Thread by @AbraarKaran

THREAD

1/ We in the US need to get creative/smart abt how we are testing people for #COVID19 esp as rtPCRs are limited, & once we have more

South Korea is doing drive through testing at less than 10 mins per test. You drive in your car; some1 swabs you

cbsnews.com/news/coronavir…

2/ China is testing people w/ CT scanners first (over 200+ scans per machine per day; that’s one scan every 6-7 minutes!!!); if your scan is positive, only then are you swabbed for a confirmatory PCR test (may be exceptions, not entirely sure)

#COVID19

nytimes.com/2020/03/04/hea…

3/ The UK, Sweden & others have used their healthcare systems to roll out home based testing; you stay at home w/ mild symptoms that do not need hospitalization; someone comes to your house and swabs you w/in 24 hours.
#COVID19

bmj.com/content/bmj/36…

xinhuanet.com/english/2020-0…

4/ And in the China example above, you went to a specific fever clinic that was set up separately for suspected #COVID19 cases; you are not having those people go to a regular ED.

Right now, in many places in our country, we are seeing our health systems strained.

5/ In the US (& do correct me if you know of examples that defy this somewhere in our country), we don’t have or aren’t utilizing a test-at-home or any sort of high-volume testing approach, whether that be CT chest or rtPCR (the latter is limited by testing kits).

6/ Multiple studies have shown CT scans have 97% sensitivity!

This means if your CT scan is negative, your chance that have COVID19 is exceedingly low. This is why China doesn’t even swab you if your chest CT is negative.

pubs.rsna.org/doi/10.1148/ra…

pubs.rsna.org/doi/10.1148/ra…

7/ While we wait for more rtPCR tests, we can/need to ramp up our CT chest scanning capacity like China is doing.

If nothing else, it can rule out people that don’t need to be tested so that we can focus on swabbing people that we need to, esp when # PCR tests are limited

8/ We also need to redirect these people away from EDs— if we can set up separate testing centers just for suspected #COVID19 cases like China, we may be able to start catching up w/ chest CT (presumably if many PCRs are being wasted on those that end up being negative)