Surrender, Accommodation and RATs

Dr. Binoy Kampmark

Dr. Binoy Kampmark

The polymerase chain reaction (PCR) test has been the mainstay of COVID-19 testing.  But reliance upon such a regime, which requires the administration of middlingly competent personnel at appropriate testing sites, has caused its fair share of global disruption. 

The dreaded queue, where one waits for hours only to be possibly turned away for capacity reasons, is one such manifestation.  During this latest phase of COVID-19 infections – that of Omicron – these human lines have spawned with inexorable force.  In Australia, where the queue is worshipped by the country’s good burghers, something near a paralysis is being experienced in terms of time taken to do the test, await the result and be in isolation.

Omicron’s arrival on the virology scene has caused a shift in public health strategy across numerous countries.  As the Washington Post remarks, the world’s nations “are making a subtle but consequential pivot in their war against the coronavirus: Crushing the virus is no longer the strategy.  Many countries are just hoping for a draw.”  Zero-covid strategists still lurk, but they are mainly found in the halls of power in Beijing, which still insists that cities can be locked down with violent spontaneity.

The popular mantra now is that of living with SARS-CoV-2, as if it were a difficult neighbour prone to throwing rubbish over the fence from time to time or steal low hanging fruit.  There will be difficulties; there will be disputes.  The nastier effects will be ameliorated, or at the very least moderated.

This was certainly the long-held approach of the financially minded policy makers, who tended to see public health in terms of tolerable deaths (if the elderly shuffle off the mortal coil, that’s no great loss, their time having come) and tolerable, self-assessed risk.  The Swedish model became something of an exemplar on this, keeping some restrictions in place while permitting the society and economy to remain, for the most part, open. 

Many European states also adopted such a policy by stealth, even before the advent of vaccines.  In September 2020, bioethicist Effy Vayena of ETH Zurich noticed “a big shift in focus.  What we’re seeing now in Switzerland is people getting used to the idea of living in a risk society.  We’re asking: ‘how do we live with this?’”

The arrival of vaccines added impetus to arguments from market planners and open society preachers that the shackles had to be removed, and the virus, to some degree, received with caution.  Finally, there was a viral exit strategy.  There was just one problem: no COVID-19 vaccine guarantees immunity.  Infections and transmissibility remain realities.

While the easing of the clenched fist in response to COVID-19 is hard to dismiss given the mind-numbing exhaustion and enervation of lockdowns and social restrictions since the early part of 2020, complacency remains the most looming threat: letting down one’s guard, abandoning the prudence of sanitation, the wearing of masks, or physically distancing. 

For Maria Van Kerkhove, an epidemiologist at the World Health Organization, the issue is almost melodramatically clear.  “This notion of learning to live with it, to me, has always meant a surrendering, a giving up.”  Angela Rasmussen, a virologist based at the University of Saskatchewan, also looks at the issue in terms of battles and games.  “I understand the temptation to say, ‘I give up, it’s too much.’  Two years is a lot.  Everybody’s sick of it.  I hate this.  But it doesn’t mean actually the game is lost.”

In Australia, the government, as part of its philosophy of making people more tolerant of the virus, is pressing for a more flexible testing regime regarding COVID-19.  The flawed, somewhat presumptuous practice of relying on people to be independent and sound on the issue of their health, has become popular.  Leave it to them, for instance, to conduct their own COVID-19 tests at home with unnerving accuracy.

Sociologist Alan Peterson is rather gloomy about the whole shift of responsibility from barely competent State to the overly burdened citizenry.  “Making individuals responsible for testing (or ‘home-testing’) with RATs [rapid antigen tests], with little knowledge of when best and how to test, and the limitations of testing, leaves much scope for interpretation and error.”

The effectiveness of RATs, notably on the issue of picking up traces of Omicron, has also become a source of unwanted excitement.  The US Food and Drug Administration did much to stir the pot with a statement released at the end of last December: “Early data suggests that antigen tests do detect the omicron variant but may have reduced sensitivity.”

With such hope vested in rapid antigen tests, there has been a run on the market.  As with the initial problems with acquiring adequate mask fittings, supplies are snapped up at a moment’s notice.  There have been price hikes of such order as to concern the Australian Competition and Consumer Commission (ACCC), with RATs retailing anywhere from AU$20 to $30 to an extortionate $AU70.  (The wholesale costs for the tests range from $AU3.95 to AU$11.45.)

In the United States, that hefty bosom of private enterprise, money is being made on bogus at-home testing kits.  The FDA warned this month that “fake and unauthorized at-home testing kits are popping up online as opportunistic scammers take advantage of a spike in demand.”

Certain countries have averted that problem by imposing price caps and providing RATs gratis to the populace in massive numbers, but Australia, where a certain predatory will to extort the highest price for the most menial service reigns, the matter is more muddled.  Hope can prove costly.

Dr. Binoy Kampmark was a Commonwealth Scholar at Selwyn College, Cambridge.  He lectures at RMIT University, Melbourne.  Email: bkampmark@gmail.com

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