Researchers at the University of Chicago Medicine and the University of Illinois at Chicago (UIC) are launching an investigational study to determine the effects of increased education and access to rapid, FDA-approved COVID-19 testing on community perceptions, access, and use of COVID-19 testing resources.
The study will be funded by $2M in support from the National Institutes for Health RADx-UP program. A part of the Rapid Acceleration of Diagnostics (RADx) initiative, the RADx Underserved Populations (RADx-UP) program supports research that aims to better understand COVID-19 testing patterns among underserved and vulnerable populations; strengthen the data on disparities in infection rates, disease progression and outcomes; and develop strategies to reduce the disparities in COVID-19 testing.
The research will be led by Ayman Al-Hendy, MD, professor of obstetrics and gynecology at UChicago Medicine, and Renee Taylor, PhD, professor of occupational therapy and Nahed Ismail MD, PhD, D(ABMM), D(ABMLI), professor of pathology and medical director of clinical microbiology at the University of Illinois at Chicago. The investigators plan to leverage existing university-community partnerships and expertise in clinical microbiology, community engagement, and epidemiological infrastructures to expand access to rapid COVID-19 testing.
“There are testing deserts in Chicago, where many people don’t have easy or affordable access to testing,” said Taylor. “We can reach individuals who maybe don’t have health insurance or are concerned about having a COVID-19 test on their medical record and provide them with an easy and private opportunity to get tested.”
The project includes collaboration with community members to co-create advertisements to recruit other participants into the trial as well as a mobile health web app, called the mHealth Literacy and Outreach Suite, that will allow individuals to not only privately order testing, but also learn how to prevent the spread of COVID-19 and care for themselves if they fall ill.
Investigators are also sending out kits so participants can collect their own samples and send them to be tested at UIC. Sample collection can be performed rapidly at home with a nasal swab, without the discomfort of the typical nasopharyngeal swab, before sending the sample to the central lab for testing.
The team hopes that the privacy offered by these options, as well as the community advocacy, will help improve the public perception of receiving a COVID-19 test.
“Many people don’t trust the test, are concerned about the expense, or are worried that they’ll be forced out of work or forced to isolate if they have a positive test, which is creating a lot of stigma,” said Ismail. “We need to expand our testing in a community setting where people have some privacy, and the mHealth Suite provides that, as well as overcoming issues of cost.”
Al-Hendy credits the skills of the interdisciplinary team and their pooled community networks for making this collaborative effort possible. “The collaboration between UIC and UChicago Medicine will allow this project to reach many underserved populations,” he said. “Our two institutions already both have robust relationships within our local communities, which will help expand the
“No testing scheme, no test is perfect. There will always be people who go undetected,” said Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins University who has researched and written about herd immunity. “The best way to protect the most vulnerable is to reduce the amount of virus that’s in the population that can get through all of those testing schemes and cause destruction.”
Dr. Atlas’s position has been challenged by medical advisers around him who have backgrounds in infectious disease response, revealing a significant rift in the White House over the right approach. Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, has pushed for aggressive, broad testing even among young and healthy people, often clashing with Dr. Atlas in meetings.
“I would always be happy if we had 100 percent of students tested weekly,” Dr. Birx said on Wednesday in an appearance at Penn State University, “because I think testing changes behavior.”
Dr. Atlas at one point influenced the administration’s efforts to install new Centers for Disease Control and Prevention guidance that said it was not necessary to test people without symptoms of Covid-19 even if they had been exposed to the virus, upsetting Dr. Birx and Dr. Robert R. Redfield, the C.D.C. director.
The administration’s efforts to fund federal and state testing have long been fraught. In July, as administration officials and top Senate Republicans clashed over the contours of their initial $1 trillion proposal, the White House initially balked at providing billions of dollars to fund coronavirus testing and help federal health agencies.
Since the early days of the pandemic, Mr. Romer has argued for a wide-scale testing program, costing as much as $100 billion. He had hoped to persuade Dr. Atlas that if officials could quickly identify and isolate people carrying the virus, they would slow its spread and allow normal economic activity to resume more quickly.
In his email, sent to Dr. Atlas’s personal account, Mr. Romer proposed additional testing and isolation efforts that could allow far more Americans to return to work and shopping, generating economic activity that would be 10 or 100 times larger than the cost of the testing program itself.