HIV self-testing has set a good precedent for at-home infectious disease diagnostic testing.
The fact that a successful at-home HIV diagnostic test has been on the market for some years will substantially simplify the development of future at-home diagnostics tests.
Although there are significant differences between HIV, pandemic influenza, and other infectious disease threats, companies developing tests to diagnose new infectious diseases will be able to study, learn from, and build on HIV self-testing learnings to bring new at-home diagnostic products to market.
The goal of at-home influenza testing is to improve antiviral prescribing and infection management.
There are currently no at-home diagnostic tests for seasonal influenza, but companies and healthcare stakeholders are eager to develop such. The present push for at-home influenza diagnostic testing is intended to increase infection control as well as antiviral prescribing—two critical areas of seasonal influenza response that deserve better. Antiviral prescribing is variable, not necessarily evidence-based, and frequently excludes persons who would benefit from them. Outpatient infection control is frequently insufficient, providing abundant opportunities for influenza spread. Potential patients may be able to lower their risk of becoming sick or infecting others in an outpatient environment by testing at home, hence reducing the force of influenza spread at the community level.
At-home influenza testing could help increase pandemic preparedness for COVID-19, influenza, and other viruses.
As at-home influenza diagnostic testing becomes available and enhances seasonal influenza response, the pandemic influenza response will benefit directly. Such tests will be able to detect novel influenza A strains, some of which may have pandemic potential or regional significance, while others will be novel to humans. The use of home influenza tests will improve antiviral prescribing, infection control recommendations, and diagnostic capabilities, all of which can be used to improve pandemic response. Furthermore, such technologies may be reasonably readily expanded to target other respiratory viruses with pandemic potential. This could be achieved by utilizing platform diagnostic devices or developing standalone diagnostic testing for new targets.
At-home diagnostic testing will confront obstacles in terms of public health, cost, and adoption.
The most significant obstacles to the success of at-home diagnostics may be the expense and public desire to use them. Developers must keep costs in mind and identify ways for third-party payers to cover some or all of the expenditures. If the prices are not too high, public acceptance and utilization are likely, particularly when access to clinical testing is limited, as it was during the initial wave of the COVID-19 pandemic.
