Dec 20, 2021 7:00 AM

Self-Testing is a Feature of the Pandemic. It’s Here to Stay

Personalized and self-managed medicine is gaining steam, but it must be easily available to all.

The Covid-19 pandemic has made many of us all too familiar with self-testing, putting us at the heart of the diagnostic process. Next year, that will accelerate, bringing in an age of more predictive, personalised and self-managed medicine.

Health screening is not new. In many countries, women routinely undertake breast and cervical cancer checks, and most older citizens in richer countries have comprehensive health checks as part of their health service or insurance plan. But several incremental shifts are changing the way we think about our healthcare.

To begin with, we now have more examinations available, covering a wider range of conditions. The Galleri test, for example, which looks for abnormal DNA in a blood sample and can detect more than 50 types of cancer at relatively early stages, is the subject of a clinical trial by the NHS.

Tests are also becoming more accurate. This will be vital as both individuals and health systems are much less inclined to use ones that generate a significant number of either false positives or false negatives.

We will also be able to target tests better to include vulnerable groups. Several cutting-edge health systems – including, for example, Intermountain Healthcare in Utah – are now providing genetic profiling of their patients as a core element of their health plan. This will not only allow us to spot early signs of disease more accurately, but the data these generate will enable researchers to better understand the links between social factors and disease prevalence.

Tests are also becoming less invasive and easier to administer, allowing the process to be undertaken by individuals in their own home at a time of their own choosing. This will increase the number of tests performed. Meanwhile, smart devices will help embed self-testing and day-to-day monitoring of health and wellbeing into a practical continuum of self-care.

What is less certain are the implications of this shift. While medtech offers the long-term prospect of moving money from expensive late treatment to earlier prevention, one immediate effect could be more people wanting more interventions, based not just on having an illness but on the risk of having one. With healthcare costs rising across the world and with nearly six million people on NHS waiting lists, we will need to ask if our current systems have the capacity to offer useful support and treatment to many “worried well” citizens.

With insurance-based systems there will also be the danger of discrimination against those who posses a greater disease risk. The pandemic highlighted the health inequalities in our societies and, unless we grasp that nettle, only the fortunate and empowered will benefit from the new opportunities frequent testing offers. This will require policy changes and education. As we have seen with the roll-out of coronavirus vaccinations, a number of factors mean that society’s least advantaged are also often the least likely to have the confidence or trust to avail themselves of health protection.

The diagnostic revolution in 2022 will make a major difference to our healthy-life expectancy. We will embark on a future in which healthcare is as much about prediction, prevention and personal action as the treatment of patients by professionals. But, if we want this new world to come about quickly and – just as important – fairly, we need to think not just about new health tests or health systems, but about how our societies are able to offer this opportunity for better health to everyone.

Get more expert predictions for the year ahead. The WIRED World in 2022 features intelligence and need-to-know insights sourced from the smartest minds in the WIRED network. Available now on newsstands, as a digital download, or you can order your copy online.