We recognize there could be value in home testing, and we’ll continue to look at this. There are concerns. When you go to home testing, how effective is the sampling a person does? That’s the importance of why we chose a nasal swab [which just goes in the nostril] instead of nasopharyngeal [which goes way up in the nose]. It’s night and day in terms of pain. And you do need a trained health expert to do nasopharyngeal. We’ll explore other pathways to getting more testing to the people who need it.
Madrigal: One complication with widespread antigen testing is that it’s blurring the national picture of the pandemic. These tests aren’t really being reported, so even though this type of test is valuable, they’re currently creating a hole in the data. Have you given some thought to the data-reporting side of this?
Hackett: People testing are supposed to report positives. For example, if you were an employer using a test like this, that is the responsibility of the health group. We have created the Navica app, a complementary mobile app that goes with the test. We weren’t using it for that purpose, but it is one that allows the person to get a digital health pass.
We were thinking about: How can you lock in testing a test result and be able to verify that you were, in fact, tested? If you were an employer, you could know the employees have done the testing at whatever interval you wanted to do the testing. The default setting for that is seven days, but that could be modified.
Madrigal: Take my kids’ school as an example. It wants to do rapid testing. How would the school go about getting your tests and doing this testing? How would it actually work?
Read: Why can’t we just have class outside?
Hackett: We at Abbott do testing of critical staff. This is the sort of thing that can be set up. You need some health-care providers and to figure out what is the interval of testing that would achieve what your goal is overall or what you think is appropriate. Then it is really just organization. Again, I think that’s where the Navica app would be a real plus. If you went into a school building, they could just check; it would be like a boarding pass. And if, unfortunately, you were positive, you’d get a message to quarantine and see your doctor.
Madrigal: But that sounds like broad screening to me, not diagnostic testing of someone with symptoms.
Hackett: Well, that comes back to the health-care provider. For this test, you still need, in essence, a prescription, saying that these individuals are suspected or they have symptoms. This test, the indication is for seven days or less after the onset of symptoms.
Madrigal: How do you improve a test like this? How do you take the basic components and say “This is how we’re going to get to this sensitivity and this specificity”?
Hackett: Well, this is a situation where, obviously in this outbreak, there has been very little time to react. We haven’t had the normal time frames that we would to develop tests like these. There was a tremendous amount of work that went into the process, every level of this.
What protein of the virus should we target? Then, looking at the reality in this format, during the extraction process off of the swab, you need to be able to separate the proteins that are part of that virus in order to be able to detect them. So would you choose spike or nuclear protein? What type of swab? Abbott’s got a long history of this in the infectious-disease area. You can go back to 1985; we had the first FDA-approved test for HIV. This is part of our history.