Bill Holton
Recently, I learned from an issue of Top Tech Tidbits that the Biden Administration was now offering a “more accessible” Covid-19 test. According to the Department of Health and Human Services’ Administration for Community Living (ACL): “This initiative complements the Administration’s efforts to expand production of more accessible tests and work with private sector partners on the development of new accessible tests.”
As an interim solution, the ACL enlisted the help of several blindness organizations, including AFB, ACB and NFB, to evaluate the accessibility of the various tests currently being distributed. And though it’s not completely accessible, for now the best offering is the Ellume Rapid Antigen Tests. One of the primary benefits of this offering is that the test processing is initiated using a smartphone app, which also displays the results. More about this later. In the meantime, here’s what you need to know to obtain, unpack and use the test.
Obtaining a test.
The link in the “early news” TTT newsletter directed me to the standard USPS test ordering site. At the time I placed my order the USPS site did not mention the accessible Covid test, and when I called the listed 800 number I had to navigate a series of messages, some of which included what turned out to be out of date information. I did receive several emails confirming my order, product shipment and delivery five days later. My two tests arrived in a shipping envelope with both boxes crushed. Happily, the individual components survived intact inside their packaging. I am told that going forward, each order placed on the ACL website will contain 12 tests, and that if you already received the original 2-pack you are eligible to receive 6 more.
The Home Test App
The free app is available for both Bluetooth-enabled iPhones and Android smartphones. Tablets won’t work. For my evaluation I installed the app onto my iPhone 12. The app is fairly accessible. Issues I found include duplicate text edit fields and combo date and state boxes that are mislabeled as text fields. The app also has a tendency to refresh to the top of the screen and get locked in places where swipe gestures don’t advance. The app asks for a good deal of personal information, name, age, address, phone number—but the only fields that are actually required are your age, state and zip. Before you can begin your test you are required to watch a 4-minute video describing the process. The video is helpful, and all the steps are restated step by step as you perform the test. However there are places where a bit of audio description would have been extremely helpful. Without this information I found some of the instructions more than a little vague, confusing, even misleading. My first attempt failed miserably. However with a bit of sighted help to get me oriented I succeeded on my second try. Here’s what I learned that may be of help.
The package contents
These are standard third party tests—along with being distributed free from the government you can find them on sale at major pharmacies for about $25. Currently, they do not come marked in Braille, or with large print or recorded instructions. The documentation is available here in an accessible PDF but most of what you’ll need to know is offered up in the app—which I encourage you to download and install before opening the box. In particular you are advised not to remove any of the four test components before beginning your test. But so you will be able to confirm you have everything you need, besides the print instruction booklet here’s everything that should be inside.
Analyzer: This is a 4” by 1” by ½” plastic strip with two depressions on the same flat edge—one of which surrounds the power/Bluetooth connection button and the other is the sample port. The Analyzer comes in a sturdy plastic wrapper—you may need scissors to open it. Dropper: This piece also comes in a plastic wrapper, but it is not as long as the Analyzer. Basically, it is a plastic cylinder with a threaded end surrounding a cavity into which you will empty the Test Fluid. We’ll discuss this soon. Swab: This component arrives in a plastic container with a peel away paper back. Be careful removing this piece. The end where the paper backing can be gripped to peel it away is also the end housing the sterile nasal swab, which you should avoid touching because of possible contamination. The Swab’s opposite end sports a snap cap—we’ll also discuss this soon. Test Fluid: This comes in a very small tube with a toothpaste-tube-type folded seal at one end and a triangular tab at the other. When prompted to open the test fluid grip the tube by the folded edge in one hand and with the other hand twist and pull off the triangular tab top.
Taking the test
First, unwrap the Analyzer and place it flat on a table beside your phone with the power button side facing up. The instructions state you should depress the power button until the light flashes. You do not need to see this light—simply pressing the button for two seconds should accomplish the job. With your smartphone’s Bluetooth turned on, another press and hold of the same button will auto-connect the Analyzer and your smartphone should refresh and announce “Connected.” Do not press the app’s Next button until you hear this refresh and/or confirmation message. You are next instructed to open the small tube of Test Fluid and squeeze it into the Dropper reservoir. Remember, this is the threaded end.. The test itself is fairly easy to do. If you’ve had a Covid test before you will already be familiar with the swab being inserted deep into each nostril and twisted. Then attach the Swab to the Dropper. One note: the test can be used on adults and children. Children’s shallower nostrils require a shorter Swab tip. Consequently, the Swab arrives with a rubber collar at the near end of the Swab. It is easily removed before you proceed with the test.
One of the final instructions is to snap open the Swab cap, flip the combined Swap and Dropper upside down and insert the exposed tip into the Analyzer’s sample port. You must then squeeze five drops of Test Fluid into the Analyzer’s test port. Happily, you do not need to visibly count drops. Simply squeeze the Dropper five times.
Each of these steps is more or less described on the app screens, with prompts at the bottom of each screen to move ahead to the next step. Press the “Begin Test button on the final screen to begin the test processing.
Scoring the Test
The test takes up to fifteen minutes to process. The results appear on the screen, and if you have supplied your email address and chosen the option, will also be emailed to you so you can share with family and/or your doctor. I did not do my first test correctly, and after half an hour I still had not received any message. Apparently the software has no time-out message to alert me to my failure. Happily, on my second try I tested negative for Covid-19.
Hopefully, with the above descriptions, you will be able to perform a self-test independently. But even if you do need a bit of sighted help, remember, Covid testing is not a one and done situation. You are almost certain to be able to do subsequent tests without any help.
If you still do not feel comfortable performing the more-accessible Covid test independently, the ACL web site offers resources that can talk you through the process, and even arrange for mail-in tests or local free professional in-home testing.
It’s a definite positive that the government has finally shown movement on making Covid tests accessible to all. However I do believe a bit more is needed. At the very least the test packaging should offer a Braille Quick Start label informing users of the test and app name. The test would also be more accessible if it included recorded documentation with a “touch tour.” The app video should also be audio-described and linked to the ACL site so users can view it before they download the app or open their test box. Myself, I would have felt much more confident going in had I realized that I wasn’t going to be required to visually count out five drops of test fluid, or that I wasn’t going to open the Swab pack and grab it by the wrong end.
Have you self-administered one of these tests? We’d love to hear about it.
This article is made possible in part by generous funding from the James H. and Alice Teubert Charitable Trust, Huntington, West Virginia.
