Covid-19 rapid antigen tests need to be two things: cheap and convenient

My joy at seeing the introduction of rapid antigen tests into New Zealand’s Covid-19 tool kit turned into deflation last week.

While there’s a sigh of relief that I won’t be arrested for sending these tests to my own family, disappointment came in the fine print of the news story.

These rapid tests, giving a result in 15 minutes, will be available in pharmacies under the supervision of staff. Pardon?

I’m sure pharmacists around the country gulped in nervous anticipation and wondered what they should charge for this service or whether there’s an announcement of full funding coming. Time will tell.

Who will be allowed into a pharmacy to do a test?

Overseas, it’s generally travel testing that is carried out or unvaccinated people who require proof to enter an event or premises.

You have to swear on your life you are symptom-free and haven’t been in contact with anyone with Covid-19.

You can’t attend the pharmacy appointment without a list of boxes ticked.

We can only assume the New Zealand Government intends a similar regime, otherwise we need separate entrances and testing rooms for the symptomatic, with separation of staff.

Home testing is essential

I’m still in total disbelief that community surveillance using home antigen tests isn’t on the Government’s agenda. The whole point is to make testing second nature – something you do between peeling the spuds and watching the six o’clock news.

This week a friend of mine met 20 relatives and rented a country pile in the Forest of Dean, on the Welsh border. With Grandad in attendance along with teenagers, they all carried out 15-minute antigen tests at the start and end of their holiday. There was piece of mind everyone had a negative test before getting together.

Unfortunately in this example, a 14-year-old returned a positive result when she arrived home. No one will know if the antigen test failed pre-holiday or if a positive result was never going to occur until later (she had no symptoms). Neither matters.

The good news is surveillance testing caught it. Grandad will avoid the bridge club next week and take a PCR test along with the rest of the party. He’s double-jabbed and boosted, but this family still use surveillance. Any chain of transmission was stopped far sooner.

Cost plus convenience is the recipe

The inconvenience of a test centre or pharmacy is one barrier to testing, but the biggest factor is money. If these tests cost, there will be little uptake.

The Australians have introduced them in supermarkets. Good luck with that, the worried-wealthy will be the only segment captured.

The British give them away by the fist full at local pharmacies. The uptake is far better but comes at a great cost to the taxpayer – not as great as repeated lockdowns and wage subsidies though.

New Zealand at the very least should be making these free to under-18s and those with community services cards, alongside highly subsidised test kits in supermarkets and pharmacies.

Schools should have the ability to offer free testing at the start of each term and home testing encouraged weekly.

Just like any market or new product, consumers behave in a similar way. If you don’t break down the barriers of convenience and cost, we won’t get material cut through. There is no point making it free but having to turn up to a pharmacy. Charging via a supermarket is no better.

Event testing and travel testing can be run on a reasonable cost-plus-profit model, but community safety is different.

The barriers topple with scrutiny

I’ve seen all manner of excuses given in New Zealand to stall the discussion on wide surveillance.

The most worrying is we want as little disruption as possible to everyday life. Variants keep coming and every part of the community has to step up and test. It’s another net that protects the economy, jobs, schools, tourism and everyday freedoms. Detection is earlier, transmission lower.

Home tests can’t be recorded

They are in other countries, and it comes down to trust – like many parts of the Covid-19 model. The vast majority of people with a positive result want authorities to know and to check on them.

In the UK, the free home tests have a QR code to scan and report.

Swab invasiveness

The antigen tests I’ve done involve swishing your tonsils and then 10 swirls in one nostril. They explicitly say to only insert until resistance is met and there is no pain.

These are not brain scrapers and every teenager I know manages to grunt and carry them out regularly. This virus and its variants are ongoing, so now is the time to train our kids, and ourselves.

Less accuracy

This is a valid point. Education and experience over time results in people treating antigen tests with the right balance of caution.

There’s widespread acceptance in the UK that medical professionals get about 80 per cent accuracy, but the rest of us go as low as 50 per cent. They are not a silver bullet.

Repeat government messaging works: always get a PCR with symptoms or if you’re a close contact.

In my experience, many friends and their children have returned positive test results using antigen kits. They do capture another layer of cases.

The message to the Government is clear – revisit your stance on surveillance testing. Cost and convenience can’t be separated and will directly control behaviour and success.

With borders opening and new variants continuing, we must catch up and teach New Zealanders that surveillance is important.

Janine Starks is the author of moneytips.nz and can be contacted at moneytips.nz@gmail.com. She is a financial commentator with expertise in banking, personal finance and funds management.