Nature Biotechnology: Radical Solutions
Technological acceleration resulting from the COVID-19 pandemic will have long term implications for clinical and point-of-care diagnostics. Nature Biotechnology ¹ recently published an editorial detailing the evolution of these changes. Prior to the pandemic, diagnostic testing markets were dominated by large centralized laboratories using traditional techniques to accommodate clinical workflows in emergency rooms and other hospital-based settings. The surge of patients at the onset of the pandemic coupled with a lack of reliable point-of-care testing platforms resulted in disruptive structural changes to the US Healthcare system almost overnight.
With emergency rooms overwhelmed, radical acceleration of diagnostic solutions was required to mitigate the spread of the virus and service community health needs. The federal government acted quickly to pass the CARES Act, which appropriated $1.5 billion to establish the National Institutes of Health’s Rapid Acceleration of Diagnostics (RADx) program. RADx has awarded over $520 million to spur the development of point-of-care technologies that speed up patient triage in emergency rooms and service emerging at-home and community based testing sites. Through its funding efforts, RADx put 125 million COVID-19 tests onto the market, supported over 150 companies, and officially launched 16 diagnostic products since last April.
Future Responses Require Ongoing Investment
The implementation of RADx coupled with Congress’s recent $71.5 billion investment in testing, contract tracing, surveillance and containment strategies could represent a departure from the status quo. Prior to the pandemic, sustained underinvestment in testing capacity resulted in only 1% of primary care facilities and 14% of hospitals in the United States having access to basic diagnostic testing capability. Preparation for pandemics of the future will require continued investment in integrated diagnostic platforms to provide accurate information to patients and caregivers across disparate clinical and community-based settings. Such investment would not only help mitigate the spread of contagion, but also expand access to basic health care services for underserved communities.
Expanded Access to Testing & Health Services
Seraph Chairman, Dr. Charles Shanley, experienced this reality first hand in his role as Chief Executive Officer of Wayne Health, a multi-specialty clinical services organization serving Detroit’s most vulnerable residents. Beginning last spring, Wayne Health deployed vehicle-based Mobile Health Units (MHU) to improve access to SARS-CoV-2 testing in at-risk communities in Detroit. The organization accomplished this by combining geocoded data on SARS-CoV-2 disease prevalence with census-tract data on social vulnerability. “Bringing diagnostic testing capacity to the communities where people live is an effective containment strategy especially in vulnerable populations lacking access to basic care”, said Dr Shanley. “What began as a SARS-CoV-2 testing strategy quickly expanded to include preventive health and social services with linkages to primary and specialty care.” Clinical initiatives that promote health equity combined with continued investment in diagnostic innovation will inform our response to future pandemics and create a healthcare system that works for everyone.
¹Radical solutions. Nat Biotechnol 39, 391 (2021). https://doi.org/10.1038/s41587-021-00908-5