS-CoV-2, the virus that causes COVID-19, have an important role to play in the safe return to normal activities. “Say Yes! COVID Test” (SYCT) is a collaboration between the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) that provides local communities with up to 1 million free, rapid-antigen tests for use at home. SYCT launched four new programs in Georgia, Hawaii, Kentucky and Indiana this fall, following successful programs earlier in the year in North Carolina, Tennessee and Michigan. Adding to important existing mitigation measures – such as vaccination, masking, and social distancing – frequent testing at-home with results available within 10 to 15 minutes might offer a strategy to reduce community spread of infection.
How does the SYCT program work?
Eligible residents can order free tests online to be delivered directly to their homes. Residents can also pick up tests at local community sites. The SYCT program is open to everyone in the targeted communities age 2 and older, including fully vaccinated people. Each resident can receive eight rapid tests, allowing them to test twice a week for four weeks. A website and digital assistant, developed by the healthcare technology company CareEvolution, are available for residents to order tests, receive testing reminders and instructions for using the tests. Users may also voluntarily report test results to their public health department. The test being used is the Quidel QuickVue At-Home COVID-19 test, which is supplied through this NIH Rapid Acceleration of Diagnostics (RADx) initiative. Results can be obtained in just 10-15 minutes using nasal swab that is self-collected. Colored lines on the test strip indicate a positive or negative result.
Who is participating in SYCT?
To select participating counties in this round, local public health departments were contacted based on the size of the county, community-level infection rates, and the potential for COVID to negatively impact their community. This fall, Fulton County, Georgia; Honolulu County, Hawaii; Louisville Metro Area, Kentucky; and Marion County, Indiana; are participating in the SYCT program. The latest sites to participate in SYCT were launched throughout the fall of 2021 and is seeing a robust participation in each community. The program runs for four to six weeks in each location.
What information on home-testing is SYCT seeking to generate?
From a public health perspective, the program aims to provide data on several important questions about self- or home-testing: What is the level of demand for home tests in the public? Are local underserved and vulnerable communities able to access tests? Are residents using these home tests, and how often are they using them? Are residents changing their behavior based on test results? Are residents willing to report test results to the public health departments? Does providing a community with a large number of tests impact community transmission of SARS-CoV-2? NIH-funded researchers at the University of North Carolina-Chapel Hill, Duke University and the University of Massachusetts will attempt to answer these questions over the coming months, using survey data and by conducting a study to determine if distributing tests decreased SARS-CoV-2 in the targeted community.
Initial findings from market research surveys
In parallel, the program has commissioned telephone market research surveys of a sample of 400 residents in each of the first SYCT communities in North Carolina, Tennessee and Michigan. These have provided some interesting insights. Most residents (over 70% in each county) were aware of the existence of home-tests in general. Most respondents reported that the tests were easy or very easy to use. Interestingly, only 1 in 10 respondents used the tests for regular screening two to three times a week, as recommended by the program. Instead, most people used the tests if they thought they had had an exposure to someone with COVID-19 or wanted to know their status before being around others. Online ordering was preferred to picking up tests at local distribution sites in all three counties.
Looking to the future
The SYCT program will provide important insights about the role of home testing as the country continues to develop mitigation strategies for COVID-19 and support communities in a safe return to normal activities. Empowering individuals to rapidly know their infection status and modify their behaviors accordingly is an important tool. The more that is understood about how people use rapid tests, whether they modify their behavior, and whether this impacts community transmission, the better national, regional and local testing programs can be tailored to increase their impact. The SYCT team extends its thanks to the teams at the local public health departments in the seven participating counties for their partnership on SYCT during this unprecedented public health emergency.
1 Interviews were conducted by Research America in Pitt County, North Carolina (May 10 – May 21, 2021), Hamilton County, Tennessee (May 25 – June 8, 2021) and Washtenaw County, Michigan (July 20 – July 29, 2021).
About the author
Rachael Fleurence is a Senior Advisor in the Immediate office of the Director at the National Institutes of Health and serves as the Special Assistant to the NIH Director for COVID-19 Diagnostics.
Matthew McMahon leads the SEED Office to accelerate National Institutes of Health (NIH)-funded biomedical innovations from bench to bedside. Matthew has a diverse background in academia, biomedical small business, congressional policy, and NIH program development and management.
Andrew Weitz is Program Director for Division of Health Informatics Technologies, National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health. Andrew oversees digital health strategy for multiple COVID-19 initiatives, including Rapid Acceleration of Diagnostics (RADx) and Researching COVID to Enhance Recovery (RECOVER).
Dr. Krishna Juluru helps to advise COVID-19 initiatives at National Institute of Biomedical Imaging and Bioengineering (NIBIB)/National Institutes of Health (NIH) with a focus on health informatics challenges and opportunities. He serves on national professional society Informatics committees and is Associate Editor for Informatics of the journal, Radiographics.
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