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We reviewed three at-home covid tests. The results were mixed.

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Over-the-counter home tests for covid-19 are finally here. MIT Technology Review obtained kits sold by three companies and tried them out.

After buying tests from CVS and online, I tested myself several times and ended up learning an important lesson: while some people worry that home tests could miss covid cases, the bigger problem may be just the opposite. These tests have “false positive” rates of around 2%, which means that if you keep using them, you’ll eventually test positive, even though you don’t have covid-19.

That happened to me. I tested negative several times, but the fourth time the result came up “POSITIVE FOR COVID-19.” I knew that was probably wrong—I’m a dedicated quarantiner who rarely goes anywhere. But I was sufficiently alarmed to follow the directions and scurry to a hospital for a gold-standard laboratory test, wasting my time and that of the friendly nurse who swabbed deep into my nasal cavity. That result was negative.

Some experts have argued that cheap, fast tests could be used to screen the whole population every week. But what I learned is that this type of mass screening could be as much of a public nuisance as pandemic-buster. In fact, if you tested everyone in the US tomorrow with over-the-counter tests, the large majority of positive results—maybe nine out of 10—would be false alarms.

After trying them, I do think there is an important role for consumer tests. Overall, I found they’re easy to use, cheaper than existing mail-in tests, and more convenient than waiting at a testing site. If you have symptoms, or fear you’ve been exposed, having a test handy could help. As a screening tool for schools or businesses, they could also work, so long as there’s a backup plan to confirm positives.

Accuracy issues

The issue with home tests is accuracy, which is between 85% and 95% for detecting covid. That is, they catch about nine of every 10 infections, a metric called the test’s “sensitivity.” Some people have said that any missed cases are a worry, since a person with a false negative could go out and infect someone else. But if the alternative is no test at all, then none of those infections would be caught, so even an imperfect test is a plus.

The tricky part of unrestricted testing, I learned, comes instead from the concept of “specificity,” or the rate at which a test correctly identifies negatives. For the home tests I tried, that figure is about 98%, with a corresponding 2% rate of false positives. What I didn’t realize—and what your everyday CVS shopper won’t either—is that there are two ways that less-than-perfect specificity can get amplified into a bigger problem.

The first way is through repeat testing, the kind I did. By the time my review of the home tests was complete, I’d tested five times in two days, accumulating 1 in 10 odds of being told I had covid when I didn’t (a 2% chance of a false positive each time, multiplied by five tests). The second source of trouble I didn’t anticipate is what is known as “pretest probability.” As I said, I don’t socialize, so my probability of actually having covid in first place was very low, maybe even zero. What this meant is that my chance of a correct positive when I took the test was also essentially zero, while my false positive chance remained 2% like everyone else’s. The way I was using the test, any positive result was nearly certain to be wrong.

Now consider this same phenomenon—a higher chance of false positives than of real ones—applying to a large group, or even a whole country. In the US, covid rates are falling. This lower background rate means if home tests were used by everyone in the country tomorrow, there could be five to 15 wrong positives for every right one.

As a result, I don’t think home tests are as useful as some have hoped. If used at scale to screen for covid, they could send millions of anxious people in search of lab tests and medical care they don’t need.

Still relevant?

As the covid-19 pandemic spread around the globe last year, economists and scientists called for massive expansion of testing and contact tracing in the US, to find and isolate infected people. But the number of daily tests in the US has never much exceeded 2 million, according to the Covid Tracking Project, and most of those were done in labs or on special instruments.

Home tests will now be manufactured in the tens of millions, say their makers, but some experts aren’t sure even tests that worked perfectly would be able to change the pandemic picture much at this point. “The real value of these tests was six months ago,” says Amitabh Chandra, a professor at Harvard University’s Kennedy School. “I think that the move to over-the-counter is great, but it has limited value in a world where vaccines become more widely available.” Vaccination credentials could be more important for travel and dining than test results are.

Companies selling the tests say they are still a relevant strategy for getting back to normal, especially given that kids aren’t getting vaccinated yet. For employers who want to keep an office or factory open, they say, self-directed consumer tests might be a good option. A spokesperson for Abbott told me that they might also help people “start thinking about coordinating more covid-conscious bridal showers, baby showers, or birthday parties.”

The UK government started giving away covid antigen tests for free, by mail and on street corners, on April 9, saying it wants people “to get in the habit” of testing themselves twice a week as social distancing restrictions are eased. Along with vaccines, free tests are part of that nation’s plan to quash the virus. Later, though, a leaked government memo said health officials were privately worried about a tsunami of false positives.

In the US, there’s no still no national campaign around home tests or subsidy for them, and as an out-of-pocket expense, they are still too expensive for most people to use with any frequency. That may be for the best, given my experience.

Types of tests

The three tests we tried included two antigen tests, BinaxNow from Abbott Laboratories and a kit from Ellume, as well as one molecular test, called Lucira. In general, molecular tests, which detect the genes of the coronavirus, are more reliable than antigen tests, which sense the presence of the virus’s outer shell.

Everything you need is in one box, except in the case of the Ellume test, which must be paired with an app. Overall, the Lucira test had the best combination of advertised accuracy and simplicity, but it was also the most expensive at $55.

We didn’t try Quidel QuickVue, another antigen test, or a molecular test from Cue Health. Those tests, while authorized for home use, are not being sold directly to the public yet.

After trying all the tests, I am not planning to invest in using them regularly. I work from home and don’t socialize, so I don’t really need to. Instead, I plan to keep at least one test in my cupboard so that if I do feel sick, or lose my sense of smell, I will be able to quickly find out whether it’s covid-19. The ability to test at home might become more important next winter when cold and flu season returns.

shipping Abbott tests

ABBOTT LABS

BinaxNow by Abbott

Time required: about 20 minutes
Price: $23.99 for two
Availability: At some CVS stores starting in April. Abbott says it is making tens of millions of BinaxNow tests per month.
Accuracy: 84.6% for detecting covid-19 infections, 98.5% for correctly identifying covid-19 negatives

This is the at-home version of the fast, 15-minute test the White House was using last year to screen staff and visitors. It’s an antigen test, meaning that it examines a sample from a nasal swab to detect a protein in the shell of the virus. It went on sale in the US last week, and I was able to buy a two-test kit at CVS for $23.99 plus tax.

The technology used is called a “lateral flow immunoassay.” In simple terms, that means it works like a pregnancy test. It’s basically a paper card with a test strip. As the sample flows through it, it hits antibodies that stick to the virus protein and then to a colored marker. If the virus is present, a pink bar appears on the strip.

I found the test fairly easy to perform. You use an eye dropper to dispense six drops of chemical into a small hole in the card; then you insert a swab after you’ve run it around in both nostrils. Rotate the swab counterclockwise, fold the card to bring the test strip in contact with the swab, and that’s it. Fifteen minutes later, a positive result will show up as a faint pink line.

The drawback of the test is that there’s room for two different kinds of user error. It’s hard to see the drops come out of the dropper, and using too few could cause a false negative. So could swabbing your nose incorrectly. Unlike the other tests, this one can’t tell if you’ve made a mistake.

And besides the prospect of user error, the test itself has issues with accuracy. BinaxNow is the cheapest test out there, but it’s also the most likely to be wrong, missing about one in seven real infections. Abbott cautions that results “should be treated as presumptive” and “do not rule out SARS-Cov-2.”

But a buyer won’t find the accuracy rate without digging into the fine print. The company also buries a crucial requirement imposed by regulators: to compensate for the lower accuracy, you are supposed to use both tests in the kit, at least 36 hours apart. I doubt a casual buyer will realize that. The two-test requirement is barely mentioned in the instructions.

Lucira Check-It

Time required: about 40 minutes
Price: $55
Availability: Can be purchased online at lucirahealth.com
Accuracy: 94% for positives, 98% for negatives

Of all the kits I used, Lucira was far and away my favorite. This is a laboratory-type test, with techniques similar to those used by professional labs, and you feel a little bit like a scientist using it.

Since it’s not in stores yet, the Lucira test needs to be ordered online, and I would suggest doing so well before you need it. The first test I purchased took five days to arrive, leaving me anxious about its whereabouts. The company says you can track its packages, but I wasn’t able to access any tracking data until after my kit arrived. I ordered a second test, this time paying $20 for express shipping, and I still couldn’t find the tracking information.

At $55, this is the most expensive test we reviewed, so it’s not something you’ll use too often. Still, it’s about half the cost of the mail-away swab tests from companies like Vault Health—previously my go-to option for avoiding hospitals and crowded testing facilities, as when I needed to test my kid last July so she could go to sleep-away camp. Those mail-in tests give an answer within 48 hours. With Lucira, you’ll get your answer in under an hour.

The test kit includes a swab, a tube of purple chemicals, and a small battery-operated base station. It works with a technology called LAMP, a molecular method that makes copies of a coronavirus gene until the amount is large enough to detect. That means it’s nearly equivalent to PCR, the gold-standard test used by labs. Unlike PCR, a test using LAMP doesn’t need rapid heating and cooling, so it can be run at home.

After swabbing your nose, you stir the swab in the tube and then then click it into place in the base station. After half an hour, one of two LED lights turns on, saying either “Positive” or “Negative.” I found the Lucira test’s readout the easiest to understand.

Ellume Home Covid Test

Time required: about 45 minutes
Price: $38.99
Availability: Available online at CVS.com The company says it is shipping 100,000 tests a day to the US from Australia and will be manufacturing 500,000 tests a day in the US by the end of the year.
Accuracy: 95% for positives, 97% for negatives

Home tests still aren’t easy to find, and I couldn’t find a pharmacy that stocked Ellume, a test marketed by an Australian company of the same name. But the company had previously sent me a sample kit, which I used in this review. As of this week, the Ellume test can also be purchased through the website of CVS.

Of all the tests I tried, Ellume’s had the most components—five, versus three for the others. That tally included an app that you have to download onto your phone. Including resetting your Apple ID if you forget it, as I always do, and answering the app’s questions, including your name, address, and phone number, plus a break to get a cup of coffee, this test took longer to carry out. Budget an hour if you decide to read the app’s privacy policy and terms and conditions.

Like the Abbott test, Ellume’s is an antigen test. But it is a more sophisticated one, with embedded optics and electronics that read a fluorescent result. In addition to looking for the virus, it also detects a common human protein, so if you didn’t swab you nose correctly, the test will know.

Thanks to these bells and whistles, and a special swab, Ellume has a higher accuracy rate for spotting covid than other antigen tests, missing only one in 20 infections, according to the company. The drawback is that it is 50% more likely than other tests to falsely inform you that you are positive for covid-19 when you are not. Indeed, my false positive result occurred while using this test.

Because it uses a phone app, you’ll need an internet connection to use Ellume, which involves communication between your phone and the kit via Bluetooth. An advantage of the app is that it provides good directions and an electronic receipt for your test—the kind you can show to a school or employer. The others I tried didn’t have a paper trail, so there’s no proof you took the test. But that receipt comes with a privacy cost. Of the three tests I tried, Ellume’s was the only one that isn’t entirely private. The app warns that it will share “certain information with public health authorities.” That information turns out to include your birthday, your zip code, and your test result. The company says the data helps health agencies track the pandemic and report infection levels.

Lyron Foster is a Hawaii based African American Musician, Author, Actor, Blogger, Filmmaker, Philanthropist and Multinational Serial Tech Entrepreneur.

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If you don’t want robotic dogs patrolling the streets, consider CCOPS legislation

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Boston Dynamics’ robot “dogs,” or similar versions thereof, are already being employed by police departments in Hawaii, Massachusetts and New York. Partly through the veil of experimentation, few answers are being given by these police forces about the benefits and costs of using these powerful surveillance devices.

The American Civil Liberties Union, in a position paper on CCOPS (community control over police surveillance), proposes an act to promote transparency and protect civil rights and liberties with respect to surveillance technology. To date, 19 U.S. cities in have passed CCOPS laws, which means, in practical terms, that virtually all other communities don’t have a requirement that police are transparent about their use of surveillance technologies.

For many, this ability to use new, unproven technologies in a broad range of ways presents a real danger. Stuart Watt, a world-renowned expert in artificial intelligence and the CTO of Turalt, is not amused.

Even seemingly fun and harmless “toys” have all the necessary functions and features to be weaponized.

“I am appalled both by the principle and the dogbots and of them in practice. It’s a big waste of money and a distraction from actual police work,” he said. “Definitely communities need to be engaged with. I am honestly not even sure what the police forces think the whole point is. Is it to discourage through a physical surveillance system, or is it to actually prepare people for some kind of enforcement down the line?

“Chunks of law enforcement have forgotten the whole ‘protect and serve’ thing, and do neither,” Watts added. “If they could use artificial intelligence to actually protect and actually serve vulnerable people, the homeless, folks addicted to drugs, sex workers, those in poverty and maligned minorities, it’d be tons better. If they have to spend the money on AI, spend it to help people.”

The ACLU is advocating exactly what Watt suggests. In proposed language to city councils across the nation, the ACLU makes it clear that:

The City Council shall only approve a request to fund, acquire, or use a surveillance technology if it determines the benefits of the surveillance technology outweigh its costs, that the proposal will safeguard civil liberties and civil rights, and that the uses and deployment of the surveillance technology will not be based upon discriminatory or viewpoint-based factors or have a disparate impact on any community or group.

From a legal perspective, Anthony Gualano, a lawyer and special counsel at Team Law, believes that CCOPS legislation makes sense on many levels.

“As police increase their use of surveillance technologies in communities around the nation, and the technologies they use become more powerful and effective to protect people, legislation requiring transparency becomes necessary to check what technologies are being used and how they are being used.”

For those not only worried about this Boston Dynamics dog, but all future incarnations of this supertech canine, the current legal climate is problematic because it essentially allows our communities to be testing grounds for Big Tech and Big Government to find new ways to engage.

Just last month, public pressure forced the New York Police Department to suspend use of a robotic dog, quite unassumingly named Digidog. After the tech hound was placed on temporary leave due to public pushback, the NYPD used it at a public housing building in March. This went over about as well as you could expect, leading to discussions as to the immediate fate of this technology in New York.

The New York Times phrased it perfectly, observing that “the NYPD will return the device earlier than planned after critics seized on it as a dystopian example of overly aggressive policing.”

While these bionic dogs are powerful enough to take a bite out of crime, the police forces seeking to use them have a lot of public relations work to do first. A great place to begin would be for the police to actively and positively participate in CCOPS discussions, explaining what the technology involves, and how it (and these robots) will be used tomorrow, next month and potentially years from now.

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Bird Rides to go public via SPAC, at an implied value of $2.3B

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Bird Rides, the shared electric scooter startup that operates in more than 100 cities across 3 continents, said Wednesday it is going public by merging with special purpose acquisition company Switchback II with an implied valuation of $2.3 billion. The announcement confirms earlier reports, including one this week from dot.la, that Bird intended to go public via a SPAC.

Bird said it was able to raise $106 million in private investment in public equity, or PIPE, by institutional investor Fidelity Management & Research Company LLC, and others. Apollo Investment Corp. and MidCap Financial Trust provided an additional $40 million asset financing.

The transaction will enable the combined entity to retain net proceeds of up to $428 million of cash, according to Switchback, which brings $316 million cash-in-trust to the table. The announcement also provided new information about a previously undisclosed $208 million, which Bird raised privately as part of an April 2021 Senior Preferred Convertible equity offering led by Bracket Capital, Sequoia Capital and Valor Equity Partners.

When and how Bird would go public has been an item of speculation after Bloomberg reported last November that the company received “inbound interest” from SPACs.

Bird’s ride has been bumpy at times. In 2020, revenue dropped to $95 million, or 37% from the previous year. That year the company also laid off around 30% of its workforce – 406 people – for cost-saving reasons. The company may use this new access to cash to expand its European operations and pay off debt.

Most importantly, the new injection of cash may help the company finally achieve profitability. It’s a rarity amongst scooter startups, who face notoriously high overhead.

Special purpose acquisition companies, or SPACs, have become a popular route for going public amongst transportation startups. Already this year, scooter company Helbiz, which is based in Europe and the U.S., went public via SPAC in a merger with GreenVision Acquisition Corp. SPAC shell corporations allow companies to list on the NASDAQ without doing a traditional initial public offering.

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Only three days left to buy $99 passes to TC Disrupt 2021

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The countdown clock keeps on ticking, and you have just three days to secure your $99 pass to TechCrunch Disrupt 2021. You read that right — $99 is all that you’ll pay, $99 is all (everybody sing)!

Silly Minions aside, you’ll snag serious savings if you buy your Disrupt 2021 pass before the deadline expires on May 14 at 11:59 pm (PT).

TechCrunch Disrupt is a massive gathering of the tech startup world’s top leaders, innovators, makers, investors, founders and ground breakers. The all-virtual platform means more global participation and exposure. It’s all designed to help early-stage founders — and the people who invest in them — build a thriving business.

The Disrupt stage features in-depth interviews and panel discussions with a who’s-who of tech talent. The Extra Crunch stage is where you’ll find a deep bench of subject-matter experts sharing practical how-to content. You’ll take away actionable insights you can put into practice now — when you need it most. Check out our roster of speakers — we’re adding more every week.

Granted, we might be a tad biased about Disrupt — of course we think it’s awesome. But your contemporaries recognize its value, too. Here’s what a few of them told us about their experience at Disrupt 2020.

There was always something interesting going on in one of the breakout rooms, and I was impressed by the quality of the people participating. Partners in well-known VC firms spoke, they were accessible, and they shared smart, insightful nuggets. You will not find this level of people accessible and in one place anywhere else. — Michael McCarthy, CEO, Repositax.

I loved the variety of topics and learning about recent technology trends as they’re happening. Disrupt gave me a whole new perspective on the ways innovation happens in big companies. — Anirudh Murali, co-founder and CEO, Economize.

Watching the Startup Battlefield was fantastic. You could see the ingenuity and innovation happening in different technology spaces. Just looking at the sheer number of other pitch decks and hearing the judges tear them down and give feedback was very helpful. — Jessica McLean, Director of Marketing and Communications, Infinite-Compute.

If watching Startup Battlefield is thrilling (and it is), imagine what it would feel like to compete — or to win. We’re still accepting applications but not for long. Want to take a shot at winning $100,000? Apply to compete in Startup Battlefield before May 13 at 11:59 pm (PT).

There’s so much more opportunity waiting for you at Disrupt 2021. Explore Startup Alley, our expo area. Better yet, exhibit there yourself and, in addition to a bunch of other perks, you might be one of only 50 exhibiting startups chosen to participate in the Startup Alley+ VIP experience. Read more about Startup Alley+ here. TechCrunch will notify selected startups at the end of June.

Time is running out, and $99 is all that you’ll pay — if you buy your Disrupt 2021 pass before Friday, May 14 at 11:59 pm (PT).

Is your company interested in sponsoring or exhibiting at Disrupt 2021? Contact our sponsorship sales team by filling out this form.


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