An effective strategy to stopping COVID-19 includes widespread and periodic testing. This was the approach taken in the northern Italian town of Vo where the pandemic was slowed down as the University of Padua study contributed to local health officials to not only slow down the virus but identify that potentially up to 50 percent of those tested positive were asymptomatic, demonstrating that COVID-19 may include more “silent carriers” than previously thought. Iceland took a comparable approach and found that potentially a third of the population tested positive were asymptomatic. Now thanks to the fact that a married couple from United Neuroscience live in the beautiful mountain, ski town of Telluride, part of the county, the company will pay for all residents in the county to have an antibody blood test. The UK is on its way to doing the same.
Rocky Mountain County High Tests All
In Colorado’s San Miguel County, public health officials are preparing to commence testing. Set in a spectacular Rocky Mountain setting, this rural county of 8,200 inhabitants perhaps is showing the rest of American how to get more aggressive with the virus. It helps to have dedicated, affluent biotech executives who organized the financing—thanks tp United Neuroscience founders Mei Mei Hu and Lou Reese, county public health officials are armed with tests, a precious anti-COVID-19 fighting tool that has been so hard to come by across the great nation. Dr. Diana Koelliker, County Deputy Medical Director leads the charge and was recently interviewed on the Rachel Maddow show on MSNBC.
Gear up Tests Worldwide
In the United Kingdom, they have come to the conclusion they do not want a repeat of Italy or what appears to be occurring at least in America’s greatest and biggest city—New York. The lack of effective planning, coordination and orchestration of tests, quarantine and treatment leads to deadly situations. Believe it or no,t this author has personally spoken with a few people that still downplay the illness comparing it to flu; yes, they share statistics about the fact that up to 60,000 can die in one year from the flu and the news media doesn’t make a big deal about that. Of course, this highly ill-informed position turns to horror when the COVID-19 hits one close to home. People with severe cases report its like flirting with death and is certainly described as a tour through hell. New York City lost over 80 people in one day in hospitals that are at their capacity. The long-term consequences to the lungs and even the liver are not fully understood.
Now the UK has ordered 3.5 million of the antibody serum tests being used in places like Iceland and San Miguel County, Colorado. But why an antibody test?
More researchers are calling for antibody tests as a way to deal with the COVID-19 pandemic. These tests don’t test directly for presence of the virus but rather assess if an individual has been exposed to the virus. The test can reveal if certain antibodies will be present such as IgG.
These tests are relatively economical and easy to implement compared to the other tests involving swabs of the throat and/or nasal cavity. Unfortunately, Americans haven’t had access to the direct test in large numbers because they haven’t been available. Moreover, when swab-based tests are available, obtaining the results hasn’t been easy or timely. For example, Dr. Koelliker reported that they were able obtain the nasal swab test and conduct 150 such tests over the past few weeks. The process was facilitated by state officials as well as members of the National Guard. However, out of those tests only one came back positive and more disturbingly only 24 results came back. This according to Dr. Koelliker is “woefully inadequate” as far as turn around times for testing in a major pandemic.
Silent carriers are those that don’t have any apparent health problems or issues, but nonetheless turn out to be positive, are potentially the ones spreading the disease. Known as asymptomatic, the University of Padua study in Italy identified this phenomenon as did the testing in Iceland. Hence, the importance of a pervasive, all-encompassing and methodical testing program. Moreover, tests must be done more than once because one can be tested today and turn out negative but contract the disease in two days and hence be positive.
Evolve the Health ‘System’
San Miguel County residents and local government are fortunate to have Ms. Hu and Mr. Reese among their inhabitants—biotech executives with an open mind, a civic-minded spirit, and the extra dollars—as well as the knowledge to stimulate action. America produces the largest GDP in the world and a fiscal stimulus of $2 trillion is being moved through the process in DC. Some of those funds should be considered for pervasive and methodical testing strategies. Long term, Americans will have to start to truly assess their health system. Despite the $3.5 trillion or so spent every year and the largest category of national spend along with social security and defense, the output of this vast pool of dollars must be questioned. One can’t overlook the massive debt currently at $23.6 trillion—one could ask of one with such debt: Is this sustainable?
The health system needs a reset toward digitally seamless, evidence-based outcomes or value-based models. An economic boom overhauling the health care models, systems and structures—powered by technology and disruptive thinking—will not only address the debt but actually bring a health care system rather than what we have called a “Sick care” system.
Given the world becomes smaller and dangerous viral outbreaks (SARS, MERS) are a way of life that must be anticipated, adequate attention must be channeled to systems, tools and processes that actually work. The precious capital of entrepreneurs such as Hu and Reese should not have to subsidize their local county but rather directed innovation-based research and development bets—focused on an even greater tomorrow. A public health test function should be covered in the $3.5 trillion already spent if the system was operating in a healthy and functional way.
In the meantime, other counties and locations should possibly consider setting up funds and conducting more pervasive antibody testing, identify asymptomatic segments and thus become far more data-driven, targeted and directed with quarantine strategies. But time is of the essence.