Illustration: Eniola Odetunde/Axios

New coronavirus diagnostics could eventually enable near-constant testing — and herald a future where even common infections no longer go undiagnosed.

Why it matters: Rapid testing could be especially important during the winter, when it will become vital to quickly distinguish between an ordinary cold or flu and a new disease like COVID-19.

What's happening: New testing technologies are being developed that, while not always as accurate as the PCR tests currently in use, can be done cheaply and quickly, at an accelerated rate that "matches the kinetics of the virus," says Jeff Huber, vice chairman of the cancer diagnostics company Grail and the science lead for the XPRIZE Foundation's $5 million rapid COVID testing contest.

  • University of Illinois researcher Martin Burke has created a rapid saliva-based test that has received emergency authorization from the FDA. That will help the university reach its goal of testing all 50,000 students and staff on campus twice a week — frequent enough to catch infected people before they can significantly spread the virus.
  • Researchers at Yale University have received emergency authorization for a similar saliva-based diagnostic that was tested on NBA players and can produce results within hours, at just $10 a sample.
  • Mammoth Biosciences last month received backing from the National Institutes of Health to scale up its CRISPR-based diagnostic in an effort to increase testing capacities at commercial labs. The company is also working on a CRISPR-based handheld, disposable test that can produce results in 20 minutes."
  • A Princeton University spinout called NeuTigers has developed an AI-powered diagnostic that identifies COVID-19 infections using health data from wearable devices like smartwatches. "You don't need nasal swabs or PCR," says Greg Nicola, chief medical officer at NeuTigers. "Just a device with a sensor."

The key is speed and frequency. Modeling done during the 2014 Ebola outbreak in West Africa found that if 60 percent of new Ebola cases had been detected within a day of patients becoming infectious — using rapid tests — the epidemic could have been immediately stopped.

  • "What makes COVID-19 so challenging is two things," says Huber. "Asymptomatic and presymptomatic spreading, and the possibility of super spreaders" — infected people who for some reason spark huge outbreaks."
  • Simply screening for symptoms is insufficient because too many people are able to spread the coronavirus without showing clear symptoms. Rapid tests can solve that problem and ensure potential super-spreaders are taken out of circulation before they begin super-spreading.

What's next: The burst of innovation around disease diagnostics — as well as the growth of at-home health tracking devices — could lay the groundwork for a range of tests that rapidly detect infections of all kind, says Jack Regan, the CEO of the molecular diagnostics company LexaGene.

The catch: Testing populations twice a week or more would require a massive leap in current capacity. As of Aug. 20, the U.S. had performed fewer than 70 million tests throughout the entire pandemic — not even enough to test a quarter of Americans once.

Correction: An earlier version of this story mistakenly stated that the NIH was funding Mammoth's work on a hand-held coronavirus test that uses CRISPR. Instead, the NIH is funding CRISPR technology that can help improve capacity at commercial labs, while Mammoth is also separately working on a CRISPR-based handheld test.

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