Direct-to-consumer testing has always been a contested topic – not just in pathology, but in medicine as a whole. The question of whether or not patients should have unlimited access to their own results is controversial on its own, but giving them the ability to choose and order their own tests is another matter entirely. It’s an issue that first reared its head as the cost of gene sequencing decreased; but now, perhaps unsurprisingly, another test is gaining traction: the over-the-counter COVID-19 test.
Around the world, health authorities are crying out for more testing. Surely increasing access can only be a good thing. Unfortunately, many direct-to-consumer tests have poor accuracy – and some are outright fakes. Every day, my spam filter catches at least one email offering to sell me a personal testing setup for the office. Several people in the UK have been arrested for selling fake COVID-19 test kits, including one that provided users with unlabeled hydrogen peroxide and potassium thiocyanate as mouth rinses. Worse yet, a “black market” has sprung up around fake COVID-19 test results, allowing people to evade quarantines and restrictions by providing a negative test result – without ever having taken a test at all.
The risks are uncountable. At best, consumers might not swab themselves correctly, potentially leading to false-negative results. At worst, they could be ingesting harmful chemicals, misusing resources intended for hospitals and legitimate laboratories, or even infecting dozens of contacts.
It’s possible that the ship has sailed on direct-to-consumer genetic testing. But is the same true of COVID-19? And – if not – what can we do to prevent its departure? The word of an expert carries a lot of weight. How can pathologists and laboratory medicine professionals contribute to the conversation and educate the general public on the dangers of illicit tests – and the value of legitimate ones?
Feel free to add your thoughts to the conversation – edit@thepathologist.com – and we’ll share them with the diagnostic medicine community.
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