I want to shout this from the rooftops!!! @michaelmina_lab, Harvard epidemiologist, explains a clear, practical solution to the #Covid_19 testing problem on #TWiV - but the FDA won't listen to him. Well worth a listen, but I will summarize what I learned in a short thread. 1/
(Note: my qualification is a PhD in chemical biology. I never studied viruses directly but I have done PCR and can follow the fundamentals of the relevant science.) 2/
Michael Mina's analysis left all the other virologists on the podcast going "Whoa! Wow! What! He's solved it!" to give you a sense of how potent this is. 3/
The headline finding: Cheap tests that can pick up cases at their most infectious stage, performed daily on everyone at home, can rapidly identify and control any potential outbreaks. It's that simple. 4/
The challenge: the FDA has stringent sensitivity requirements on assays. That means it is requiring the tests pick up very low levels of virus. It is keeping many effective, cheap home tests (think spitting on a piece of paper! Easy peasy!) stuck in labs. 5/
The fundamental problem is that we don't NEED to pick up low levels of virus. Sensitive, clinical grade assays pick up fragments of RNA from dead viruses floating around the body long after the virus is actually alive or transmissible. 6/
Therefore, many positive tests with current testing methods are actually far too late in the virus lifecycle to even mean anything. Possible infectious contacts would be 2 weeks ago - impossible to contact trace, and useless anyway. 7/
With daily screening, you would pick up a person on the first day their viral load skyrockets. It goes from low to high within HOURS, so if you miss it one day, you get it the second, and they quarantine. Anyone else they infected would also test positive soon and quarantine. 8/
So daily, "less sensitive" testing would actually give the most useful, actionable results. It would identify all the silent transmitters and lock them down fast.
Huge implication: It would allow schools to open in a state of control!! 9/
Huge implication: It would allow schools to open in a state of control!! 9/
The elegance and beauty of this is powerful. A solution exists. It is real, it is sensible, it is practical.
But it requires resources and coordinated efforts. It requires the federal government to mass produce cheap tests and distribute them. 10/
But it requires resources and coordinated efforts. It requires the federal government to mass produce cheap tests and distribute them. 10/
It seems unlikely that will happen with this government. I am furious and heartbroken about that. But the difference now for me is that I know a solution exists. It is possible. And when a Democrat takes office in January, it is doable. That gives me hope. 11/
Finally, Michael Mina wrote a @nytimes op-ed explaining this in more detail, and I encourage you to read it. We have to find hope in these dark times. 12/ nytimes.com/2020/07/03/opi…
Thank you to @profvrr for hosting this podcast and getting @michaelmina_lab's incredible work out there. /Fin
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