March 16, 2020

COVID-19 At Home Self-Diagnosis

By Shantanu Nundy, Chief Medical Officer, Accolade

Disclaimer: To be clear, as of March 23, 2020, such at-home testing is not currently approved for use by the FDA, but is being reviewed for approval in an Emergency Use Application. Such approval by the FDA could open the door to a powerful tool in combating the spread of COVID-19. Accolade intends to stay abreast of all latest development and support members with the latest information available about testing options, including drive-through testing and, if approved, at-home testing.

The coronavirus pandemic, COVID-19, is gripping the world’s attention, causing swift action in an attempt to further reduce its spread. In the United States, most medical and disaster response experts agree that the lack of access to testing is challenging our ability to respond. To accelerate access, on Friday, March 13th, the federal government announced a major investment to scaleup testing across the country.

However, the current testing model has limitations. To get tested, individuals need to schedule a visit with a doctor or go to an urgent care center or ER. But this risks strain on our already crowded health system. As the COVID-19 epidemic continues to grow, clinics and hospitals face overcrowding and are prioritizing their resources on individuals needing treatment. Having individuals wait for hours in a crowded clinic or ER for testing also risks exposing others to infection.

The question for us is how can we simplify testing to reassure Americans, get them the results they need so they can live their healthiest lives and reduce the spread of the virus and the burden on the health system?

In the Journal of American Medicine Association’s (JAMA) Health Forum, my colleague from Johns Hopkins Medicine, Dr. Kavita Patel, and I propose such an option – the home self-service COVID-19 test.

In this paper, we propose a three-step model:

  • Step 1: Individuals talk to a doctor via telemedicine to get assessed for COVID-19 using the latest guidelines from the Centers for Disease Control and Prevention (CDC).
  • Step 2: Those able to be safely tested at home have a nasal swab kit delivered to their home.
  • Step 3. They do the nasal swab themselves and mail the test back for analysis and results in 1-3 days’ time.
gq8dld0b8jyu

Such a model would enable us to assess, test, and diagnose COVID-19 completely remotely for individuals at low-risk of complications, which would offload the health system and reduce the risk of transmission. It also has the potential to be rapidly scaled up across the country, including in rural communities and those with limited access to a clinic or hospital.

At Accolade, we are focused on reinventing the healthcare experience to empower our members and give them a better experience. As we focus on changing how healthcare is delivered, we are sharing ideas that can help the country respond to this pandemic.

We put forth this proposal in JAMA’s Health Forum to start the conversation about innovative ways to increase access to testing. This is just one example of how Accolade is supporting ideas to reinvent the health care experience.

Read and share the paper here: https://jamanetwork.com/channels/health-forum/fullarticle/2763264

Check out Dr. Nundy's op-ed in The Washington Post on the same topic: https://www.washingtonpost.com/opinions/2020/03/20/coronavirus-is-upending-society-here-are-ideas-mitigate-its-impact/

The views or opinions in this post are personal to the author and may not represent the views or opinions of their employers or other professional associations.