very fast test taking ~ carrying out a saliva test can be done very quickly, when appropriate or convenient (24h/7d)
'point of need' ~ carrying out the tests can be done wherever and whenever it is appropriate ~ unlike traditional (diagnostic) 'point of care' or laboratory tests
routine job ~ daily users can take this test on their own in less than 1 minute on a routine basis, to read the result of the test less than a quarter hour later
ready-to-use ~ new testing regime that can be immediately implemented ~ no need for new anti-viral drugs, no need for new medical treatment methods, no need for additional medically / para-medically trained personnel, no need to wait for the new 'emergency vaccines', no need for doctor visits or COVID-19 hospital admissions, no dire shortages of diagnostic test tube reagents, etc. ~ the necessary technology and infrastructure are already largely available
‘fast positives’ ~ virus positive cases get an almost instantaneous 'NO GO' or 'NOT OK' test result, and can adjust to this result immediately
rapid isolation ~ virus positive testers can go into isolation immediately within 15 minutes after the test is administered, with the possibility of an additional 'confirmatory' saliva test and / or a confirmation based on a gold standard clinical RT-PCR diagnosis
possibility of immediate counter-assessments ~ direct access to a confirmatory test ~ for confirmation purposes, a limited number of identical paper-strip saliva tests are also supplied with every 100 paper strips that work on the basis of an alternative molecular composition (= double-check)
"fast negatives" ~ virus negative cases get the 'GO' or 'OK' result of their test very quickly, and can continue the activities that are planned for the rest of that day in an unhindered / unabated way; albeit - evidently - without prejudice to the continued observance of the applicable preventive precautions
user-friendly ~ test results are easy (and without risk of confusion or differences of interpretation) for laymen and users to read and to understand
safe ~ by definition the testing protocol involves self-testing ~ in other words, no assistance from third parties or specialized personnel is required, so that these third parties can never become infected during the taking of the test ~ unlike with PCR tests, no "Martians"/PPE are required, which in turn saves a lot of time and money
low cost ~ can be applied on a massive scale by the entire population (eg daily, at less than € 1 per test) ~ economic leverage effect ~ negative opportunity costs + return on investment
"scalable" ~ test that can be applied massively (= by the masses + frequently) in the short to medium term ~ ideal for pandemic screening and / or population screening ~ this is a very interesting feat not just for the users, but also for their organizations and authorities
statistically relevant ~ (structured) test results can assist scientists and policymakers in their decision-making ~ decentralized population screening = a cheap research, development and policy tool
practical / effective triage tool ~ interplay between screening and diagnostics ~ the new paper-strip saliva test screening method is an ideal supplement and / or precursor and / or selection and triage tool for traditional diagnostic tests, which addresses the massive demand / need for RT-PCR tests, whereas at present such massive numbers of RT-PCR-tests can absolutely not be handled by hospitals and diagnostic labs
anonymous ~ (in principle) no need for track & trace ~ protection of privacy ~ protection against 'big brother' and against so-called 'digital surveillance capitalism'
comfortable ~ can easily be taken at home by laymen - no need for terrifying nose swabs, no need for complex lab equipment
compact ~ is portable and stowable ~ can easily be carried in a pocket in a jacket or in a backpack or in a handbag
child-friendly ~ comfortable for children aged 7 to 77, and possibly for those who are younger or older
practical for traveling ~ eg public transportation, airplanes, etc.
practical for on the road ~ eg work, school, hospital, theater, station, airport, stadium, place of worship, workshop, Christmas party at grandma's, etc.
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limited risk of "false negatives" if the test is not administered correctly and / or if the test results are not correctly read and / or misinterpreted.
~ However: all kinds of precautions can be taken by the user himself/herself (e.g. assistance of children and the elderly, 4-eyes principle within the same family, pointing-and-calling method, test in a quiet room such as a bathroom, etc.). Organizing organizations can also take extra precautions. And in the first place, the manufacturers themselves will of course take the best precautions - as much as possible and as useful as possible. In addition, the government and the media can also raise awareness among the population about the risks of 'false negatives', which will always exist anyway (as they do with other tests), and which of course should not be underestimated. ~ Past experience with other self-tests (such as pregnancy tests, HIV tests, etc.) shows that this type of risk does not have to be an insurmountable problem, and that in developed countries (such as the EU member states) these risks practically can be reduced to almost zero. But even then, even if something goes wrong now and then, the ultimate global effect of this screening method remains predominantly positive, and its ultimate impact remains much better than anything that has been tried so far.
limited risk of 'false negatives' at the (in any case asymptomatic/presymptomatic) very beginning of the 'highly-virus-infectious phase'; this is the 'Virus Infectious / Transmissible Phase with high viral loads and high viral shedding' = 'Ultra-Ansteckende Phase'.
~ However: during their so-called 'viral peak' (60-72h with highest risk of infection) this 'initial risk' for false negatives in virus-positive test users is not statistically relevant (thus negligible) from an epidemiological point of view; although it may be useful to remind each test user at an individual level of the existence of the (limited) probability of 'false negatives' at the very beginning of the virus-contagious phase: this risk is not to be 100% neglected indeed, so that other precautions must still be permanently observed.
likelihood of "false positives" (especially given certain typical Bayesian effects), which may give rise to an increasing demand for additional RT-PCR tests, as well as give rise to unnecessary panic, anxiety, work disabilities, school quarantines, etc.
~ However: this risk is largely offset by the additional special 'confirmatory tests' that are included with each batch of standard tests, and that reduce the probability of 'false positive' test results (after a double saliva test) to less than 1/1000 (~ <0.1%).
risk of unexpected escalations and / or other butterfly' or 'bullwhip' effects as a result of some technical details that currently still need to be - at long last - clarified (and preferably as soon as possible), because otherwise they could cause confusion / disinformation with the users of the respective tests, as they will be marketed by different manufacturers. Obviously, what we are dealing with here are simple screening paper-strip tests and not diagnostic devices, but nevertheless there exists a risk for some (admittedly technically-scientifically perfectly explainable) differences in the field of test criteria (specs / specifications) as used by the different Ag saliva test manufacturers; which could indirectly lead to confusion and / or misplaced dissatisfaction among test users, a phenomenon that should therefore be avoided as much as possible.
After all, there is a real possibility of:
(a) divergent test results of scientific samples, (partially due to :)
(b) divergent quantitative and qualitative benchmark and threshold specifications as used by the various saliva test producers. On this very issue, some notable suggestions were launched in recent weeks (among others by certain academic circles in the US and in Berlin), but today the transparency needed to make rapid progress in this field is still lacking.
This concerns, for example, the criteria (to be applied) for 'viral loads & shedding' / 'RT-PCR-ct cycle threshold equivalents'; and this both in terms of the relevant ct values and the VL / ct calibration methods. These are important in delineating what actually constitutes a "positive" and what actually constitutes a "negative" saliva test.
In addition, there is a real possibility that the various saliva test producers apply different criteria with regard to the exact method/protocol to be followed by the individual private users for administering the saliva test; among other things each depending on possibly divergent test specifications (e.g. as a result of differences in the molecular composition of the actual antigenic test strips, which may or may not be open source), in function of diverging views on quality control, in function of user support 'at the point of use', etc.
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However, this mainly concerns scientific-philosophical discussions. Those can quickly (and easily) find a technical / economic / administrative solution: within the acceptable safety margins and within the probability intervals for screening tests; especially in the framework of the pandemic emergency situation Europe finds itself in. Moreover, the quasi-100% reliability of the saliva tests at the time of a so-called 'viral peak' (i.e. the period of 60-72 hours with the highest risk of infection) must also be considered as a key success driver for the lowcost antigen tests. Hence, possibly divergent criteria and, later on, the risk of divergent tests-results between the different saliva test platforms - in case of a virus-positive test - are actually statistically irrelevant (and therefore practically negligible from an epidemiological point of view); whereby it can not or may not be expected that each test user would (wish to) take these differences into account on his/her individual level. Nevertheless one should caution against a cacophony of differing expert opinions or differences in diagnostic interpretations, which may lead to the test users losing confidence or becoming confused and disinformed. In any case, it would be intellectually dishonest for certain public authorities and / or certain academic bodies and / or certain big-pharma companies to abuse this kind of backbench discussions to block the necessary transition to the new screening test-regime. Such hesitations simply amount to culpable negligence on the part of those responsible. After all, what we are dealing with here are (by definition slightly less accurate) mass public health surveillance screening tests, and not (by definition highly accurate) clinical diagnostic tests. This is precisely the crux of the story, and one should therefore refrain from confusing the population / citizens / test users about the tradeoffs at hand ...
limited risk of technical problems and teething problems, whether or not in combination with incorrect use and / or incorrect interpretation of the confirmatory tests supplied with each batch of standard tests, and whether or not organized by 'test-organizing' organizations. This is all the more so, because the 'viral cell load' of a simple saliva sample can be lower than an equivalent nasopharyngeal swab, possibly leading some to conclude 'that opportunities or signals are being missed'.
~ However, these risks can be managed to a significant degree, by way of a phased-in deployment of this new low-tech testing technology, by way of preliminary testing and simulations, by way of sampling and quality control, by way of appropriate training and by way of a Europe-wide awareness-raising campaign that is aimed at the individual testers, at the organizing organizations, as well as at some of the health care personnel. Speed and ease of use are precisely the drivers required for widespread public support for these antigen auto-tests as they will underpin their massive, frequent use, eventhough they are less reliable to begin with. After all: one should not put the cart before the horse; and what clearly prevails here is that the European population continues to frequently test itself in massive numbers, without quitting or giving up because of all kinds of discomforts or inconveniences. What counts is that the decentralized population screening and public health surveillance programs can continue unabated. In other words, and as strange as this may sound: in the case of the modern Ag SARS-CoV-2 saliva tests (and this is particularly true from an epidemiological point of view) the ease of use and the fast turnaround times prevail over the accuracy of the test, which comes in second place. Obviously, one must continue to take as much care as possible (or as useful) to avoid testing incidents and testing accidents, yet especially the speed, the massive numbers and the high frequency, but also the low cost and the comparative ease of use, should prevail over the fact that these Ag saliva tests are somewhat less accurate than the gold standard RT-PCR tests.
isk of dangerous behavior and / or a careless attitude in some who think that - in the case of a negative, ie "OK" or "GO" test result - they can let go and start taking unnecessary risks: both in the context of social distancing and personal prevention measures, and in the context of the testing strategy; e.g. in case they no longer regularly observe the frequency and the user instructions such as they apply for the respective saliva test regimens.
~ However, once again, an appropriate enforcement policy, in combination with a Europe-wide awareness-raising campaign, can work miracles, especially among certain population groups (e.g. among children, among the elderly, among tourists, among university students, among the homeless, among refugees, among drug addicts. or also: in the case of schools, associations, airlines, bus companies, organizers of sporting events, etc.). In addition, past experience with other home tests (pregnancy tests, HIV tests, etc.) in developed countries such as the EU member states demonstrates that this kind of risks is certainly manageable, and that it is possible to rely on the common sense and civic spirit of our fellow Europeans.
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