While the COVID-19 outbreak continues to rise in some countries, many others have successfully brought down the number of daily new cases and reproduction number. European countries have loosened the general lockdown, such as Germany, Spain, and UK. Gone together with the quarantine are the huge daily COVID-19 testing numbers.
On the contrary, testing remains one of the strongest measures to control new outbreaks. In this article, we show how the focus of COVID-19 diagnostics shifts from massive testing to more effective measurement and fast response. This will bring about a change in the type of diagnostic technologies used. Find a detailed comparison of different COVID-19 diagnostics technologies in the IDTechEx report "COVID-19 Diagnostics", from the perspective of technique advancement, performance, cost, availability and key suppliers.
The virus will be still among us for the long term in the absence of a vaccine. To prevent future large outbreaks and a second wave of national lockdown, early and quick diagnostics will become essential. Instead of massive testing, contact tracing and confinement of local outbreaks will be needed. In this way, testing methods that do not require extensive central lab equipment and that can be deployed at community settings will be more prominent in the market.
Reverse-transcription quantitative polymerase chain reaction (RT-qPCR) is the technology that has dominated and will continue to dominate the COVID-19 testing market in the outbreak due to its high reliability and large throughput. However, the centralised setting leads to long sample-to-answer time (24 hours to 6 days), mainly due to logistic problems and long testing time. This disadvantage is becoming a bottleneck in the new phase of COVID-19 testing.
This sets the scene for the growth of point-of-care molecular diagnostics (POC MDx) devices such as Abbott's ID now and Cepheid. In less than 30 minutes, the genetic material found in a sample can be amplified and detected in a printer-sized device. POC MDx is a premium solution to provide fast testing to new outbreaks and support a swift response to confine the spread of coronavirus. Although these POC technologies have lower sensitivity and specificity than the gold standard RT-qPCR, they prove a valuable resource in surveillance testing in the post-quarantine time. "COVID-19 Diagnostics", identifies key innovations and technology trends currently being developed in the diagnostics ecosystem that will enable quick and sensitive diagnosis of COVID-19 at point-of-care settings.
Figure: some of the POC MDx devices for COVID-19 diagnostics. More details can be found in the IDTechEx report, "COVID-19 Diagnostics".
Another trend IDTechEx predicts is the fast adoption of Serological tests, which indicate the presence of antibodies against the virus. Serological tests are of importance for assessing the severity of outbreaks and obtaining valuable epidemiological data. Rapid lateral flow assays (LFAs) that resemble "pregnancy tests" have had issues of low sensitivity and specificity. As the pandemic gets under control, the demand for more accurate serological test will be higher. In this context, accurate immunoassays, such as ELISA or chemoimmunoassay, will be more relevant as opposed to traditional lateral flow assays. Although many of them will require large equipment or even a laboratory setting, high sensitivity and specificity will be the key driver for the adoption.
Figure: various serological testing devices. IDTechEx predict a growing market for the immunoassay devices as the high sensitivity and specificity is becoming dominate consideration. More details can be found in the IDTechEx report, "COVID-19 Diagnostics". Source: IDTechEx
We have seen a faster than expected development of diagnostics technologies, such as CRISPR based POC MDx, DNA sequencing as diagnostics protocol and a hybrid system combining amplification with various detection methods. The transfer of technology from R&D to commercial devices has been accelerated from years to only a couple of months. The IDTechEx report, "COVID-19 Diagnostics", provides a comprehensive analysis of and deep insights into the technology evolution. Furthermore, this report highlights the bottleneck for the testing and identifies the promising technologies for the years to come.