Vastly expanded approval and distribution of rapid, at-home tests represents a powerful tool in the fight against COVID-19 — and just possibly, the future of disease diagnostics.

Why it matters: Vaccines will take time to arrest the spread of the coronavirus — even without problems around distribution and acceptance. Some experts believe mass rapid testing could quickly identify who is really at risk of spreading COVID-19 and turn around the out-of-control pandemic in the U.S.

Driving the news: On Tuesday, the FDA granted emergency authorization to Ellume's over-the-counter antigen COVID-19 test for fully at-home usage — akin to a standard home pregnancy test.

• This is the first test the FDA has approved that can be taken without a prescription and produce results — in about 20 minutes — without the need to either mail in a sample to a lab or wait in line for a clinic.
• Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, believes if just half the U.S. population were able to test themselves every four days, the country could quickly achieve vaccine-like "herd immunity" by letting people know in real time when they were contagious.

How it works: What Mina is suggesting is similar to the daily COVID-19 testing carried out by the NFL and other professional sports leagues — which is meant to regularly sweep for infections before they lead to outbreaks — albeit on a much larger scale.

• The economic benefits of mass, rapid COVID-19 screening for the country would exceed the costs — which they pegged at around $28 billion — by 4–15 times, even without adding in the value of the lives that might be saved, according to a paper published by Mina and a team of economists in October.

The catch: Using less-accurate antigen tests would inevitably result in both false negatives — meaning cases that would be missed — and false positives.

• Such testing errors could end up "eroding confidence to the point where people don’t trust it," Amanda Harrington, director of the clinical microbiology laboratory at Loyola University Medical Center in Illinois, told the New York Times in September.
• As infectious disease experts Matthew Pettengill and Alexander McAdam wrote in a journal editorial earlier this year, it remains "an open issue whether such tests can be developed and produced at the massively needed scale any more quickly than vaccines."

Yes, but: Mina has argued while rapid tests will miss some cases that PCR diagnostics would pick up, antigen tests are particularly good at identifying when people are most contagious.

• The false-positive problem can be countered by having those who test positive take another rapid test for confirmation.
• As for feasibility, Mina told New York magazine it's largely a matter of will. "If the government really wanted to do that, that is not hard to do at all."

What's next: For all the U.S.' struggles around testing, the pandemic has seen an explosion in innovation around at-home diagnostics, as my Axios colleague Marisa Fernandez reported.

• Companies like LetsGetChecked and Everlywell have experienced a surge in demand for at-home tests for other conditions like Lyme disease and vitamin deficiencies.
• Wearables that track biometrics have shown some success in identifying probable COVID-19 cases before clear symptoms even begin to show up.
• "One of the good things to come out of this terrible year is that we've gotten used to doing more testing," says Isaac Turner, the CIO of Curative, a startup that handles some 10% of COVID-19 testing each day in the U.S. "There are many diseases where extra testing would be fantastic."

A new report — first seen by Axios — lays out what could go wrong in the worlds of geopolitics, business and technology in the coming year, as well as what could go right.

The big picture: Viewed side by side, many of the risks and opportunities of 2021 present a mirror image, where different decisions in the same part of the world can lead to positive outcomes — or another year of catastrophe.

What's happening: Robert Manning and Mathew Burrows of the Atlantic Council cite the dangers of an extended COVID-19 pandemic, the stifling of the Biden presidency, and a new debt-driven global financial crisis as the top risks for next year, in a report to be published later today.

• They also list what they see as the top opportunities of the coming year, led by a reborn World Trade Organization, a revived and updated multilateralism, and a turnaround of the worsening U.S.-Russia relationship.
• "It's tempting to say that in 2021 there's nowhere to go but up," they write. "But there will be further unanticipated shocks and no shortage of risks."

Between the lines: Every incoming presidential administration faces what Manning calls the "tyranny of the inbox" — the overflow of crises and opportunities that demand the White House's attention. And Biden's inbox is already overflowing.

• Still, what struck me about the report is how many of the risks could be flipped into opportunities — and vice versa — depending on the moves the administration makes.
• Much of it comes back to the pandemic. If Biden's team can quickly curtail the spread of COVID-19 and kick-start the economy, it takes pressure off the possibility of a new global financial crisis, which in turn would help increase the chance of "rejuvenating rules-based global trade," as Manning and Burrows write.
• If the White House can effectively resurrect multilateralism, it will reduce the fallout from any confrontations with Russia and China.

Of note: One of the risks Manning and Burrows cite is arguably already underway, even if it is under the radar: the worst global food crisis in decades.

• That includes the U.S. — experts warn the richest country on Earth is facing "unprecedented" levels of child hunger.

The bottom line: The new administration has its work cut out for it.

A new UN report on human development makes the case that our species faces a dire future of our own making.

The big picture: The COVID-19 pandemic — which emerged from nature but is in every other way a human-made catastrophe — is the most recent signal that we are firmly in the Anthropocene, a new epoch in which human beings are the most powerful force on the Earth. What comes next is on us.

What's happening: The 2020 Human Development Report — published earlier this week — marks the 30th year the United Nations Development Programme (UNDP) has assessed the holistic state of humanity.

• The short version: it's not good, as COVID-19 illustrates the pressures we've put on the planet — pressures that have "grown exponentially over the past 100 years," as UNDP administrator Achim Steiner writes.
• Beyond the direct costs of the pandemic, COVID-19 has thrown human development into reverse, with social mobility declining and social instability rising.
• Climate change — the clearest and biggest challenge posed by the Anthropocene — continued its acceleration, with 2020 likely to go down as the hottest year on record.

Of note: The peril and the promise of the Anthropocene are seen most clearly in the case of existential risks, those catastrophic dangers that threaten the future of human civilization.

• While we've always faced rare but potent cosmic threats like asteroids, today "the dominant risks to its survival come from humanity itself," writes existential risk scholar Toby Ord in the report.
• But the same power that poses existential risks in the form of nuclear war or bioengineered pandemics means that "humanity’s future is largely within humanity’s control" — provided we're willing to take those risks more seriously than we have to date.

The bottom line: For better or for worse, we'll be the authors of our own future.

The government is still getting its arms around the scope of the Russia-linked hack that penetrated the Pentagon, Treasury, Commerce, Homeland Security and State departments (at least), and other institutions are bracing for damage, Axios Codebook author Zach Dorfman writes.

The big picture: The news, which Reuters broke Sunday, has shaken the government and larger cybersecurity world. The National Security Council reportedly held an emergency meeting over the weekend to discuss the breaches.

What we know:

• Who was (probably) behind it. Cyber operators likely working for the SVR, a Russian intelligence service, compromised the software of IT contractor SolarWinds to gain access to these government networks — and have been potentially roaming in them since March.

What we don't know:

• What they were after. The hackers appeared to gain access to email systems at affected agencies, though we don’t know whose emails, nor just how sensitive they are. It's possible they got deeper into government systems than merely scraping unclassified emails.

Be smart: As stunning as the hack's apparent success may be, the effort behind it is par for the course in the world of cyber espionage. The general public just rarely gets a glimpse into the machinery of modern spying.

• And while the SolarWinds hack is immensely serious, the targeting of government agencies is precisely the type of cyber spying all capable intelligence services do — including those in the U.S.

My thought bubble: This major hack and Google's brief but widespread outage earlier this week are a reminder of how dependent we are on an increasingly complex network of digital information — and how vulnerable that network is.

Read the rest of Zach's story

How a 1980s AIDS support group changed the internet forever (Michael Waters — OneZero)

• The fascinating story of Ben Gardiner, a San Francisco activist whose early online AIDS bulletin board marked the first major use of the nascent internet for public health.

DNA is now solving decades-old newborn killings (Emily Mullin — Future Human)

• Forensic genetic genealogy — the police technique of combining information in consumer DNA companies with genealogy — helped solve tragic child murders, but it poses major questions about justice.

My vaccine paranoia didn't begin with my grandmother's death (Bonsu Thompson — Level)

• A personal story that helps explain why so many people of color are wary about the COVID-19 vaccine, and the medical establishment pushing it.

In a surprising binge of transparency, battery companies tell us what they really have (Steve LeVine — The Mobilist)

• My Axios Future predecessor breaks down a week of surprisingly good — and public — news from normally secretive battery companies.

A team of scientists at a Department of Energy national laboratory for the first time demonstrated sustained, high-fidelity quantum teleportation.

The big picture: Besides sounding really cool, the experiment represents one more step toward the development of a viable quantum internet, a new network that promises to be far more secure and powerful than the current web.

How it works: In the experiment, the results of which were published in PRX Quantum, a team of researchers from Fermilab and several other corporate and academic partners teleported qubits of photons over 44 km of fiber-optic cable with a fidelity greater than 90%.

• Teleportation, in this case, means the disembodied transfer of quantum states from one location to another. It's possible because of the weird physics of the quantum world, where two or more particles can become inextricably linked to each other through the process of entanglement.

Background: In July, the DOE laid out a blueprint for the eventual development of a national quantum internet.

• In theory, a quantum internet should be all but unhackable, which makes it particularly attractive for national security, as well as the financial industry.
• Such a network might also be able to transmit vastly larger amounts of data than the current web.

What to watch: Whether the U.S. can keep pace with China, which has an early lead in the quantum internet race.

• Earlier this year, Chinese researchers used a satellite that had been specifically designed for quantum information science to securely transmit data between two ground stations more than 1,200 km apart.

The bottom line: Beam me up.