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WHO Will Provide Rapid COVID-19 Tests for Lower-Income Countries
By Alexander Freund
The World Health Organization, along with its global partners in the fight against the COVID-19 pandemic, has announced that it will provide 120 million rapid-diagnostic antigen tests to people in lower- and middle-income countries over the next six months. The tests represent a "massive increase" in testing worldwide, according to the Global Fund, a partnership that works to end epidemics.
"We have an agreement, we have seed funding and now we need the full amount of funds to buy these tests," said WHO Director-General Tedros Adhanom Ghebreyesus on Monday, without providing further details. The program will initially require $600 million and is planned to start as early as October.
This mass testing campaign is part of a global initiative launched in April by the WHO, the European Commission, the Bill & Melinda Gates Foundation and the French government. Additional partner organizations include the Global Fund, the Africa Centers for Disease Control and Prevention, the Clinton Health Access Initiative, the Foundation for Innovative New Diagnostics (FIND) and Unitaid.
The test manufacturers, South Korea's SD BioSensor and U.S.-based Abbott Laboratories, have agreed to provide 20% of their test kits to lower- and middle-income countries. The remainder will be made available to wealthier nations, some of whom are helping to finance the test drive. Germany, for example, has already ordered some 20 million test kits.
Quick Test Can Break Infection Chains
"These tests provide reliable results in approximately 15 to 30 minutes, rather than hours or days, at a lower price with less sophisticated equipment," said WHO head Tedros, adding that the tests would cost as little as $5 each, and could become cheaper still. He said the rapid tests would help expand testing to hard-to-reach areas which aren't as well-equipped, or which are lacking trained health workers.
"High-quality rapid tests show us where the virus is hiding, which is key to quickly tracing and isolating contacts and breaking the chains of transmission," said Tedros. "The tests are a critical tool for governments as they look to reopen economies and ultimately save both lives and livelihoods."
Catharina Boehme, head of FIND, also welcomed the widespread rollout of cheap test kits. "This really shows what can be achieved when the world and leading global health partners come together with a common priority," she said.
How Do COVID-19 Antigen Tests Work?
There are currently three different types of coronavirus diagnostic tests on the market: antigen tests, polymerase chain reaction (PCR) tests and serology tests (ELISA).
Rapid antigen tests target virus proteins, and somewhat resemble pregnancy tests. They aren't yet available at pharmacies and can only be administered by trained medical personnel. With a nasal or throat swab, testers can find out within approximately 15 minutes whether a patient has contracted the SARS-CoV-2 virus and is infectious and must be quarantined.
The advantage of rapid antigen tests is that they can be conducted quickly and on the spot.
It's hoped that this will help save the lives of thousands of people and slow the spread of the pandemic in the world's poorest countries. Rapid antigen tests can be used to carry out mass screenings among health care workers in low-income countries, who are at greater risk of death from COVID-19. These tests could also be used in schools, in the workplace and in nursing and retirement homes.
The major disadvantage of rapid antigen tests is that they're less reliable than PCR tests, which are conducted in labs and designed to detect the virus' genetic material. Rapid antigen tests may also be less effective in detecting infections in the early stages.
Still, a growing number of medical experts are backing the mass rollout of antigen tests, as they allow infected people to be identified even before they show symptoms, when individuals have a high viral load and are especially infectious.
Not All Rapid Test Kits Are Reliable
Hundreds of rapid COVID-19 test kits have come on the market recently. Many of them are reliable, but not all. In March, for example, Spain sent back two batches of unlicensed Chinese test kits because they were flawed.
The European Center for Disease Prevention and Control has pointed out that even though many tests have been approved for sale on the European market, very few clinical studies show whether they are actually effective.
The 120 million test kits set to be rolled out by the WHO are the first to meet all of the organization's standards; test makers SD BioSensor and Abbott were granted emergency approval by the WHO last week.
The manufacturers claim their tests are up to 97% reliable in lab conditions; in the real world, the tests are said to be between 80% and 90% reliable. While this is good, it also means some 20% of patients will receive negative results despite being infected, which could lead to further spread of the virus.
What Are the Alternatives to Antigen Tests?
Rapid antigen tests are ideal to test scores of patients quickly, simply and cheaply. Lab-based PCR tests, however, are superior in terms of reliability.
The PCR test detects genetic material, or RNA, from the SARS-CoV-2 virus. Patients are asked to provide a throat swab. One part of the person's genetic material is then synthesized, after which a biochemical process known as agarose gel electrophoresis is used to detect if the sample contains virus RNA. These tests are highly reliable but can only be conducted in specialized labs.
Serologic testing, on the other hand, detects antibodies in a person's blood that form when the immune system responds to a certain pathogen. This indicates that a person has already been exposed to the virus. While quick test kits are available for this method, these are mainly used for scientific studies.
Reposted with permission from Deutsche Welle.
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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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