Some 720,000 rapid COVID-19 tests nearing their official expiration date in March sit in a state warehouse.

The Hawaii Department of Health bought the rapid tests last fall to meet the needs of long-term care facilities after a federal allotment of the tests ran dry. Eventually, long-term care facilities received another type of test — Abbott BinaxNOW tests — sent to nursing homes by the U.S. Department of Health and Human Services that do not require extra equipment to analyze results. That led to the current stockpile, according to DOH Spokeswoman Janice Okubo.

Since their purchase last year, the tests have been used during COVID-19 outbreaks at nursing homes, care homes, prisons, housing complexes and hospital facilities.

The state has accumulated a hefty stockpile of rapid antigen tests, which yield results in minutes but aren’t as accurate as some other testing methods. | dronepicrCC BY 2.0, via Wikimedia Commons dronepicr, CC BY 2.0, via Wikimedia Commons

In an email, Okubo said the remaining supply could be used beyond the tests’ March expiration date if they undergo extra validation tests.

“The goal is to use the tests before they expire,” she said. “If we determine appropriate uses for the tests, then we will use them before expiration. However, it seems likely that the State Laboratories Division will validate some of the tests to continue to use them beyond expiration, and they are preparing for this contingency.”

Some of the extra tests are currently being used for a pilot project led by the Waianae Coast Comprehensive Health Center to test schoolchildren and their household members, she said. That initiative could expand if the project is successful.

The BD Veritor rapid antigen tests yield results in minutes, but a major limitation is an 84% accuracy rate. Other states have collected similar stockpiles, too, limiting their use because of the relatively low accuracy rate.

The accuracy of the rapid Abbott BinaxNOW tests are now also coming into question. A January study by the Centers for Disease Control and Prevention found the Abbott BinaxNOW tests may miss about two-thirds of asymptomatic cases and that it was better at detecting cases among people who had symptoms. The CDC study was published just 13 days after the federal government purchased 150 million of them.

Aly Morici, Abbott’s public affairs representative, told Civil Beat by email that the study maintains that BinaxNOW “facilitates earlier isolation of infectious people and that rapid antigen tests are an important tool to reduce community transmission.”

Rapid tests are still crucial screening during emergencies, according to Keith Kawaoka, a deputy director at the Department of Health. They have been useful during outbreaks on Lanai and at the Yukio Okutsu State Veterans Home on the Big Island, he said.

“You don’t want to keep too little in reserves or too much,”  Kawaoka said. “If there’s an outbreak like in prisons or other institutions, we provide those kits to that outbreak investigation.”

Okubo said the department has plans to continue sending them for testing drives on neighbor islands, to screen prison employees and to keep on hand for long-term care facilities.

Independent pharmacies that have the training and workforce to conduct the rapid antigen tests have temporarily suspended community testing to focus on mobile vaccinations, she said.

Douglas Carroll, spokesman for the Hawaii Emergency Management Agency, said the agency has sent nearly 50,000 rapid test kits to various testing initiatives organized by county health offices during the past four weeks. The agency is accepting proposals for the remaining tests in its inventory, he said.

Dr. Scott Miscovich, who has led dozens of testing drives across the islands over the past year, said he believes the rapid tests could be used to bring back activities such as school sports.

Miscovich’s Premier Medical Group Hawaii is currently testing travelers who arrive at the Big Island airports with the rapid tests in coordination with the Hawaii County Civil Defense, the Hawaii county mayor’s office and local airport officials.

“We understood there were large quantities of these available and we were helping them prioritize the ones that were coming up on an expiration date to use at airport arrival testing,” he told Civil Beat.

Miscovich said he sees great potential for rapid testing to assist with reopening schools. His company has already helped local private schools establish regular testing for students.

More funding and support from the new presidential administration could expand COVID-19 testing at schools, he said.

“President Biden has made it crystal clear that within 100 days he wanted a large portion of kids to go back to school and he’s committed to making funding available,” Miscovich said. “We are the number one state in the country in terms of how we’ve controlled COVID-19. Let’s be a leader for the rest of the country.”

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