Access to accurate diagnostic testing is a key step in identifying clinical illnesses in the community and directing high-risk patients toward appropriate therapies for infections such as COVID-19, influenza and other pathogens. The COVID-19 diagnostic landscape changed rapidly throughout the pandemic, evolving from scarce polymerase chain reaction-based testing in health care settings to widely available antigen-based testing often performed at home. These tests differed in sensitivity, cost, turnaround time and ultimate clinical application.
The future of testing for COVID-19 and other viral syndromes is challenging to predict given advances in technology as well as the changing use cases and regulatory landscape for community diagnostic testing. Rapid point-of-care testing, however, remains one promising frontier following the success and scale of use during the COVID-19 pandemic, particularly the potential for multiplex testing of pathogens for which there are established monitoring and treatment paradigms.
Indeed, two point-of-care multiplex antigen-based technologies are already FDA Emergency Use Authorized to detect both influenza and SARS-CoV-2 using nasal swabs. An additional promising strategy includes investment in flexible diagnostic platforms that contain an efficient core technology that permits “switching out” of pathogen probes to target new threats to health as they emerge in relative real time; this strategy has practical applications for pandemic preparedness.
Overall, novel approaches to infectious disease diagnostics will likely play an important role in monitoring and combating future disease outbreaks and pandemic events (G7 Pandemic Preparedness Partnership, June 2021; Chu, July 2020). Across these efforts, many institutions and policymakers have also emphasized a need to assure equity and affordability of testing among at-risk communities to mitigate infectious diseases-related health disparities (Ost, November 2021; Batista, December 2021; RADx, October 2022; Emanuel, May 2020).