The National Eye Institute (NEI) is issuing this Notice of Special Interest (NOSI) to support research addressing the urgent need to provide accessible home-based COVID testing to people who are visually impaired.
The global pandemic of coronavirus disease 2019 (COVID-19) has had widespread impacts. The respiratory disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), exhibits a wide range of clinical outcomes from asymptomatic to severe complications and death. Concerns regarding highly transmissible variants, such as omicron, have underscored the need for public health measures that will mitigate infection rates.
Testing is a particularly important component of the public health response to the COVID-19 pandemic, in addition to the crucial roles that vaccine uptake, physical distancing, and masks have played in slowing the spread of the virus and preventing future outbreaks. Testing provides infection status to symptomatic and asymptomatic individuals, which can allow a COVID-19-positive person to isolate and initiate contact tracing with others. With the potential for SARS-CoV-2 reinfection, new viral variants arising that may be resistant to current vaccines, and possible transmission of SARS-CoV-2 from vaccinated to unvaccinated people, testing will continue as a key strategy to reduce the spread of the virus.
Currently, two types of viral tests are available to detect infection status – an antigen test and a molecular polymerase chain reaction (PCR) test. Both are available at community testing sites and national pharmacy chains. For people with visual disabilities, however, access can be difficult. For example, individuals who cannot drive vehicles or use transportation may not be able to access tests that require people to remain in the vehicle when obtaining samples.
In 2021, at-home rapid antigen tests that can identify SARS-CoV-2 were given FDA Emergency Use Authorization for self-testing without needing to ship samples to a lab. They are particularly important for people who have difficulty reaching testing sites and have been in high demand as infection rates rise and people seek them ahead of gatherings and travel. For people with visual disabilities, securing at-home tests is only part of the challenge; currently, there are limited at-home testing options that people with visual impairment can use independently. Existing test kits do not provide instructions in Braille, large text, or audio formats. The interaction with the test requires precise visuomotor dexterity to insert the sample. Interpreting the results relies on low-contrast visual cues, often using colors to convey information. Although technologies exist for other diagnostics to deliver information by tactile means, SARS-CoV-2 tests do not.
This NOSI encourages researchers to leverage existing partnerships and build new partnerships with key stakeholders to develop and implement specific, targeted approaches for home-based testing strategies for people with visual impairment. Strategies should be scalable, sustainable, and consider the multiple stakeholders (e.g., visually impaired, blind children, adults with low vision, older adults, parents/guardians, caregivers).
This notice applies to due dates on or after March 7, 2022, and subsequent receipt dates through March 9, 2024.
NOT-EY-22-010
