Following a severe 2025 flu season, there are some clear lessons shaping how clinicians are preparing for the next cold and flu surge. Here, Tommy Hall, Director of US Sales, and Paul Kase, Chief Commercial Officer, from Lumos Diagnostics, discuss the new innovations changing respiratory care as we head into what’s set to be another busy season.
Looking back at the 2025–26 flu season, what were the biggest diagnostic challenges, and what lessons should laboratories take forward?
Tommy Hall: We’ve made considerable progress in diagnostics, particularly in delivering rapid, accurate information that helps clinicians make diagnoses and treatment decisions. However, there is still room for improvement.
Last year’s flu season demonstrated the need clearly. As more patients presented with acute respiratory illness, clinicians needed reliable results quickly, often while managing crowded waiting rooms and staffing shortages.
Rapid diagnosis supports what I call “test and treat”: understanding what is happening and acting during the same visit. This avoids waiting hours for results or sending patients home and contacting them later. The challenge is ensuring clinicians receive the right information soon enough to make an appropriate treatment decision while the patient is still there.
Paul Kase: In recent years, CLIA-waived rapid panel testing has expanded considerably at the point of care (POC). Developments that once might have taken years happened quickly, producing new tests for COVID-19 and influenza, combined COVID-19 and influenza diagnostics, and panels that also included respiratory syncytial virus. Some became available over the counter.
Many organizations entered an increasingly crowded market, often seeking to differentiate their panels by adding another antigen. That trend was particularly visible last year.
The unmet need remains, but introducing more tests is only part of the answer. The next step is ensuring that useful innovations are adopted where clinicians see patients and can use the results to guide decisions during the same visit.
Which diagnostic innovations are having the greatest impact on how respiratory infections are identified and managed?
PK: The market is much more familiar with and receptive to POC testing than it was six years ago. The COVID-19 pandemic accelerated innovation by creating an urgent need for tests that did not yet exist.
It also increased awareness among consumers and clinicians of the value of rapid, accurate results. In 2018 or early 2019, many people would not have understood what rapid POC testing meant. Today, the benefits of receiving reliable results within minutes are widely recognized.
The pandemic also expanded the over-the-counter market, creating a path from COVID-19 tests to combined COVID-19 and influenza tests and, later, panels that also detect respiratory syncytial virus.
This broader acceptance gives newer rapid diagnostics an opportunity to address other unmet needs, including acute respiratory illnesses.
That matters because respiratory conditions account for a substantial share of patient visits. The Health Care Cost Institute analyzed 73 million urgent care visits from 2018 to 2022 and found that respiratory symptoms and infections accounted for about 35 percent of visits in December 2022. When large numbers of patients arrive at practices and urgent care centers with overlapping symptoms, better testing can help clinicians manage those visits more effectively.
How is multiplex testing changing the way laboratories differentiate between influenza, respiratory syncytial virus, SARS-CoV-2, and bacterial respiratory infections?
TH: Panel testing has expanded substantially alongside the broader rapid testing market, improving the ability of laboratories and health care facilities to identify specific pathogens.
However, multiplex panels can only detect the pathogens they are designed to target. Host-response testing provides different information by helping clinicians initially distinguish between bacterial and nonbacterial infections. This may guide decisions about further pathogen-specific testing.
Panel testing remains important to patient care, but the two approaches can provide complementary diagnostic information.
PK: Whether it is a rapid, molecular, or other panel test, any diagnostic entering the market today must address three areas: clinical utility, operational efficiency, and health care economics.
A product that does not meet all three needs may struggle to gain adoption. As Tommy noted, these technologies are complementary rather than competitive. The aim is not for one test to replace another, but for each to provide useful information at the appropriate point in the diagnostic workflow.
How can newer diagnostics help clinicians distinguish bacterial from nonbacterial infections and support antimicrobial stewardship?
TH: Conversations with clinicians, nurses, and health care facilities show that distinguishing between bacterial and nonbacterial respiratory infections remains a challenge.
Patients may present with similar symptoms despite having different infections. Strep throat and influenza, for example, can share clinical features. Clinicians must distinguish between them quickly, particularly during respiratory illness season, when waiting rooms are crowded and consultation time is limited. Rapid diagnostics can help support these decisions during the patient visit.
Immediate results can also help clinicians explain why antibiotics may or may not be appropriate. A clinician can review the findings with the patient and clarify when the results do not indicate a bacterial infection requiring antibiotic treatment. This creates an opportunity to discuss appropriate antibiotic use and antimicrobial resistance.
Rapid testing can therefore support clinical decision-making, antimicrobial stewardship, and clearer communication with patients.
PK: There is a fundamental difference between ruling in and ruling out an infection. Antigen tests are generally used to identify a specific pathogen, while host-response tests can help rule out bacterial infection.
For our in-house test, this rule-out function is supported by a reported negative predictive value of 99 percent for bacterial infection. Clinicians can then use pathogen-specific tests if further testing is needed.
This distinction is particularly relevant in CLIA-waived settings, where ruling out bacterial infection may support antimicrobial stewardship and treatment decisions.
Host-response testing is not intended to replace panel or antigen tests. It can be used alongside existing rapid diagnostics to provide additional information and help guide the next stage of patient care.
What role will rapid and POC testing play during the 2026–27 flu season, and how should these approaches complement central laboratory testing?
PK: The key is to view rapid POC diagnostics as complementary rather than competitive. These tools can work alongside tests performed at the POC, in the central laboratory, or elsewhere in the diagnostic pathway. The aim is to provide useful information during the patient visit without disrupting workflows that already work well.
The coming respiratory season will likely bring further education, awareness, adoption, and data collection around newer point-of-care technologies.
TH: Rapid diagnostics continue to advance each year, and the 2026–27 influenza season is likely to follow that trend.
POC testing can give clinicians an initial indication of what may be causing a patient’s illness. When necessary, they can then proceed to broader panel testing or additional analysis in the central laboratory.
This stepwise approach – providing rapid results during the patient visit and further testing when needed – is likely to become an increasingly important part of the diagnostic pathway.
What can dual-biomarker tests tell a clinician that single-marker or pathogen-detection tests can’t, and where does that make the most difference in practice?
TH: C-reactive protein (CRP) and myxovirus resistance protein A (MxA) can each provide useful information about a patient’s immune response, but they offer a more complete picture when interpreted together.
CRP is a nonspecific marker of inflammation that may increase in both bacterial and viral infections. MxA is a host-response protein associated with viral infection. Assessing both biomarkers can therefore help clinicians distinguish between bacterial and nonbacterial infections.
The dual-biomarker approach combines two different biological signals to provide additional information about the likely cause of a patient’s illness.
PK: This approach may be particularly useful in CLIA-waived settings, including urgent care centers, where patients increasingly expect convenient services and rapid answers.
To meet this need, POC testing must provide both timely and accurate results. A dual-biomarker approach is intended to give clinicians reliable information quickly enough to support diagnostic and treatment decisions during the patient visit.
Looking beyond the coming season, which emerging diagnostic technologies have the greatest potential to transform respiratory care over the next few years?
PK: Innovation in rapid respiratory diagnostics is likely to continue because demand remains high. However, the broader opportunity is to identify unmet needs and determine where clinicians and patients still require better diagnostic information.
Host immune-response testing is one area in which further development is expected. Regardless of the technology, new diagnostics must meet regulatory and clinical requirements while also demonstrating clinical utility, operational efficiency, and value to the health care system to support adoption.
TH: Technologies that could improve care, particularly during respiratory illness season, must provide useful clinical information while fitting realistically into health care delivery.
A diagnostic may help clinicians manage patients more effectively, but it must also be affordable and practical for the facility using it. When these factors align, the technology may support respiratory care during influenza season and throughout the year.
This combination of clinical value and real-world practicality will be essential as new diagnostics enter routine care.
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