OPINION

Dr. Marc Siegel: Rapid testing and antiviral drugs may offer way out of COVID pandemic

Vaccines, rapid COVID tests and access to the emerging antiviral treatments like molnupiravir will provide us with a clear path out of the pandemic.

Dr. Marc Siegel
Opinion columnist

Masks are a final useful barrier against the spread of a highly contagious respiratory virus like SARS-CoV-2, but their effectiveness is limited, especially when there is a lot of virus around. 

The best way to limit spread with the easily transmitted variants is not masks alone; it is a high rate of vaccination combined with home testing with rapid antigen tests.

If you never go out of the house carrying the coronavirus in the first place, you won't be able to spread it, mask or no mask. If you find out you have it early enough, you can avoid spreading it to others. This is a basic principle of public health.

This ramped up testing approach may soon be combined with the early use of antiviral drugs. The promising new antiviral drugs in later stage clinical trials by Pfizer and Merck with Ridgeback Biotherapeutics (molnupiravir data in late stage trials of 775 patients shows it decreases hospitalization and death by 50%) will likely receive emergency use authorization in coming weeks. The drugs will be even more effective the earlier in the disease process they are given. 

New treatments target spread of virus

This is a major breakthrough. We have finally reached the point of developing small molecule treatments that target specific mechanisms of action of the virus itself, rather than having to rely on other treatments that were developed for other diseases or injecting convalescent or synthetic antibodies to target the virus once it is already spreading.

Keep in mind that this virus has two distinct phases, the replicating and spread of the virus itself, followed sometimes by a multisystem inflammation, especially in those most at risk, the elderly, the obese, those with diabetes, chronic heart and lung disease. 

The experimental antiviral drug molnupiravir on May 26, 2021.

At-home rapid testing can help diagnose COVID-19 when it is still asymptomatic or mildly symptomatic – before it has replicated to a great extent. Giving the new Merck pill at this point could help head off a more severe illness, much as Tamiflu does for flu.

The problem is that there is still a great shortage of rapid testing, and though the White House has said it is addressing it, it may take weeks for the supply to significantly increase. The standard PCR test often takes several hours or days to provide a result, and by then, spread has already occurred in many cases.

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I and others are calling for another Operation Warp Speed, this time for testing, a public/private partnership with the goal of providing rapid COVID-19 tests in every home in the country.

This should have been done many months ago and should still be done now. Test shortages have been too commonplace for months, and must be overcome by use of the Defense Production Act and the government’s pre-purchase of home tests for all, much as they did for vaccines.

The $3 billion the White House is spending for rapid tests, including $1.2 billion for Abbott Laboratories and Celltrion Inc., are still not sufficient.

The Food and Drug Administration's emergency use authorization of ACON Laboratories' Flowflex COVID-19 home test is a further step in the right direction of increasing supply and availability of an inexpensive rapid test, but it's still a long way away from getting a kit in every home. 

Home testing will limit spread  

People can test themselves before going to school or work, dramatically decreasing the chance that they have COVID-19 and don’t know it. Testing at home, with the results sent in instantaneously via a smartphone app, is the best way (combined with vaccines and serological tests for immunity) to keep schools and businesses open.

Antigen tests have not been found to have a high false positive rate, meaning if you test positive, it is likely that you really have COVID-19. This approach will help limit the increasing number of breakthrough cases with an effective but not perfect vaccine.

Marc Siegel:Stop shaming people over masks. Focus on COVID vaccines and testing.

The path out of the pandemic is clear. Vaccinate a very high percentage of the population, by whatever means necessary including mandates, and combine this with a rapid test for COVID-19 in every home, as well as easy access to the emerging antiviral treatments, beginning with molnupiravir.

Mask wearing is useful, but it doesn’t take the place of knowing you have the virus, or have come in close contact with it.

Dr. Marc Siegel, a member of USA TODAY's Board of Contributors and a Fox News medical correspondent, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. His latest book, "COVID: the Politics of Fear and the Power of Science," was published last fall. Follow him on Twitter: @DrMarcSiegel