The Rise of Rapid Home Testing for Illness (AI Translation)
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文｜财新周刊 崔笑天
By Caixin Weekly's Cui Xiaotian
晚上6点，已到下班时分，北京儿童医院的20余个内科诊室前，仍坐着不少候诊的孩子，要么发烧，要么咳嗽不断，让陪同的家长心焦不已。还有不少刚刚赶来的患儿和家长，他们前往楼上的小夜门诊。为了迎战流感季，这里无论是内科，还是小夜门诊都不限号，每天的门急诊量约有1万人次。
At 6 P.M., already after working hours, more than 20 outpatient clinics at Beijing Children's Hospital still saw numerous waiting children, many suffering from fever or persistent coughs, causing considerable anxiety for the accompanying parents. Additional children and their families, who had just arrived, headed to the upstairs evening clinic. To combat flu season, neither the regular outpatient clinics nor the evening clinics have imposed limits on patient numbers, with daily visits reaching approximately 10,000.
据中国疾控中心发布的监测数据，2024年12月9日至15日急性呼吸道传染病呈持续上升趋势；流感病毒、0—4岁的呼吸道合胞病毒、14岁及以下的人偏肺病毒阳性率都在上升。不同病原引起的症状相似，但用药有别，因此需要先明确感染病原。北京儿童医院开通了诊前检测，让患儿在候诊时就先去检测血常规、甲乙流核酸、肺炎支原体核酸，医生再根据检测结果下诊断，这样可以节约就诊时间。
According to surveillance data released by the Chinese Center for Disease Control and Prevention, acute respiratory infectious diseases are showing a continuous upward trend from December 9 to 15, 2024. The positivity rates for influenza viruses, respiratory syncytial virus in children aged 0-4, and metapneumovirus in those aged 14 and below are all rising. Symptoms caused by different pathogens are similar but require different medications, thus it is necessary to identify the infectious pathogen initially. Beijing Children's Hospital has opened a pre-diagnostic testing service, allowing young patients to undergo tests such as blood routine, nucleic acid tests for Influenza A and B, and pneumonia mycoplasma nucleic acid while waiting for consultation. Doctors can then make a diagnosis based on the test results, thereby saving consultation time.
与此同时，不少出现症状者选择在流感季绕开医院。居家快检（京东也叫“到家快检”）新业态悄然兴起。消费者出现感冒、发烧症状后，在美团、京东等互联网平台下单呼吸道多病原核酸检测，约半小时后有外卖员上门取咽拭子样本，再过两三个小时后可以查看检测报告，由线上医生对症开方，再送药上门。
Meanwhile, many individuals exhibiting symptoms during flu season are opting to bypass hospitals. A new business model for at-home rapid testing (also referred to as "home delivery rapid testing" by JD.com) is quietly emerging. When consumers experience cold or fever symptoms, they order multi-pathogen respiratory nucleic acid testing on internet platforms like Meituan or JD.com. Within about half an hour, a delivery person arrives to collect a throat swab sample, and two to three hours later, the test report becomes available. Online doctors then prescribe treatment as needed, and medication is delivered to the doorstep.
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- Beijing Children's Hospital sees persistent demand, with approx. 10,000 daily visits due to rising respiratory infections.
- An innovative at-home rapid testing service, offered by platforms like JD.com, provides results within hours for 12 pathogens, including Mycoplasma pneumoniae and influenza.
- While this model aids in quick diagnosis and treatment, challenges like cost sustainability and acceptance in healthcare systems remain significant hurdles.
At 6 P.M., even after standard working hours, over 20 outpatient clinics at Beijing Children's Hospital were busy with many children suffering from fevers and persistent coughs, leading to rising anxiety among accompanying parents. The hospital had not restricted patient numbers during flu season, witnessing a daily influx of approximately 10,000 visitors. Surveillance data from the Chinese Center for Disease Control and Prevention indicated an upward trend of acute respiratory infectious diseases from December 9 to 15, 2024, with rising positivity rates for influenza, syncytial virus in children 0-4 years old, and metapneumovirus in those 14 and under. The hospital started pre-diagnostic tests for young patients to identify the infectious pathogen and save consultation time [para. 1].
To avoid hospitals during flu season, many people favored a new at-home, rapid testing model. Platforms such as JD.com are part of a new business model called "home delivery rapid testing," expanding multi-pathogen respiratory nucleic acid testing services online via Meituan or JD.com. Priced significantly lower than hospital testing—69.9 yuan for 12 common respiratory pathogens—this model allows patients to get results and medication prescriptions delivered at home in a few hours. This trend, aligned with a surge in mycoplasma pneumonia infections in 2023, reported over 500,000 home tests from August 2023 to May 2024 [para. 2].
The business model is supported by a collaboration between internet platforms, reagent companies, and third-party testing labs. However, its challenges include below-cost introductory pricing and the cyclic nature of respiratory illnesses. As infections decrease, losses due to fixed costs are expected to increase, leading some labs to stop cooperation. Hospitals do not universally accept these at-home test results, affecting consumer decisions and prompting many to switch to traditional healthcare settings [para. 3].
In early December 2024, amid flu symptoms, Liu Yang in Beijing used these home tests and received a rapid treatment, unlike Xue Qing, who faced limitations at a community health service center, prompting a more complex process. Although community centers offer basic tests, their reliance on antigen and antibody testing results in less accuracy compared to nucleic acid tests, influencing patients' testing choices [para. 4].
Stemming from a desire to mitigate overcapacity in molecular diagnostics post-COVID-19, the at-home rapid testing initiative was a response to a marked increase in respiratory illnesses. Major platforms introduced these services by October 2023 in reaction to high demands, with some labs achieving substantial financial gains initially. Yet the decreasing infection severity in 2024 curtailed expected profits, as the business model relies on testing volumes. [para. 5]
The at-home rapid testing concept, despite facing profitability challenges due to seasonal infection fluctuations and platform reliance, aims to provide a solution for diagnostics precluding hospital visits. This option is not as significant in financial terms for hospitals because it primarily serves patients with less severe symptoms, complementing traditional hospital-based diagnostics [para. 6].
Regulatory authorities are taking note of the trend, with ongoing discussions regarding quality control and service implementation within regulatory norms. While these platforms enhance accessibility and autonomy for users, real empowerment requires accurate and effective testing with significant clinical value, as exemplified by explorative health approaches suggested by experts [para. 7].
- Meituan Pharmacy
美团买药 - Meituan Pharmacy has partnered with third-party labs to launch at-home respiratory multi-pathogen testing after the COVID-19 pandemic. This service allows users to diagnose respiratory illnesses from home via online platforms, reducing the risk of hospital cross-infection. Since its launch in October 2023, the service became popular during the respiratory infection surge, surpassing 500,000 home tests from August 2023 to May 2024, despite facing challenges in cost and profit margins.
- JD Health
京东健康 - JD Health has expanded its home testing services, initially launched in Beijing and Shanghai, to several cities. The platform aims to integrate "medical-testing-diagnosis-pharmacy-care" in one seamless process, responding to consumer demand for at-home healthcare solutions. JD Health provides home testing for respiratory pathogens and other health issues while addressing challenges like cost coverage, online medication purchasing, and insurance reimbursement for home-tested results.
- Sansure Biotech
圣湘生物 - Sansure Biotech saw significant growth in the respiratory field by leveraging at-home diagnostics, becoming a market leader. In the first half of 2024, the company’s total revenue exceeded 700 million yuan, showing a growth of about 70%. Although specific financial details for its at-home testing business weren't disclosed, the overall revenue increase was attributed to the expansion in domains such as respiratory diagnostics.
- Yuanma Gene
元码基因 - Yuanma Gene is one of the earliest third-party laboratories to collaborate with Meituan on at-home rapid testing for respiratory pathogens. The company's CEO, Tian Geng, noted that sample volumes have increased significantly, peaking at around 500 daily cases during the 2023 flu outbreak and then aligning with typical seasonal infection rates in 2024.
- June 2023：
- Yang Yifan of Sansure Biotech met a partner from Meituan Medicine, leading to the development of an at-home rapid test for multiple respiratory pathogens.
- August 2023：
- Yuance Gene partnered with Meituan, receiving an increasing number of samples for testing.
- October 2023：
- Professional evaluations and testing for at-home rapid testing were completed, and services launched on Meituan and JD.com.
- November 20, 2023：
- Beijing Children's Hospital set a record with approximately 13,800 outpatient and emergency visits in a single day.
- After August 2023：
- More than 500,000 instances of multi-pathogen respiratory home rapid testing were conducted.
- 2023：
- Surge in mycoplasma pneumonia infections coincided with the introduction of at-home rapid testing.
- 2024：
- At-home rapid testing faced challenges with costs not being covered by the introductory price and subsidy rates decreasing after several adjustments.
- Early December 2024：
- Two individuals, Xue Qing and Liu Yang, caught colds while on a business trip.
- By December 9 to 15, 2024：
- Acute respiratory infectious diseases showed a continuous upward trend according to surveillance data by the Chinese Center for Disease Control and Prevention.
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