Testing Works, but It Takes Organizing and Resources

Health Care
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Pearl River     If there’s any consensus about dealing with Covid-19, it involves the critical role of testing right now, and a vaccine down the line.  Testing allows all of us and especially public health workers and epidemiologists to identify positive individuals, potential asymptomatic carriers, and, most importantly, hot spots that can receive interventions to stop community spreading.  Countries with successful short- and long-term response in the pandemic have been those like South Korea, Taiwan, and even Germany that have managed to implement almost universal and repetitive testing.

It’s all possible, but it takes extensive resources, organization, logistics, and a testing methodology that works efficiently.  Talking to Maggie Calmes, the New Orleans manager of CORE Response, on Wade’s World offered a lot of insight into the nuts and bolts of testing.  CORE Response is one of the major supplemental testing organizations working in New Orleans.  Originally, founded by Sean Penn, the actor, with others, to provide relief during the devastation in Haiti several years ago, they adapted to respond to other crises both globally and domestically.  Calmes said there was a major testing operation in Los Angeles, as well as a handful of others in places like Washington, DC and Detroit.

There are three testing protocols, she explained.  Two are nasal.  One probes deeply and is commonly administered by nursing professionals in my experience and involves inserting a thin stick up your nose, which is not very pleasant.  The other probes about two inches inside the nasal cavity.  The third method, the one used by CORE Response, is oral, making it more attractive to many who understand that there are choices.  It is also self-administered which is a huge advantage.  People are trained and then swab the roof and both sides of their mouths and return the swab to the CORE Response team.  Protecting the chain of custody is key.  All the samples are shipped in their case to a lab in California with a turnaround time that is about three days on average.  The oral tests have about the same 98% level of accuracy as the nasal tests.

Most experts argue, and experience in other countries indicates this as well, that we need a faster turnaround on results once the tests are taken.  Calmes told me the actual processing takes about twelve hours, so it would seem that we need a way to get results to officials and patients more quickly.  There just aren’t enough testing people, sites, or kits available.  CORE Response says within 15 minutes every day after they open, they have 250 people good to go, and that’s all they can handle.

The takeaway seems to be that if we had enough supplies and people trained, note that none of the CORE team are professional healthcare or public health people, testing could be ubiquitous, and that is probably what we need.  All of that is possible, but it would mean having the federal government put the resources and logistics together to get this down to the ground level where all of us are fighting this one on one with bare hands against a killer.