LONDON — Before she met friends to go ice skating, Anne Bearne-Rolfe did a rapid antigen test for the coronavirus. It wasn’t mandatory, but she considered it a social courtesy.
After quick swabs, drops on a test strip and 15 minutes on the stopwatch, it seemed that she and her family probably didn’t have the virus. And so she met up with two other families to enjoy an afternoon of skating at London’s Somerset House.
The U.S. government is just beginning to roll out free antigen home tests. A website for ordering launched this week, with the first batches — four per household — scheduled for delivery later this month. But while up until now, home tests have been expensive and hard to find in much of America, in other countries — Britain, Singapore and India among them — rapid self-tests have been widely accessible for some time. And people have incorporated them into their everyday lives.
Brits are testing before book club meetings
Whereas the Biden administration announced it is buying 1 billion rapid tests, Britain’s National Health Service has already distributed 1.7 billion free home tests (in a country of 67 million) over the past nine months. With packs of seven available via home delivery and at pharmacies, people have boxes in their kitchen, next to the daily bread, ready to go.
We continue to expand our testing capacity, so that the right kinds of tests are available for those who need them. You can order rapid lateral flow tests via https://t.co/8BjU9ofGNr https://t.co/29Ni2bXCAM as well as collecting them from local pharmacies and community sites. pic.twitter.com/tudQ90wQna— UK Health Security Agency (@UKHSA) January 14, 2022
Brits test as part of quarantine rules, but also before meeting friends for a book club, taking their kids to a birthday party or visiting elderly relatives. They might share their negative results with each other on WhatsApp before heading over — or offer condolences to anyone whose positive result keeps them at home. Although people are also encouraged to upload their results to a government app, only a small fraction of people actually do.
“It’s become a social phenomena, something you do before going to the pub or going to see Granny,” said Iain Buchan, chair of public health and clinical informatics at the University of Liverpool.
Liverpool knows a thing or two about mass testing. In late 2020, officials attempted to test the entire city. Analysis of the rapid test kits showed they detected infection in only half of asymptomatic people who then tested positive on a PCR test. But Buchan said the antigen tests were about 90 percent effective at picking up cases in people who were most likely to be infectious.
Preliminary U.S. data suggests that the rapid tests may be less effective at detecting the omicron variant. But the British government has offered an early assessment that antigen tests have “comparable sensitivity” for omicron as for previous variants. (Some enterprising British children, keen to get a few days off school, figured out that dipping the swab in orange juice or cola can produce a positive.)
The widespread testing is considered a win for otherwise embattled Prime Minister Boris Johnson. There had been many doubters in September 2020 when he pitched “Operation Moonshot,” a vision of testing everyone in the country every week.
But this massive national experiment hasn’t been cheap. It has cost the government more than $8 billion. And as Britain attempts to “live with” the virus, in hopes of shifting from pandemic to endemic status, free rapid tests may come to an end. Johnson told Parliament on Wednesday that the tests will be offered “for as long as is necessary.” A few hours later, Health Secretary Sajid Javid said they “won’t remain free indefinitely.”
Allyson Pollock, a professor of public health at the University of Newcastle, is among those who thinks mass testing should stop. She argues that it is hugely expensive and under-evaluated and gives people “false reassurance.”
Self-test kits are everywhere in Singapore
Singapore has also relied heavily on rapid self-testing. The Health Ministry considered it an important part, along with mass vaccination, of transitioning away from the need for circuit-breaker lockdowns and toward being a “covid-19 resilient nation.” The government sent six-packs of free tests to each household in late summer.
Antigen tests are also easy to find at local supermarkets and drugstores in Singapore, where 20-packs cost about $67.
“We’re flooded with antigen tests. Drugstores, supermarkets — there are boxes and boxes all over the place,” said John Lee, 50, an American living in Singapore. He said friends back in the States have jokingly asked if he wouldn’t mind sending over a few packs.
While people in Singapore need to be vaccinated to do most things — such as going to the mall or a coffee shop — Lee said locals use the antigen tests when they are not feeling well and when they are traveling. After he returned from the States this month, his family of four had to do a series of PCR and antigen tests, including about 16 self-administered tests over the course of a week. In some cases, they had to go into a physical center so officials could supervise the testing.
Home tests are helping India through its third wave
In India, the first rapid home tests launched commercially in the spring, priced nominally at a little over $3. But Hasmukh Rawal, co-founder and managing director of Mylab Discovery Solutions, said it was only recently that demand shot up for the CoviSelf test kits.
“From the baseline demand of a few thousand, we have seen a 500 percent rise in demand since the last week of December,” Rawal said. The company is now producing 1.1 million test kits a day, the majority of which are being sold in big cities.
The first thing Divyank Dhingra, a 25-year-old engineer, did after landing in Delhi last week from a work trip to another state was to call his local pharmacy and order a coronavirus self-test kit. Within 15 minutes of reaching home, Dhingra had a negative test result and felt comfortable interacting with his family.
“It was a precautionary step to protect me and my family,” said Dhingra who used the at-home test kit for the first time. “It was easy and budget-friendly.”
India is experiencing its third wave of the virus, with about 300,000 reported daily cases. That is presumed to be an undercount, as doctors warn that many people are not reporting their home test results. In Mumbai, the city administration last week mandated that pharmacies keep records of customers buying home tests and that customers, in turn, upload their results, positive or negative.
India’s second wave devastated the country’s health-care infrastructure as resources ran dry. Rawal said the self-test kits ease the pressure enormously. “Each person becomes a lab. You don’t need to delay treatment,” he said. “It gives power to the people.”
Neha Ghosh, a 32-year-old business development associate, said her family struggled to get PCR tests at the height of the second wave in May. The result for her father came after three days, in which crucial time was lost for his treatment.
But when her 15-month-old daughter developed covid symptoms in late December, the family was able to use rapid tests — and took steps to quarantine immediately after Ghosh’s husband tested positive.
Ghosh said the rapid tests were helpful because “it gives you an idea whether to do more.”
She said that before the third wave, she had stocked up on kits for the family.
Masih reported from Delhi.