HHS Plan to Send Rapid Covid-19 Tests a Possible Game-Changer for Assisted Living

A new plan from the U.S. Dept. of Human Health and Services (HHS) to include private-pay assisted living providers in the allocation of Covid-19 antigen tests is a significant step in the right direction, according to some leaders in the senior living industry — even while there are still many unknowns about the effort.

HHS announced this week it plans to send rapid coronavirus test kits to assisted living communities across the country. If all goes according to plan, the government will begin sending the testing kits to states later this month, according to HHS Assistant Secretary for Health Admiral Brett Giroir. HHS plans to send its first shipments to areas hit by natural disasters, such as hurricane-damaged parts of Louisiana and western states affected by recent wildfires.

The federal government previously announced in late August it had ordered 150 million BinaxNOW Ag Card tests from Abbott Laboratories in a $750 million deal. The $5 test is administered using nasal swab, and is purportedly easier to administer than some previous tests. The test itself is about the size of a credit card, and shows results in about 15 minutes without needing any special equipment or training.

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The new BinaxNOW test is one of several rapid coronavirus antigen tests released in recent weeks and months. But many others need a special machine to read results, and those machines require more training to use.

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Potential ‘game-changer’

The announcement to distribute rapid coronavirus tests to assisted living providers is significant, given that private-pay assisted living providers haven’t received as much support as nursing homes have amid the coronavirus pandemic. And for Juniper Communities Founder and CEO Lynne Katzmann, it’s a sign that the federal government is now taking seriously the important role that senior living communities play in the fight against Covid-19.

“What this says to me is that the government now understands that Covid-19 has affected senior living and assisted living providers, even though we are a largely private-pay business,” Katzmann told Senior Housing News. “By testing and providing funding to assisted living, you keep people healthy, and therefore out of hospitals, and therefore lower the cost for the government as a whole.”

Major senior housing and care industry associations also applauded the announcement. The news comes as a significant boon for the senior living industry, which has had to grapple with long wait times on results on other Covid-19 tests, according to David Schless, president of the American Seniors Housing Association (ASHA).

“Screening for symptoms and testing that returns results in five to seven days offers little help in the face of this pandemic,” Schless told SHN. “HHS’ distribution of rapid testing kits that can deliver results in 15 minutes, without the need to be sent to a lab, will be a game-changer in the fight against Covid-19 entering our communities.”

And while there are still many unknowns regarding how HHS will distribute the tests, gaining access to rapid and accurate testing is “absolutely essential” for senior living communities, according to Argentum President and CEO James Balda.

“As we anticipate that antigen tests will increasingly become more widely available, a methodology for accessing, administering, and seeking reimbursement for testing will need to become more clear,” Balda told SHN. “We’ll continue having conversations with HHS to provide further education on what may be required for successful distribution among assisted living communities.”

LeadingAge, the association of non-profit senior service providers, also views the announcement as a welcome development. But, the organization said there are many details left to clarify, and sees antigen testing as just one of the crucial tools needed in the fight against Covid-19.

“We do not have many details as to how many of the tests will be directed to senior living communities, what criteria will be used to allocate the tests to providers, nor do we know the mechanism by which the tests will be delivered,” LeadingAge President and CEO Katie Smith Sloan told SHN. “We are in wait-and-see mode, and are eager to learn more.”

Added layer of safety

The new BinaxNOW tests are far less expensive and show results much faster than some previous Covid-19 tests, and a recent clinical study showed the tests carry a sensitivity of 97.1% and specificity of 98.5%. But senior living providers including Bloomfield, New Jersey-based Juniper and Columbus, Ohio-based nonprofit National Church Residences don’t plan to use the antigen tests as their only line of defense against the coronavirus.

“Depending on the reliability of the test, I think it could be beneficial,” National Church Residences Chief Medical Officer Dr. John Weigand told SHN. “But the jury is still out on that.”

Regarding implementing the tests, Weigand said the organization is still determining the best course of action. But he envisions a day when antigen tests can be used to quickly screen community visitors for Covid-19 or spot asymptomatic carriers of the disease.

“We’re going to have third, and fourth and fifth generations of these tests, and they’ll become cheaper, more plentiful, and hopefully, more accurate,” he said.

In Juniper’s case, the test will serve as an added layer of safety along with the more traditional Covid-19 testing. The company is working with Oakland, California-based Dascena on new and innovative ways to test for the disease, such as transitioning from a PCR nasal swab test to a cheek swab test, and processing samples using gene-editing technology CRISPR.

Juniper is also working with Dascena to develop algorithms that will determine who should get an antigen test, and under what circumstances the provider should use another kind of viral test.

“We’re going to layer antigen testing on it, but while utilizing data and analytics to determine the best way to administer that,” Katzmann said. “The combination of the two should allow us to use more antigen testing, which is a lot cheaper and quicker, but still maintain a sense of security regarding using a more accurate test when it’s appropriate to do so.”

Regarding distribution of the tests, Katzmann expects the government will prioritize providers in Covid-19 hotspots just as it did with similar aid for skilled nursing providers. It’s also not clear whether the federal government plans to send more rounds of testing kits in the future after the initial supply runs out.

“We don’t have enough supply for the demand, so I would not expect that this is going to solve all the problems right away,” Katzmann said. “But it’s heading in the right direction.”

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