The shortage of coronavirus testing kits in the United States has quickly come to the surface as the virus continues to spread. However, several industry players are racing to get tests out to the public. This week EverlyWell and Nurx have emerged as two of the leaders in the COVID-19 take-home testing space.

On Monday consumer healthcare business EverlyWell will be launching an at-home testing kit for COVID-19. This development is poised to give the United States an additional 30,000 tests.

The company is offering consumers the test at cost ($135), with no profit to the company. It noted that it will be covered by HSA and FSA providers.

Users will get the kit delivered to their homes, and will include sample-collection tools and shipping materials.

Users will get the test results digitally within a 48-hour window. If the results are positive, users can tap into a telemedicine consult with a board-certified doctor from PWN health. All positive results will be communicated to mandated federal and state reporting agencies.

The effort started when EverlyWell announced a $1 million development incentive for labs to prioritize the development of COVID-19 diagnostic tests.

This isn't the only at-home testing service we are seeing dive into the testing space. Nurx, which is best known for its at home STI-testing, is teaming up with Molecular Testing Labs and plan on launching a telehealth consultation and home-testing service "within the week."

Similar to EverlyWell, Nurx and Molecular plan on overnighting the test to patients, who can collect samples and send back their results in prepaid packaging. Nurx will then provide telehealth to patients about their next steps.

The company noted that the tests are limited, and therefore it will be concentrating its efforts on people who had direct exposure to the virus or who are experiencing symptoms.

WHY IT MATTERS

When it comes to testing for the coronavirus, the United States is lagging behind other nations. According to a report by Oxford University's Our World in Data, the per capita number of tests in the U.S. is 40 times lower than that in South Korea.

Pharma-giant Roche has also been working on providing tests for the virus. On Monday it announced that it began the first shipment of tests to a network of hospitals and reference labs across the US. The initial shipments included 400,000 test kits.

"As the COVID-19 public health emergency continues to worsen with community spread across the United States, there is an unmet medical need to broaden the access to testing for SARS-CoV-2 coronavirus in a responsible manner to complement and help alleviate the potential overload on healthcare systems and healthcare providers if testing was only available in the limited clinical setting," Dr. Frank Ong, chief medical and scientific officer of Everlywell, said in a statement.

THE LARGER TREND

To date there are 191,127 confirmed coronavirus cases, according to the World Health Organization. Within the last few weeks the U.S. has seen an increase in cases, with 3,536 currently reported in the country.

Since January, we have seen efforts in testing innovation. For example, in late January Singapore-based Veredus Laboratories announced the development of the VereCoV detection kit, a portable Lab-on-Chip application capable of detecting the Middle-East Respiratory Syndrome Coronavirus (MERS-CoV), Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and COVID-2019 in a single test.

Also in Singapore, researchers at the Institute for Health Innovation & Technology (iHealthtech) announced that they were working on the development of a rapid COVID-19 detection kit based on the enVision technology platform, which they invented in 2018.

ON THE RECORD

"The extreme shortage of tests for COVID-19 puts millions of Americans at risk," Julia Cheek, founder and CEO of Everlywell, said in a statement. "Everlywell is committed to helping stop the spread of COVID-19 in the U.S. by making this test widely available. As the national leader in at-home lab testing, we want to use our resources and expertise to help as many people as we can. We are committed to this fight, and we're here to help."

Evidation Health, a technology company that generates insights from real-world behavioral data collected through devices, has kicked off a new effort to better understand individuals' health behaviors and concerns throughout the COVID-19 pandemic.

Yesterday the company announced that it has recruited 100,258 people living in the U.S. into a longitudinal survey through the Achievement app, Evidation's patient engagement and rewards product for health organization customers.

These participants – a subsample of the app's nearly four million users who live in all 50 states and the District of Columbia – will be regularly providing their COVID-19 perceptions, changes in their behavior and any device-tracked activity data that is synced with the app.

“One of the great things about Achievement is our ability to layer permissioned data from connected devices and apps with self-reported outcomes we capture through surveys," Ernesto Ramirez, senior data scientist at Evidation Health, told MobiHealthNews in an email. "The trust and transparency we build with our members allows us to conduct novel research into the relationship between person-generated health data and important health conditions and outcomes like influenza and COVID-19.

The digital survey has already collected some baseline data in its first few days, the company wrote on its website. For instance, of respondents answering between March 12 and March 15 fewer (23%) said they believed that the U.S. was prepared or very prepared for the outbreak (23%), while roughly half ( said they believed that the virus represented a major threat to public health. Respondents said that they were generally washing their hands more frequently during the previous seven days (64%), but less often reported that they were avoiding large gatherings (34%).

There were also differences in replies between participants who did or did not have health insurance. The latter group more often said that they would not seek care if they developed coronavirus symptoms (8% versus 21%), and those who would more often said that they would most likely go to an emergency room (19% versus 26%).

A state-by-state breakdown of participant responses also illustrated differences in opinion among the populace. Here, Evidation highlighted the contrast between Washington, D.C. and Louisiana, which as of March 15 had the third- and fourth-highest number of cases per 100,000 residents. The former's respondents were the least assured in the country's preparedness for the disease and most often reported preventive behavior changes, while the latter's residents were among the most confident, and did not change their behaviors to a similar extent.

WHY IT MATTERS

The COVID-19 pandemic is escalating at a rapid pace, with the CDC disclosing thousands of new cases reported within the last day alone. Evidation's approach to polling can quickly yield a large quantity of information from generally decentralized responders, and complement those qualitative responses with quantitative activity data collected by their devices.

"Our ability to tap into a large virtual cohort of Americans shows the potential for leveraging new models of engagement and data collection not only for research purposes but meaningful and rapidly scalable public health surveillance," Ramirez said. "And because we're able to communicate with our members, we can track how behaviors and attitudes change over time as social and health dynamics shift in the future.”

With that being said, the strengths of these types of large, app-based studies can come at a cost. According to a recent meta-analysis of eight digital studies with similar designs, these approaches are often subject to low retention rates and participant samples that often skew younger and whiter than the general population.

THE LARGER TREND

Even in the earlier days of COVID-19's U.S. spread, health organizations and startups alike had developed a number of data-driven tools to track the outbreak. In February, Boston Children's Hospital's John Brownstein and Buoy Health's CEO Dr. Andrew Le described one such example that combines the former's data science tools with the latter's triaging chatbot.

For its own part, Evidation Health has a hefty collection of app-based health studies both logged and ongoing. Some of these have also been conducted in collaboration with big names. It was just a few weeks ago that its name was attached to Apple and Johnson & Johnson's Heartline Study of Medicare seniors.