Affordable, Self-Administered COVID-19 Tests Could Use Your Cell Phone
As the world continues to navigate the line between reopening and maintaining safety protocols to slow the spread of the coronavirus, rapid and accurate diagnostic screening remains critical to control the outbreak. New mobile-phone-based, self-administered COVID-19 tests being developed independently around the world could be a key breakthrough in making testing more widely available, especially in developing nations.
Point-of-care testing (POCT) involves the use of easily portable devices to carry out analytical testing outside of a central laboratory, in places like long-term care facilities, local clinics and patients' homes, a new study by the National Center for Biomedical Information said. POCT provides early and fast diagnostic results; when combined with microfluidic systems that can measure traces of diseases and infections based on small amounts of fluids with daily high sensitivity and speed, POCT can result in faster, more cost-effective diagnostic instruments that do not require any trained healthcare workers to administer them, the study reported. Smartphone-based microfluidic POCT uses personal mobile devices to carry out the whole analytical process using bodily fluids like saliva. Critically, this also will result in earlier diagnoses that can help slow the spread of diseases like COVID-19.
Recently, Rhoel Dinglasan, a University of Florida infectious diseases professor and his industry collaborators won second place in a national technology competition sponsored by the National Institutes of Health for a smartphone-based, rapid saliva test they developed that can be used to diagnose COVID-19, along with two other diseases of major global importance, malaria and anemia. The test adapted the team's existing mobile-based test for malaria to also test for anemia and COVID-19, explained Dinglasan in a University of Florida Health news release.
"This test will leverage existing technology to fill a pressing and unmet need in global public health by allowing us to differentiate between three diseases that can present similarly in terms of symptoms," Dinglasan said in the release. "As treatment and containment protocols differ for each disease, the proper diagnosis delivered in literally minutes could save lives."
Their solution is the CLIP-CAM, an adapter that attaches to a smartphone that fits a detection cassette, the release detailed. A saliva sample is self-collected and activated, and a droplet is put into the cassette. The camera flash is used to excite the detection system in the cassette, which can then be read by a smartphone app. Results are available in 15 minutes or less, Dinglasan said, the release reported.
He further explained the importance of quick diagnoses to the Gainesville Sun: "When we go out to work in these different countries, we need to differentiate when a person comes in, we need to know if it is COVID-19, malaria or anemia. Without that ability, how would we know if we should send this person home to quarantine because we think he has COVID-19? What if it is malaria? You need to give that child or adult anti-malaria drugs or they will die."
Similar prototyping is underway around the world. At the University of Utah, electrical and computer engineering professor Massood Tabib-Azar adapted the platform he used to detect the Zika virus to now detect COVID-19, reported BioSpace. His sensor can also test for the presence of the virus on surfaces like door handles or desks by brushing a swab on a surface and then onto the sensor, the news report said. Tabib-Azar is also exploring the potential of detecting COVID-19 in floating microscopic particles in enclosed spaces like an elevator.
The Utah sensor is reusable, because samples can be destroyed using a small electrical current to disintegrate viruses or saliva can be placed on a disposable sheet like a piece of paper put on top of the sensor, Tabib-Azar told BioSpace. His test is also designed to upload the results to a central server that can map out positive results in an area to give public health experts a better idea of where outbreak hotspots are, the report said.
"Mobile-based epidemic monitoring is nothing but a logical next step, because only the mobile devices that move with people can keep up with the contacts they make," Tabib-Azar said, speaking of related research in IEEE Access.
In Ontario, Canada, a third diagnostic prototype called Atlas hopes to use the same saliva-to-mobile-phone testing concept to make testing more widely available, from remote communities to front-line screening, reported HospiMedica.com. Atlas is designed as a single-use, disposable device that could deliver results in 20 minutes.
All three tests have received enough funding to get through the prototype phase. Additional support will help to quickly transform the design concepts into mass-produced products for global health.
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By Teri Schultz
Europe is in a panic over the second wave of COVID-19, with infection rates sky-rocketing and GDP plummeting. Belgium has just announced it will no longer test asymptomatic people, even if they've been in contact with someone who has the disease, because the backlog in processing is overwhelming. Other European countries are also struggling to keep up testing and tracing.
Meanwhile in a small cabin in Helsinki airport, for his preferred payment of a morsel of cat food, rescue dog Kossi needs just a few seconds to tell whether someone has coronavirus.
<div id="bfda0" class="rm-shortcode" data-rm-shortcode-id="c60b1a0dedbedbe5e0ce44284aff852f"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1308390775328251906" data-partner="rebelmouse"><div style="margin:1em 0">Covid-19 dogs started their work today at the Helsinki Airport at arrival hall 2B. Dogs have been trained to detect… https://t.co/nw4mrw6eJM</div> — Helsinki Airport (@Helsinki Airport)<a href="https://twitter.com/HelsinkiAirport/statuses/1308390775328251906">1600779644.0</a></blockquote></div><p>If it were left to Kossi and his pals, crowds of potential virus carriers could be cleared in a fraction of the time for a fraction of the cost with none of the physical discomfort that accompanies the current nasal swab test based on the polymerase chain reaction (PCR) method.</p>
No Human Nose Needed<p>A dog can sniff a cloth wiped on a wrist or neck and immediately identify if it comes from someone who has contracted the virus as much as five days before any symptoms appear which would lead a person to go into isolation. "A dog could easily save so so, so many lives," University of Helsinki veterinary researcher Anna Hielm-Bjorkman told DW, who says their testing has shown an accuracy level of nearly 100%.</p><p>It was originally her idea to see whether Kossi, a talented disease-detection dog, could redirect his skills in sniffing out mold, bedbugs and cancer to detecting the new virus just as it started to spread in Europe. "It took him seven minutes to figure out 'okay, this is what you want me to look out for," Hielm-Bjorkman said. "So that totally blew our minds."</p><p>Susanna Paavilainen, the executive director of the Wise Nose scent-detection foundation and the woman who saved Kossi from euthanasia in a Spanish shelter eight years ago, immediately started retraining her dogs to find the coronavirus.</p><p>Miina, who used to track a young girl's blood sugar levels by scent, quickly came on board, along with two others already working in disease detection. In all, they hope to train 15 dogs in the first phase.</p><p>Hielm-Bjorkman said once they discovered the new capabilities, while the normal academic procedure would be to test, publish and get peer-reviewed, their first instinct was to get the dogs into service. "[Researchers] who are actually publishing," she noted wryly, "are not at the airports."</p>
Wags, Not Wages<p>But for that, they needed permission and ideally, some funding. Vantaa Deputy Mayor Timo Aronkyto, who is also responsible for airport security, saw the benefit straight away. "It took me two minutes," he told DW.</p><p>However, his funding options were limited to about $390,000 total for the four-month pilot project aiming to prove that results from the dog tests are at least as accurate as the PCR test. Anyone who tests positive at the voluntary canine site is requested to go to the medical unit for confirmation.</p><p>The interest of Aronkyto, a trained physician, is rooted in both health and wealth. "Our testing at the airport costs more than 1 million [euros] (USD $1.2 million) a month at the moment," he said, explaining he expects that to go up to €3 million (USD. $3.5 million) per month in winter. "These dogs would be much cheaper," he pointed out.</p><p>He's optimistic support will grow as data from the current pilot project accumulates, explaining there is already work underway to change Finnish legislation so eventually sniffer dogs would have the same "authority" as customs dogs.</p><p>Aronkyto anticipates one animal performing both functions in the near future. He plans to continue this level of funding from his city budget into next year but that doesn't train new dogs nor expand the capacity beyond the four that split shifts currently at the airport, even as infection rates rise.</p>
Helsinki Hesitates<p>Notably, however, the Finnish government has not signaled it would like to pick up the program itself, despite a huge surge in publicity and, as Hielm-Bjorkman and Paavilainen emphasize, interest from other countries. Travelers have been eager to participate, waiting in line more than an hour at times.</p><p>Finnish ambassador in Ramallah, Palestine, Paivi Peltokoski, praised the experience after a recent trip but, apparently, her enthusiasm is not overly contagious.</p>
<div id="d9823" class="rm-shortcode" data-rm-shortcode-id="61d382f115fe66a44eb793d9ebee3d94"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1318564228450615299" data-partner="rebelmouse"><div style="margin:1em 0">I was tested negative by two #coronadogs upon arrival at the #Helsinki airport in #Finland. Later a medical test ve… https://t.co/cGlWQn8DJb</div> — Päivi Peltokoski (@Päivi Peltokoski)<a href="https://twitter.com/PaiviPeltokoski/statuses/1318564228450615299">1603205184.0</a></blockquote></div><p>"If the government would see this already as something that they would believe in," Hielm-Bjorkman said, she could envision training hundreds of dogs, stationing sniffers at concert halls or sports matches or elderly care homes. She adds there's a need for a "paradigm shift" for both medical professionals and the public.</p><p>Usually it's doctors telling patients if they're sick, she explained, and "here it's a dog handler."</p>
Little Political Will on German Project<p>This situation is not limited to Finland. In Germany researchers also <a href="https://www.dw.com/en/german-sniffer-dogs-show-promise-at-detecting-coronavirus/a-54300863" target="_blank" rel="noopener noreferrer">announced promising results</a> with canines <a href="https://www.dw.com/en/coronavirus-german-military-training-sniffer-dogs/a-54062180" target="_blank" rel="noopener noreferrer">detecting COVID-19</a>, but no dogs have been used anywhere so far. And then, says Professor Holger Volk of the University of Veterinary Medicine Hanover, there has been insufficient political will or funding to move the project forward, something he called "very troubling" especially with a resurgent infection rate.</p><p>"When we started this whole project, we we did it because we wanted to help to stop the pandemic," Volk told DW. "It's really has been a very frustrating ride. I have had a lot of naysayers in the whole process. If I wasn't a very determined person, having done a lot of research, I would have probably stopped it."</p><p>He agrees with Hielm-Bjorkman's assessment that "it's just not in the perception of doctors that dogs are able to do this precise work." But he also echoes her faith in the vast potential of their discovery. "If you had a dog who could sniff every day quickly your cohort of workers, for example," he said, "think about the impact. You could continue having a workplace."</p><p>Speaking of workplaces, Susanna Paavilainen is starting to think if Finland doesn't want to unleash the dogs' potential at home, she and Kossi might accept one of the many requests from all over the world to provide training. "We can move because Kossi likes warm weather," she says, petting her star sniffer.</p>
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