Gov. Larry Hogan said Thursday that Maryland would be the first in a 10-state compact to buy large batches of a new kind of rapid coronavirus test for use in nursing homes, prisons and possibly college dorms and other places prone to outbreaks.
The purchase of 250,000 rapid antigen tests, at $30 a test, would be paid for with a grant from the U.S. Centers for Disease Control and Prevention. The tests will not replace the slower, but more accurate, molecular tests available to the public at sites around Maryland.
But the tests would help the state stay on top of the pandemic by quickly — in about 15 minutes — alerting authorities to outbreaks in congregate living facilities, poultry plants, schools and other places.
“This state-of-the-art rapid testing will be critically important to our continued economic recovery and will also help to keep the people of our state safe,” the Republican governor said during the announcement at the Sparks location of Becton, Dickinson and Co., a global medical technology firm making the tests.
The announcement marks the first purchase by a state in the compact, which had announced it would negotiate with companies for the antigen tests and diagnostic machines needed for processing them.
Hogan said nearly all of the other states have signed letters of commitment to purchase the tests. The other compact members are Arkansas, Louisiana, Massachusetts, Michigan, North Carolina, Ohio, Rhode Island, Utah and Virginia.
The Becton, Dickinson test, the BD Veritor, has been touted as an improvement to other antigen tests, which have high rates of false negatives and positives. They often fail to detect the virus if the test is conducted too soon after infection.
Health experts recommend using the rapid antigen tests on people with symptoms, not for screening people without symptoms or those who need definitive results to go to work, such as health and emergency workers.
But Dennis Schrader, a Maryland deputy secretary of health, said the guidance on antigen tests is “evolving” and the tests have value in returning results quickly.
The governor said the tests will be put to use “as soon as we get the first supply, which I think is days away.”
“We’re anxious to get it implemented right away,” Hogan said.
Gigi Gronvall, a senior associate in the Johns Hopkins Center for Health Security, agreed there was value in quickly testing a lot of people, particularly in vulnerable congregate settings, even if the tests are imperfect.
“The real plus of them is not only the ease of use, but the speed,” she said. “It takes 15 minutes, which is a reasonable amount of time to ask someone to sit there and wait. Some of the testing delays for other kinds of tests, going on days or over a week, make them worse than useless because people go about their day and think they did due diligence and they could be spreading virus.”
Contrary to recent federal advice, Gronvall said, asymptomatic people should be tested because they can just as easily spread disease. For now, however, anyone with a negative antigen test should get retested with a molecular test, especially if they have symptoms or possible exposure.
Ideally to get everyone back to school and work, however, she said what’s needed is a cheap and accurate test that doesn’t require equipment, like “where people spit on a piece of paper and get an instant result.”
A test that could be done easily by individuals at home, like a pregnancy test, or at work or school would be best, said Dr. Georges Benjamin, executive director of the American Public Health Association.
He and Gronvall agreed prices would have to come way down. Gronvall said even $1 a test wouldn’t be sustainable for schools that need to test every student every week, for example.
For now, just more, and faster, testing will help contain the virus, said Benjamin, also a former Maryland health secretary.
He said the pubic will have to live with testing, as well as contact tracing and quarantining, to contain the spread of the coronavirus for the foreseeable future. Preventive measures, such as hand washing, masking and social distancing, also remain vital.
“Over time, those tests will become more plentiful and more reliable,” he said. “We’re not there yet, but we’re getting there.”
The new Veritor tests come as the state is allowing more rapid testing in doctors’ offices. More than 120 offices have said they would offer such tests. The state initially permitted six types of tests because they had emergency approval from the U.S. Food and Drug Administration.
The state has not decided how to account for results from any of these rapid tests or the new Veritor tests. Hogan said they would be reported but not added to the daily tally from 215 community testing sites displayed on the state’s pandemic website, coronavirus.maryland.gov.
Including them in the tally could mean a less accurate positivity rate, the percent of tests that are positive, he said.
Hogan was joined at Thursday’s news conference by Dr. Rajiv J. Shah, president of the Rockefeller Foundation, which is also part of the purchasing compact. The nonprofit organization has pushed for faster, cheaper tests to be made widely available, and pledged to spend $50 million on the effort.
“No one should have to choose between doing their job and doing their part to end this pandemic,” Shah said. “Beating back this pandemic requires a massive scale-up of rapid screening testing to 200 million a month.”
Rockefeller has been pushing for the United States to conduct 30 million tests weekly by this fall, when the seasonal flu is expected to emerge. The nation currently conducts only several million tests per week.
The foundation and the 10 states allied with the goal of buying half a million rapid antigen tests for each state. Hogan touted it as a first-of-its-kind cooperative purchasing agreement.
Hogan said it “made more sense” for the states to work together in negotiating test purchases, instead of competing, as was common in the early days of the pandemic when states scrambled to buy tests and protective equipment.
When the compact was announced in early August, Hogan said the group was in talks with Becton, Dickinson and Quidel Corp., two companies that have tests on the market that received emergency approval from the FDA.
Antigen tests look for a protein associated with the coronavirus and can return results within minutes. Conventional molecular tests detect the genetic material from the virus and take longer to analyze in the lab. While some conventional tests return results in one or two days, there were reports this summer of even longer waits as commercial labs got backed up with tests.
The quick return of results from antigen tests holds appeal in the effort to quickly identify and contain coronavirus infections.
The Veritor test involves taking a swab from a patient’s nose, mixing it in a solution and placing a few drops from the sample on a cartridge that’s read by a handheld machine.
A Becton, Dickinson team at Sparks performs quality control on some of the lots of Veritor tests. Local employees also helped coordinate the federal government’s purchase of 2,000 machines and 750,000 test kits this summer, company officials said.
The company has a goal of producing 12 million antigen tests kits per month by February.
“This test is very accurate,” said Dave Hickey, worldwide president of integrated diagnostic solutions at Becton, Dickinson. “This point-of-care test announced today is appropriate for mass screening of the population.”
