Media Confusion Adds to Problems with Fact Based CoronaVirus Testing

This NYT article just adds to the growing list of confusing, misleading media coverage of COVID19.

Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be
New York Times, Aug. 29, 2020

The amount of media confusion surrounding COVID19 is staggering. In addition to this article there was the recent confusion about what the CDC was trying to say about testing last week — that testing too soon after a possible exposure can be misleading.

It’s true that the PCR-based tests, like the test that Bedford Research performs, are very sensitive — it is highly unlikely that 20 copies of SARS-CoV-2 (the viral load that BRF testing can detect) would indicate a contagious person. Rapid instruments (like the one Abbott sells) are likely to be far less sensitive, and maybe more useful, to indicate risk of contagion. They will only detect a higher viral load, but that is most likely perfect for detecting contagious individuals.

So, if a hospital has someone in an ER to triage, risk of contagion is the first order of concern, and a rapid test would be very helpful. Same for schools trying to limit spread by an asymptomatic carrier.

Nonetheless, a more sensitive test is clinically far more valuable — a beginning infection, the end of an infection, etc. Especially in circumstances where close physical contact is necessary — day care centers, phlebotomy stations, long term care facilities, barbers, etc.

Those working in long term care facilities and ICUs — are frustrated by negative tests when the patient has all the symptoms of COVID19. Hence, once the immune system kicks in (which is when fever, cough, etc. starts), virus titers drop precipitously, and a sensitive test may be the most useful way to be able to classify the patient.

 

Bedford lab steps up to bolster coronavirus testing efforts

An enduring theme of the COVID-19 pandemic has been the difficulty getting tested for the virus. Identifying the need, the nonprofit Bedford Research Foundation has shifted its focus – and its lab space – to address the testing deficit.

“We have [testing] capacity that is not being used. We probably have 50 slots a day not being used. We would really like to run at capacity,” said Ryan Kiessling, operations manager for the foundation… Read more.

Read the full article, “Bedford lab steps up to bolster coronavirus testing efforts”, by Jesse Floyd on Bedford’s Wicked Local site.

Masks Are Not A Substitute For SARS-CoV-2 Testing

Matt Antonellis, left, a BRF scientist, and Dr. Maria Batilo, right, give a COVID-19 test to Shawn Hanegan, of Bedford, at a testing tent on the Bedford Common in Massachusetts Tuesday, April 21, 2020. [Wicked Local Staff Photo/Ann Ringwood]

It’s important to keep in mind that no “randomized, controlled trials,” the type Dr. Tony Fauci frequently espouses, have demonstrated that wearing fabric face masks inhibits transmission of respiratory viruses, including SARS-CoV-2, the causative agent of COVID19. As quoted in a recent British Medical Journal review of 32 studies “The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19.”

The basic problem is that viruses are the “infectious agents” that pass through filters that block bacteria. There is speculation that fabric face masks may decrease the distance viruses are exhaled, but they do not block viruses from being inhaled. Wearing face masks is probably benign, however, unless they (a) increase the frequency with which the wearer touches his/her face throughout the day, and (b) create a false sense of security against virus transmission.

Wide-spread community testing is the only answer to stopping the spread of SARS-CoV-2 and re-opening schools and Bedford’s recreation areas. It’s time to stop hiding from the virus, and take advantage of the robust testing capacity now available in Massachusetts.

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Expanding Coronavirus Testing to the Public

It’s been about two weeks since our director, Dr. Ann Kiessling, ran a SARS2 (Coronavirus) test on her daughter, Wilma, that came back positive. Thankfully, Wilma had few symptoms, and Wilma’s husband and toddler continue to test negative. Dr. Kiessling ran this test because Wilma, a worker at a Massachusetts state hospital, was unable to get tested at work after being exposed by one of her patients.

This incident has underlined the urgent need for on-demand testing for SARS2. In this case, the testing and results were so tardy that Wilma was not even aware that she might be exposing her husband and toddler for almost a week.

Since March 19, BRF has been offering SARS2 (Coronavirus) testing to local hospitals, and yesterday, Tuesday, April 21, BRF piloted a new program of completely open, public testing (see pics on WickedLocal). The program was run in partnership with Bedford’s First Parish Unitarian Church. The church set up a tent on its front lawn to collect samples, and members from the congregation were invited to participate. Online pre-registration streamlined the process so that no paperwork was needed on-site. This pilot program was a huge success, and BRF is hoping to expand it in partnership with other local organizations. Find out more about signing up your organization by emailing: covid@bedfordresearch.org

PHOTOS: Bedford residents get tested during BRF’s pilot program on Tuesday, April 21, 2020. [Wicked Local Staff Photo/Ann Ringwood] More photos at WickedLocal.

Front-line workers are still unable to get adequate access to testing in Massachusetts. Please donate now to help support our public testing program.

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Why Aren’t There More Programs Like This?

This program is now possible because federal guidelines recently lifted the limitation of “symptoms only” testing by independent laboratories. Simultaneously, Governor Baker’s task force has urged us to do our own outreach to encourage “public” testing, which we have now begun.

However, a couple of key barriers still exist in MA. First, there is an old public health law that testing by licensed laboratories can only be performed at the request of a physician. The Obama administration tried to eliminate this provision entirely, country-wide, in keeping with Institute of Medicine recommendations from 20 years ago, but the Commonwealth is one of a few states has retained it nonetheless. For our pilot program, BRF has partnered with a local physician to provide these requisitions and collect the samples from patients.

A second barrier is reimbursement for testing. BRF has been informed by doctors that Medicare is reimbursing at a significantly lower rate for small labs, like BRF, than for large labs, like Quest Diagnostics. This lower reimbursement is happening even though in many cases BRF is able to provide faster and/or more specialized results. This puts doctors in the difficult position of choosing between the best test for their patient and covering the costs of their practice. BRF is looking into why this is the case.

We Need Your Support

State funds and insurance reimbursements don’t cover the costs of this vitally needed testing program. We need support from donors like you to provide as many tests as possible to the community. Please consider a donation today!

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On-Demand Testing Needed

Letter to the Editor from Dr. Ann A Kiessling:

Wilma is a social worker on a medical ward at a state hospital. The patient she helped on Thursday developed fever and sore throat on Friday and was tested for COVID19 “sometime over the week-end.” Wilma was notified of the patient’s positive COVID19 test result on Wednesday, five days after the onset of the patient’s symptoms.

Concerned that she was also infected and had infected her husband and her toddler son, Wilma immediately asked to be re-tested at Bedford Research Foundation. She had been tested a week prior because as a front-line health care worker, she was concerned about infecting her family, and was unable to be tested through her work. The first test at BRF was negative. The second test at BRF was positive.

Wilma is my daughter. I am the lab director at BRF. I watched the positive test appear on the qPCR instrument. It was more positive than the positive controls included in the test run. I called her cell phone and told her that her test was positive. “I know, Mom, I’m in bed, I’m exhausted.”

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COVID-19 Testing Now at BRF

Lack of testing still remains a key issue in the battle to contain COVID-19. The Bedford Research Foundation is proud to announce that we’ve expanded our non-profit laboratory services to offer fast and accurate COVID-19 testing in Massachusetts.

BRF laboratory technicians are now working long, rotating shifts to test hundreds of samples each week and ensure that results are available within 24 hours of the sample arriving at the lab. As of April 8th, we’ve tested 460 specimens with 79 testing positive (state report).

BRF is now one of just 66 organizations on the FDA site with an approved test for COVID-19 in the United States. (see the list)

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