Fischhoff co-authors NASEM report on self-tests for infectious diseases

Engineering and Public Policy Professor Baruch Fischhoff co-authored a new NASEM Health and Medicine report, "Rapid Expert Consultation on Self-Tests for Infectious Diseases: Lessons Learned from COVID-19."

The COVID-19 pandemic self-testing experience has shown some great successes, which are a tribute to the hard work of individuals at all stages in the development, manufacture, regulation, distribution, and uptake processes. However, it has also demonstrated notable challenges, many arising from the lack of a proactive and comprehensive strategy, with the feedback and flexibility needed for adaptive management as the disease, diagnostic tests, and public opinion evolved. 

The newly released rapid expert consultation summarizes the lessons learned from the COVID-19 pandemic for the future development and usage of self-tests for circulating infectious diseases and future outbreaks and pandemics.

Self-tests emerged as a critical public health tool in combatting the COVID-19 pandemic, providing individuals with greater ability to track their health status and mitigate the spread of an infectious disease (Crozier et al., 2021). Self-tests provided benefits to health care and public health systems by reducing pressure on those systems and in some cases, allowed for re-opening of schools, businesses, and workplaces. However, challenges remain. There are difficulties with ensuring equitable access to self-tests and linking positive results to health care quickly, including equitable access to treatment options. There are difficulties ensuring that individuals can administer self-tests and interpret their results. Additionally, there are barriers (e.g., lack of plans, processes, and funding) in conveying test results to public health officials, and with supporting the manufacturing bases needed to provide self-tests for a pandemic or infectious disease event with fluctuating demand and an evolving pathogen.

Based on experiences with SARS-CoV-2 self-tests, the authors have identified the following considerations as critical to strategic planning for self-tests for infectious diseases and future outbreaks and pandemics. Planning is needed to take full advantage of the expected progress in diagnostic technologies for self-tests, including antigen, molecular, and multi-pathogen tests, in terms of the performance, timeliness, simplicity, scalability, costs, and availability of self-tests (ECDC, 2021). Planning should also consider the interdependent needs of individuals, communities, and health care systems for effective, equitable, and efficient delivery (Wong et al., 2019). 

To learn more, read the full report.