It has been over a year since the first COVID-19 case was confirmed in the United States, and in a month, it will be a year since COVID-19 was declared a pandemic by the World Health Organization. At the beginning of the pandemic, mask-wearing wasn’t incredibly widespread and many Americans chose to wipe down and sanitize their groceries for fear of contracting COVID-19 from surfaces. Now, approximately 74 percent of Americans “always” use masks when they go outside of their homes, and we know that airborne respiratory droplets are the primary mode by which the coronavirus spreads, rather than through surfaces.
For all of the new things we have learned about the virus and how to manage it, one aspect of pandemic life has stayed relatively constant this past year: Polymerase chain reaction tests are the gold standard for diagnosing COVID-19. Still, making improvements to the current testing system is essential to preventing further outbreaks in the coming months. LAMP, short for loop-mediated isothermal amplification, is a faster, more accurate and more cost-effective testing method that, with widespread utilization, will allow the U.S. to hasten the end of the pandemic and pave the path to normalcy in our daily lives.
Since COVID-19 first emerged in December 2019, the Food and Drug Administration has approved a host of PCR tests for Emergency Use Authorization, allowing the use of these tests for the diagnosis of disease in a public health emergency. PCR, short for polymerase chain reaction, is a molecular biological technique used to make very large quantities of a specific segment of DNA in a sample. After many reagents, or “ingredients,” are added to the sample and it is processed for some hours, the PCR will eventually lead to the production of millions upon millions of copies of that specific stretch of DNA. RT-PCR, or reverse transcription PCR, is adapted from the basic PCR and is one of the most common techniques for detecting COVID-19. In RT-PCR, the molecule that will be copied over and over is RNA. This is useful for detecting viruses within a sample since their genetic code is in this form rather than DNA. The viral RNA is converted to DNA first, after which some of the added reagents bind to the DNA and fluoresce into a special kind of light that indicates a positive COVID-19 test result.
Despite the strides made in our understanding and handling of COVID-19, there are still some flaws in the testing system nearly a year into the pandemic. Namely, PCR tests are costly in time and money due to the complex steps involved. Most testing facilities and pharmacies ship samples to a laboratory for PCR analysis. The turnaround time can range from 24 to 72 hours depending on the testing facility location, testing protocol and the number of tests in line for processing. This is a longer process compared to antigen tests, also known as “rapid tests,” which can deliver results in 15 to 30 minutes. (However, antigen tests are known for their relatively high false negative rate, making them an unreliable method for accurate COVID-19 testing.) Furthermore, the cost of PCR testing can be steep. While there are free testing sites in some larger cities, sites in other areas charge a wide range of prices from $20 to $850 for a single test. If insurance does not cover these costs, COVID-19 testing can be completely inaccessible to many people.
Fortunately, current research is showing that COVID-19 testing using LAMP, a similar biological technique to PCR, can be accurate, quick and affordable. LAMP works by a different molecular process from PCR, but like the latter, it also amplifies genetic material to test for the presence of the coronavirus. Vitally, LAMP has been shown to have a higher sensitivity than PCR, meaning it is potentially even more accurate at testing for the presence of viral RNA like COVID-19. The science of LAMP is fascinating in itself, but what makes this method most exciting as an option for COVID-19 testing are its rapid results and cost-effectiveness. LAMP can produce results in an hour, compared to the four to eight hours it takes to analyze a PCR test. LAMP also uses different “ingredients” than PCR, but these can be dried and stored in a wider range of locations than PCR reagents, which typically need to be kept frozen. Crucially, LAMP is an even cheaper process than PCR because of the ease of ingredient storage, meaning there is less skilled labor required.
It is understandable why we have relied on PCR thus far. It has been around for 20 years longer than LAMP; PCR was first developed in 1983, and the first paper discussing the development of LAMP was published in 2000. PCR has a wide variety of applications, speaking to the science community’s trust in the technique. However, with the onslaught of new, highly infectious and potentially deadlier COVID-19 variants, speeding up the testing pipeline is of the utmost importance. COVID-19 tests are only an in-the-moment snapshot of one’s health, and a negative result from three days ago means nothing if that person is infected with COVID-19 one day after getting tested.
More research laboratories are catching on to the power of LAMP. Color, a health technology company based in Burlingame, California, was the first laboratory in the U.S. to obtain Emergency Use Authorization approval for their LAMP diagnostic for COVID-19. Color partners with the city of San Francisco to provide rapid and accurate testing. The success of this testing system so far is a testament to the viability of using LAMP on a large, citywide scale.
As vaccination efforts rise — approximately 13.3 percent of the U.S. population has received at least one dose of the COVID-19 vaccine — life will slowly return to normal. Experts project that Summer 2021 will be the closest thing to pre-pandemic life that the country has seen since 2019 thanks to widespread vaccination. However, Fall and Winter 2021 are expected to have at least some resurgence of COVID-19 as the temperatures drop and more people head indoors where transmission is more likely to occur compared to the outdoors. These upticks are not projected to have an outcome worse than the incomprehensible losses that the country faced this winter. Still, more contagious COVID-19 variants circulating across the country and around the world are sure to complicate this optimistic view of the future. Already, these variants are showing some resistance to vaccines, and if the pandemic persists as the years progress, COVID-19 may mutate and be able to evade existing treatment and prevention methods altogether. This illustrates how important it is for the U.S. to pivot to rapid and accurate testing using LAMP. Giving results even a day sooner can mitigate increased transmission of the virus and save lives. All in all, LAMP offers to light our path to the end of the dark days of the pandemic.
Rachael Schmidt ’21 can be reached at rachael_schmidt@brown.edu. Please send responses to this opinion to letters@browndailyherald.com and op-eds to opinions@browndailyherald.com.
Correction: A previous version of this column incorrectly referred to Color, the health technology company, as Color Genomics. The Herald regrets the error.
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