[BostonCard]

A number of articles suggest some good news about testing:

1) We are up to 250,000 tests a day: https://thehill.com/policy/healthcare/pu...-still-lag on average for the first week in May.  Based on what I've seen, we need between 2 and 10 times as many tests (my instinct is that something around 1 million tests daily, if strategically deployed, would be effective).

2) The FDA approved an in-home saliva test, which will simplify one of the big challenges about testing (deploying adequately protected workers who can obtain the nasopharyngeal swabs).  We will see how well the test performs, but if they perform well enough and can scale up, this would be a good way to do community surveillance (give people a tube, have them spit into it, and use the results to estimate prevalence in the community and quickly identify an outbreak).

3) The FDA also approved an antigen test: https://www.npr.org/sections/coronavirus...tigen-test, which is a bit like the "rapid" flu test.  This will be really helpful for scenarios where you need results quickly (like healthcare providers treating patients or even workers more generally).

On the negative side, the Economist made a good point about testing.  With the president continually saying "everyone who wants a test can get one", companies have been slow to ramp up production, because everyone is assuming the someone else has already ramped up production.

BC

[BostonCard]

A number of articles suggest some good news about testing:

1) We are up to 250,000 tests a day: https://thehill.com/policy/healthcare/pu...-still-lag on average for the first week in May.  Based on what I've seen, we need between 2 and 10 times as many tests (my instinct is that something around 1 million tests daily, if strategically deployed, would be effective).

2) The FDA approved an in-home saliva test, which will simplify one of the big challenges about testing (deploying adequately protected workers who can obtain the nasopharyngeal swabs).  We will see how well the test performs, but if they perform well enough and can scale up, this would be a good way to do community surveillance (give people a tube, have them spit into it, and use the results to estimate prevalence in the community and quickly identify an outbreak).

3) The FDA also approved an antigen test: https://www.npr.org/sections/coronavirus...tigen-test, which is a bit like the "rapid" flu test.  This will be really helpful for scenarios where you need results quickly (like healthcare providers treating patients or even workers more generally).

On the negative side, the Economist made a good point about testing.  With the president continually saying "everyone who wants a test can get one", companies have been slow to ramp up production, because everyone is assuming the someone else has already ramped up production.

BC

[M T]

A test that was as cheap to use & as quick as, say, toothpaste would make it a lot easier for people to know if they are sick.  Especially if it can detect you are shedding virus before you have symptoms.

[M T]

A test that was as cheap to use & as quick as, say, toothpaste would make it a lot easier for people to know if they are sick.  Especially if it can detect you are shedding virus before you have symptoms.

[BostonCard]

Another good bit of news, the Trump administration is providing states with $11 billion to ramp up testing capabilities:

https://www.fiercehealthcare.com/hospita...ster-tests

I'm a bit confused whether this is money that was already appropriated by the CURES act or if it is something new:

More funding could be coming to states to shore up testing. Congress a few weeks ago passed legislation that provided $25 billion for the development of tests.

This seems to suggest that the $11 billion is on top of what was appropriated by CURES.  Regardless of the source, this is a positive development for which, dare I say, I will give the administration credit for implementing.

BC

[BostonCard]

Another good bit of news, the Trump administration is providing states with $11 billion to ramp up testing capabilities:

https://www.fiercehealthcare.com/hospita...ster-tests

I'm a bit confused whether this is money that was already appropriated by the CURES act or if it is something new:

More funding could be coming to states to shore up testing. Congress a few weeks ago passed legislation that provided $25 billion for the development of tests.

This seems to suggest that the $11 billion is on top of what was appropriated by CURES.  Regardless of the source, this is a positive development for which, dare I say, I will give the administration credit for implementing.

BC

[BostonCard]

More testing news:
https://www.politico.com/news/2020/05/11...rus-249270

The White House is pushing for 2% of each state's population be tested in the month of May (that's 12.9 million tests over the month, which is weird because the math suggests that 12.9 million is 4% of the population).  Importantly:

To meet that goal, the federal government is providing states with 12.9 million swabs and nearly 10 million tubes of chemicals used to transport samples.

The FDA has authorized Abbott's test to run on a new platform.

https://www.reuters.com/article/us-healt...SKBN22N2II

Abbott also said it could have capacity for shipping 60 million antibody tests across the world in June, which included tests on its Architect system, for which it gained authorization last month.

Now the bad news is that the antigen test I mentioned before is not as accurate as PCR.

https://apnews.com/adb76dc11182714e12a4a3a1e33abb3e

The new test is expected to detect about 80% of active COVID-19 infections, according to the FDA. That accuracy rate is similar to other rapid antigen tests for seasonal flu.

“They are going to pick up fewer people that are infected,” said Simner of Johns Hopkins. “So that’s where you see a lot of skepticism around using antigen tests for the diagnosis of COVID-19.″

So, it will be useful in certain settings.  Obviously, if it is positive in the right clinical scenario that can be helpful.  On the other hand, a negative test if a patient has appropriate symptoms should still probably be sent out for PCR testing to confirm it is not a false negative.

BC

[BostonCard]

More testing news:
https://www.politico.com/news/2020/05/11...rus-249270

The White House is pushing for 2% of each state's population be tested in the month of May (that's 12.9 million tests over the month, which is weird because the math suggests that 12.9 million is 4% of the population).  Importantly:

To meet that goal, the federal government is providing states with 12.9 million swabs and nearly 10 million tubes of chemicals used to transport samples.

The FDA has authorized Abbott's test to run on a new platform.

https://www.reuters.com/article/us-healt...SKBN22N2II

Abbott also said it could have capacity for shipping 60 million antibody tests across the world in June, which included tests on its Architect system, for which it gained authorization last month.

Now the bad news is that the antigen test I mentioned before is not as accurate as PCR.

https://apnews.com/adb76dc11182714e12a4a3a1e33abb3e

The new test is expected to detect about 80% of active COVID-19 infections, according to the FDA. That accuracy rate is similar to other rapid antigen tests for seasonal flu.

“They are going to pick up fewer people that are infected,” said Simner of Johns Hopkins. “So that’s where you see a lot of skepticism around using antigen tests for the diagnosis of COVID-19.″

So, it will be useful in certain settings.  Obviously, if it is positive in the right clinical scenario that can be helpful.  On the other hand, a negative test if a patient has appropriate symptoms should still probably be sent out for PCR testing to confirm it is not a false negative.

BC

[Hurlburt88]

I wonder if the antigen test might be useful in places like a workplace where someone tests positive and you want to rapidly test an asymptomatic workgroup?    Or maybe just for surveillance testing on a regular basis?

[Hurlburt88]

I wonder if the antigen test might be useful in places like a workplace where someone tests positive and you want to rapidly test an asymptomatic workgroup?    Or maybe just for surveillance testing on a regular basis?

[burger]

I wonder if the antigen test might be useful in places like a workplace where someone tests positive and you want to rapidly test an asymptomatic workgroup?    Or maybe just for surveillance testing on a regular basis?

It's only useful if you're okay with missing 20% of infected workers.

Until the accuracy gets a lot closer to 100%, this isn't going to help much, as BC pointed out.

[burger]

I wonder if the antigen test might be useful in places like a workplace where someone tests positive and you want to rapidly test an asymptomatic workgroup?    Or maybe just for surveillance testing on a regular basis?

It's only useful if you're okay with missing 20% of infected workers.

Until the accuracy gets a lot closer to 100%, this isn't going to help much, as BC pointed out.

[burger]

Ouch.  The new Abbott test being used at the White House might be missing 50% of positives (note: I believe this is a different test than either of the 2 mentioned above by BC).

The analysis, which has yet to be confirmed, found that Abbott’s ID NOW missed at least one-third of positive cases detected with a rival test and much as 48% when using the currently recommended dry nasal swabs, according to the report posted on BioRxiv, a server where researchers post early work before it has been reviewed by other scientists.

https://www.bloomberg.com/news/articles/...study-says

Caveat: results are from a pre-print

[burger]

Ouch.  The new Abbott test being used at the White House might be missing 50% of positives (note: I believe this is a different test than either of the 2 mentioned above by BC).

The analysis, which has yet to be confirmed, found that Abbott’s ID NOW missed at least one-third of positive cases detected with a rival test and much as 48% when using the currently recommended dry nasal swabs, according to the report posted on BioRxiv, a server where researchers post early work before it has been reviewed by other scientists.

https://www.bloomberg.com/news/articles/...study-says

Caveat: results are from a pre-print

[magnus]

Ouch.  The new Abbott test being used at the White House might be missing 50% of positives (note: I believe this is a different test than either of the 2 mentioned above by BC).

The analysis, which has yet to be confirmed, found that Abbott’s ID NOW missed at least one-third of positive cases detected with a rival test and much as 48% when using the currently recommended dry nasal swabs, according to the report posted on BioRxiv, a server where researchers post early work before it has been reviewed by other scientists.

https://www.bloomberg.com/news/articles/...study-says

Caveat: results are from a pre-print

If true, no wonder McConnell and Pelosi declined WH's offer to use it. =)

[magnus]

Ouch.  The new Abbott test being used at the White House might be missing 50% of positives (note: I believe this is a different test than either of the 2 mentioned above by BC).

The analysis, which has yet to be confirmed, found that Abbott’s ID NOW missed at least one-third of positive cases detected with a rival test and much as 48% when using the currently recommended dry nasal swabs, according to the report posted on BioRxiv, a server where researchers post early work before it has been reviewed by other scientists.

https://www.bloomberg.com/news/articles/...study-says

Caveat: results are from a pre-print

If true, no wonder McConnell and Pelosi declined WH's offer to use it. =)