False-negatives & distrust of science

Earlier this year (pre-COVID-19), some colleagues and I wrote an article [A_new_era_for_food_safety_tests], where we raised concerns about how improperly validated consumer diagnostics could lead to a distrust of science. We were (and still are) concerned that any non-compliant or false-negative results could lead to ‘‘unwarranted scares on social media platforms’’.

For those who are unaware, a false negative is what it sounds like – when a positive test generates a negative result. For food safety, false negatives could lead to people consuming foods that are not safe to eat. This is why when we develop immunochemical assays, we extensively validate them. Really, any false-negative rate above 5% makes a test unsuitable for consumer testing.

In recent months, mass consumer-testing has been hotly debated with many speculating that on-site, home-testing is the only way we will be able to safely return to pre-COVID activities1. Scientists have had to develop diagnostics for COVID in record time, under immense global pressure, leading to some less than optimal assays with up to 30% false-negative rates2. Inevitably, this has further fueled the public’s general distrust of science3. Which, in turn, has led to a spread of misinformation causing (as predicted) unwarranted scares on social media platforms. This is obviously not good considering the growing trend of anti-science movements (e.g., anti-vaxxers, climate deniers, flat earthers, etc.)4.

I personally find this distrust incredibly frustrating. Especially when considering just how groundbreaking a properly validated, inexpensive, consumer diagnostic for COVID-19 could be. If we imagine the consumer diagnostics situation through the lens of smartphone testing, the benefits are immediately visible. A simple app could guide the consumer on how to perform the nasal swab test and how to analyze the result by recording it with the smartphone camera. The consumer would then be able to transmit their findings to relevant healthcare providers – getting a positive or negative result, without ever having to leave their home. It is even easy to envision how such an app could be combined with the infamous track and trace app allowing for truly decentralized and result based testing. It would also be possible to have face to face contact with healthcare providers without having to visit a doctor/hospital. Now, that is what I call social distancing.

I think it is crucial we do not dismiss these rapid consumer diagnostics so, well – rapidly.

 

(1)        Ramdas, K.; Darzi, A.; Jain, S. ‘Test, Re-Test, Re-Test’: Using Inaccurate Tests to Greatly Increase the Accuracy of COVID-19 Testing. Nature Medicine 2020, 26 (6), 810–811. https://doi.org/10.1038/s41591-020-0891-7.

(2)        Ghebreyesus, T. A.; Swaminathan, S. Scientists Are Sprinting to Outpace the Novel Coronavirus. The Lancet 2020, 395 (10226), 762–764. https://doi.org/10.1016/S0140-6736(20)30420-7.

(3)        Zastrow, M. Coronavirus Contact-Tracing Apps: Can They Slow the Spread of COVID-19? Nature 2020. https://doi.org/10.1038/d41586-020-01514-2.

(4)        Hotez, P. J. Combating Antiscience: Are We Preparing for the 2020s? PLOS Biology 2020, 18 (3), e3000683. https://doi.org/10.1371/journal.pbio.3000683.

 

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