A decentralised point-of-care testing model to address inequities in the COVID-19 response

Abstract

The COVID-19 pandemic is growing rapidly, with over 37 million cases and more than 1 million deaths reported by mid-October, 2020, with true numbers likely to be much higher in the many countries with low testing rates. Many communities are highly vulnerable to the devastating effects of COVID-19 because of overcrowding in domestic settings, high burden of comorbidities, and scarce access to health care. Access to testing is crucial to globally recommended control strategies, but many communities do not have adequate access to timely laboratory services. Geographic dispersion of small populations across islands and other rural and remote settings presents a key barrier to testing access. In this Personal View, we describe a model for the implementation of decentralised COVID-19 point-of-care testing in remote locations by use of the GeneXpert platform, which has been successfully scaled up in remote Aboriginal and Torres Strait Islander communities across Australia. Implementation of the decentralised point-of-care testing model should be considered for communities in need, especially those that are undertested and socially vulnerable. The decentralised testing model should be part of the core global response towards suppressing COVID-19.

Associations of the Initial COVID-19 Lockdown on Self-Reported Happiness and Worry about Developing Loneliness: A Cross-Sectional Analysis of Rural, Regional, and Urban Australian Communities

“…However, this may well be a double-edged sword in that remote and regional access to healthcare and medical resources in the event of an outbreak is limited [ 40 , 41 ]. Moreover, Australian rural and regional communities carry higher rates of co-morbid health issues that further predispose individuals to COVID-19 [ 42 ]. It is also possible that the livelihood of many remote and rural Australians is dependent on transient economics (e.g., tourism and fly-in-fly-out workers in mining), which effectively ceased during the period of lockdown, contributing to reduced feelings of happiness despite anxiety levels remaining low.…”

One swab, two tests: Validation of dual SARS-CoV-2 testing on the Abbott ID NOW™

“…Limiting SARS-CoV-2 spread is dependent on the rapid identification of individuals who are communicable. Diagnostic methods with short turnaround times are desirable in certain settings, such as in outbreak investigations or in remote areas where rRT-PCR testing is not readily available [3] . The ID NOW™ COVID-19 assay (Abbott Diagnostics Inc, USA), is a rapid (<15 minutes) molecular in vitro diagnostic test that uses isothermal nucleic acid amplification technology to qualitatively detect SARS-CoV-2 viral RNA directly from nasal, throat or nasopharyngeal (NP) swabs [4] .…”

Detection of Sars-Cov-2At the Point of Care

“…At-home testing for SARS-CoV-2 SARS-CoV-2 tests with FDA authorization for use at home are primarily based on rapid isothermal amplification of nucleic acids or antigen detection. The advantages and limitations of these methods have been described [92]. At-home testing (specimen collection, test and result interpretation) is performed by an individual on their own without supervision of a trained health professional.…”