Most New Yorkers—and a huge part of the world—might agree today that there are few terrors worse than testing positive for Covid-19.
That reality struck us several weeks ago. We are brothers who live together in Manhattan’s East Village and can not easily social distance from each other. Suraj started experiencing the symptoms of a Covid-19 infection including 101–102-degree fevers, shortness of breath, and body aches for several days. Fortunately, Viral is an ER physician whose ability to return to work is dependent on our household being Covid-free. Viral swabbed Suraj at home and safely sent the sealed sample to a lab in Brooklyn without coming into contact with anyone or clogging hospital waiting rooms. The test came back positive and allowed us to notify recent contacts to go beyond basic social distancing and strictly self quarantine. It also stopped two physicians in our household from going back to work and spreading the illness.
Suraj Patel is an attorney, lecturer at New York University, and a Democratic Candidate for US Congress in New York City. Dr. Viral Patel is an emergency medicine physician, telehealth physician, and Founder of Radish Health.
Fortunately, we have all fully recovered, and thanks to the confirmed result of a test, both of us will be able to donate our antibody-rich plasma this week and Viral will be safely working in the ER.
We were lucky to face this terror, because the only thing scarier than a positive test for Covid-19 is not being able to know whether you’ve contracted Covid-19.
As this pandemic becomes less abstract and more personal– when people’s own loved ones start to show symptoms—it’s only human that they will want certainty and safety. Around the world we have taken ourselves out of the equation for the sake of our global and public health. And that’s bad for public health.
We have no idea what the spread of this virus truly is thanks to costly under-testing at the start of this pandemic, but all of the evidence points to mass testing as the only way out of a perpetual cycle of social distancing and caseload spikes. Social distancing is buying us time, but without universal testing, this period of pause delays the inevitable. That’s why we’re calling for a national mobilization to create a universal testing program for every American.
Such a program should categorize people in three ways: they had Covid-19, they have Covid-19, or they are still at risk for getting Covid-19. Green, Red, Yellow—that simple, no more uncertainty. It would use two types of tests to accomplish this categorization.
The Two Types of Tests for Covid-19
When testing for Covid-19, we can look at the presence of either (1) the actual viral antigen during infection or the (2) antibodies during the middle stage of infection and after. (For the sake of simplicity we are only going to talk broadly about the antibody test as one type of antibody.)
Covid-19 testing in the U.S. currently is focused on antigen testing; a nasal swab is used to test for the presence of Covid-19 proteins in your mucous.
Such tests need to be made widely available in ways that do not clog our emergency rooms. Mobile testing for at risk seniors as well as rapid expansion of drive through testing facilities, or even self-administered home swab kits that can be securely sent to labs can help rapidly identify those who need to be on the strictest quarantine (Red).
We also need to increase the capacity to read these tests. South Korea reported its first Covid-19 case the same day as the USA, but had six times the testing capacity per capita. Fortunately, the science behind analyzing Covid-19 antigen tests is widely available—university labs, commercial labs, and the government all have the equipment needed to read them. They just need to be set up for testing and approved to analyze samples. That requires no medical breakthrough, just political leadership, which may be the taller order right now.