BEGINNING APRIL 7th, Seoul National University (SNU) will start implementing Seasun Biomaterials’ “AQ-TOP COVID-19 Rapid Detection Kit Plus” to all its students and staff. This recently-approved rapid test uses a novel RT-LAMP testing method, described to be 95% accurate in detecting strands of the COVID-19 virus within 2 hours.

   The first of their kind to be approved by the Ministry of Food and Drug Safety (FDS), RT-LAMP tests are key to SNU’s plan for an offline semester this year. As the government considers the dissemination of the test to be the “catalyst” in controlling the spread of the pandemic, the technology seems more important now than ever. 

PCR vs Antigen vs RT-LAMP

   There are currently three types of COVID-19 testing mechanisms in South Korea. The most widely used method is the Polymerase Chain Reaction (PCR) method, used in testing booths all across the country. PCR testing requires swab samples of the patient’s inner nose-area to be sent to a lab and tested over a series of experiments. Labs then record the sample’s reaction and calculate whether the patient has contracted the virus. Samples are put under heat, first at 95 degrees to separate the DNA strands and then to 50 degrees in order to evaluate the changes. While extremely accurate, this process takes at least 6 to 24 hours to receive results since the samples have to be sent to labs for such complex procedures that cannot be conducted on the spot.

   A newly-developed method, approved recently by the FDS is the antigen-based methods of detection. Defined as “immunoassays that detect the presence of a specific viral antigen,” antigen tests look for specific proteins of the COVID-19 virus in a swab sample. The main advantage of antigen testing is its rapid result compared to the existing PCR testing. Antigen-based tests can yield results on the spot within 15 minutes and are also relatively easier to conduct, only requiring a swap of the outer part of the nose. This is a major advantage over PCR tests, which require a medically-licensed worker to insert a sampling pin to the back of the nose. Antigen tests can successfully be administered by normal everyday citizens anywhere and anytime without medical oversight. “They are cheap and effective,” said the FDS in their description of their approval for the new drug. Additionally, the FDS stated that it will continue to approve new antigen-based tests by other pharmaceutical companies.

   However, in a recent study by Seoul National University, antigen-based tests proved to be only 23% accurate in a sample size of over 1,000 people. This study illustrated that despite their convenience, antigen tests are faulty because they are often contaminated due to the inexperience of non-medical personnel administering it. 

   “Test patients usually touched the sample with their bare fingers or blew their nose 12 hours before the tests, which resulted in negative results for patients with the COVID-19 virus” said Dr. Park, the lead researcher on the case.

   Even when all procedures are kept to the highest standards, Humasis, the producer of the antigen tests, states in its product description that the tests are only 63% effective. The inaccuracy of these tests could create the problem of “false confidence,” where positive patients receive negative results and proceed to go about their daily lives. Some might even increase their outdoor activities in the confidence of their than before about their physical well-being, which leads to additional spread of the virus. 

   For instance, in Latvia, where the Humasis antigen kit had been in use since last February, many patients have complained about this false sense of security. The government, overconfident about the test, precipitously eased travel and work restrictions without fully understanding the size of the patient population. As a result, Latvia is currently in lockdown once again after seeing a spike in infections this April.

RT-LAMP tests: The best of both worlds

   Addressing these problems is a new player in town— RT-LAMP testing. RT-LAMP enhances DNA strands at a much lower degree than the PCR tests to look for specific proteins of the COVID-19 virus in a swab sample, while maintaining a high level of accuracy. It is the same type of testing, just less complex. This results in quicker test results within 2 hours at testing centers.

   The Food and Drug Administration (FDA) approved the RT-LAMP method last November and has since used the kits across the country for increasingly efficient COVID-19 tests. While still requiring medically-trained professionals to take the tests, unlike the newly-developed antigen-based testing, RT-LAMP tests are far more accurate compared to the existing two tests.

  Hence, this type of hassle-free testing is becoming a crucial facet of the South Korean government’s national testing strategy. With medical workers currently stretched thin, the government hopes that such easy testing at home will alert citizens with the virus quickly without the need to wait days for the results.

The Yonsei use-case

   The RT-LAMP testing is an excellent match for Yonsei University, which has been unable to conduct any classes or school events in light of the COVID-19 pandemic for the past three semesters. A quick testing solution based on the RT-LAMP technology will enable students to finally resume the long-awaited offline classes in 2021.

   When entering the school campus, students can be administered with the test after verifying themselves with the school app. Recently, the university announced that it will partner up with Naver, the South Korean technology conglomerate, to develop a “smart ID” exclusively for Yonsei based on block chain technology. This mobile ID will be handy for quick and non-contact verification of students.

   Meanwhile, on-site workers can conduct the series of experiments on the samples, after which the student’s ID card can receive codes to allow the student into classes, or alert students in the vicinity, based on the results. This can also be applied for the upcoming Yonsei-Korea matches and school festivals, which are in dire need to be commenced again. 

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   Costs and funding will be the major hurdle when it comes to implementing this solution to the Yonsei University campus. However, when considering the human and economic costs of maintaining both campuses amidst another six-month shut down, the benefits of LAMP kits seem to far outweigh the costs.