Michael Mina: Rapid COVID Testing | Lex Fridman Podcast #235

The following is a conversation with Michael Mina, his second time on the podcast. He's a professor at Harvard doing research on infectious disease and immunology. In my view, the most powerful, doable, and obvious solution to COVID-19 from the very beginning is rapid at-home testing. This is what Michael has been talking about and writing about since the beginning of the pandemic. The accuracy of these tests is high for the task of detecting contagiousness, which is what matters. Hundreds of millions can be manufactured quickly and relatively cheaply, privacy and individual freedoms are preserved. I believe that if you give people the power of information, information about whether they are contagious or not, they will do the right thing, at scale, all while respecting their freedom and minimizing the destructive effects of the pandemic on our health and our economy. This solution was obvious in May of 2020. It was obvious when Michael and I spoke the first time a year ago, and it is obvious today. We talk about why it has not yet been done and how we can still do it. This is the Lex Fridman Podcast. To support it, please check out our sponsors in the description. And now, here's my conversation with Michael Mina. We spoke a year ago about rapid at-home testing, and I think, you think, it should have been, still should be a big part of the solution to COVID. So let's recap. Where do things stand today in terms of rapid at-home testing?

Well, (laughs) it's, uh, it's certainly something that, uh, you're right. I do think we should have them today. We've now had almost 20 months of living in anxiety, uncertainty, uh, being afraid for our health, for our family's health, for our friends', you know, shutdowns, economic instability. Everything has been uncertain because of this virus. And then there's this little test, and it's the first time for many people that they are, they're using it and they're feeling empowered. They're feeling like they can control their little slice of this pandemic. So as these tests have come out and more and more and more Americans have had an opportunity to go and buy them from, you know, CVS or Walgreens or wherever they're at, I think that it's really shifting the tenor of the discussion. For a long time, all of 2020, it was like, I often felt like it was me and a few other people against the world, you know?

Mm-hmm.

These tests should be public health tools. These tests are infectiousness indicators. They shouldn't be compared to PCR. You know, all of the, these different things, and we could of course go through and recap (laughs) what those, what the benefits and the, and the, and the metrics are that we should be looking at. But the point is, last year and most of this year was about educating scientists, educating public health leaders, educating physicians to get them to understand that there is a different reason to test in a pandemic than purely diagnostics, and transmission blockade and severing transmission chain is the big one. So now I think we're at a point where people are now understanding. And they're understanding because they are feeling it, they're holding it, and they're doing it and they're seeing, they're feeling the delight of seeing a negative and saying, "I feel more comfortable. It's not perfect, but it's pretty darn close to perfect to allowing me to go and see my mom without mistakenly infecting her." You know, or whatever the story might be. And now that that's happening, I think all of a sudden we're seeing a massive change, uh, politically for these tests. Uh, Biden just came out with the COVID-19 action plan the other day, and one of the main pillars of it was testing, and in particular bringing rapid tests, uh, scaling them up. So on that front, I think finally there is success. People are actually understanding. And, you know, I haven't stopped beating this drum for far too long, and I, like, hate rapid tests now. (laughs)