Imagine: You wake up in the morning, brush your teeth, get dressed, and then remember that you're due for one more bit of maintenance — a quick nostril-swabbing and finger prick.
It's time for your free monthly at-home coronavirus tests — the swab to check for the virus itself, and the finger-prick for a droplet of blood to test for the antibodies that would indicate you've had the virus recently.
Amid ongoing supply strains and logistical hurdles that limit coronavirus testing, that routine may sound like a fantasy.
But TestBoston -- a project now being launched by Brigham and Women's Hospital and the Broad Institute — plans to offer such at-home testing to thousands across Greater Boston in the coming months, at no charge.
TestBoston aims to pull together a group of 10,000 patients who’ve gotten Brigham care recently and who represent the region — by age, sex, race and ethnicity, and income, as reflected in zip codes.
One of its goals is to make testing more accessible for groups hit hardest by the virus, says Brigham infectious disease specialist Dr. Ann Woolley, one of the project's leaders.
"We want to be sure that we can expand the testing capacity, have it be done at home, and to remove bottlenecks in the system," she said.
TestBoston also aims to help detect the spread of the virus, and to advance research, including on the urgent question of how much protection antibodies may provide after someone has the virus, and how long that protection lasts.
Participants will test themselves monthly for six months, and can also have a test kit sent to their home whenever they have symptoms.
"We are trying to make this as easy as possible, to give people as much access to testing as possible," said Dr. Deborah Hung of the Brigham and the Broad.
If you're thinking "Sign me up!" — sorry, you have to be asked (though you can sign up for updates or express interest for the future.) Invitations are now going out only to patients within a 45-mile radius of Boston who are already in the Brigham's medical records system, so their information can be used to select a representative cohort that reflects Boston's make-up.
Some 48,000 people are being invited in the coming weeks in hopes that 10,000 will enroll, Woolley said, and the project may eventually expand. Participants enroll online and get kits in the mail. After they test themselves, they can have UPS pick up the test kit or they can leave it in a dropbox.
The program is donor funded, costing about $100 per participant per month, she said.
Some commercial labs already provide coronavirus tests by mail, and Massachusetts already runs free in-person testing programs in high-prevalence "hot spots."
TestBoston aims to complement the state's efforts as one more piece of the puzzle, Woolley said, and is working with public health officials.
"This isn't about being the first or the only," she said. "It's about 'How do we add to what we believe is the right thing that should be done for COVID testing, in our state and beyond?"
In particular, TestBoston could help pick up a rise in cases as they begin to spread, before an area becomes an official "hot spot."
Two areas right next to each other can have dramatically different coronavirus prevalence rates, Hung noted. "So this is not simply to get an average over the whole greater Boston area," she said. "It's to provide that granularity that's able to actually look into individual communities," and zero in on hyper-local upticks. Boston breaks down its coronavirus rates by zip code, while the state provides town-by-town data.
The project's surveillance function is tightly integrated with the medical system, she said, "so it will, hopefully, be seamless to not simply surveil but actually deliver medical care" to patients who test positive.
The project, based on the Broad Institute's ramp-up of mass testing, seeks to partner with patients and communities, Woolley said, to make more progress against the pandemic.
"To me, that's the silver lining, if you will, to an otherwise very depressing pandemic that we are all facing and dealing with on a daily basis," she said.
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