(SHORT) Thread

Another terrific study showing rapid tests WORK & can be key tools to combat this virus

Of 897 people w high virus (Ct<25): 888 were detected w Rapid Test

Sens: 99.1%
Spec: 99.5%


*repeat tweet b/c typo in last

If these ppl were screening, this would be 888 INFECTIOUS ppl who'd KNOW they’re contagious–and be empowered to act IMMEDIATELY Instead

In USA today, these 888 INFECTIOUS ppl would simply NOT be tested OR find out ~3-7 days later -> often AFTER contagiousness clears!

In this study there was a specificity of 99.5%!

In other words, out of 1000 tests, 5 people would be called falsely positive

This is OK–simply test again- w another rapid confirmatory test that should come with the first test. Those 5 would NOT be likely to be pos on both

POPULATION SCREENING with frequent rapid tests (at home) will allow people to go about days more safely. Do everything else the same. But IF +ve, isolate.

If they can't isolate - for any number of reasons - they'd at least KNOW that they are +ve and can try to limit spread.

For many ppl who WILL have to go to work either way and are reluctant to test for fear of no income... these tests will empower them.

If choice is (i) work and NOT know or (ii) work and KNOW infectious... I choose (ii) any day!!

Small changes even at work can limit spread

RIght now, our status quo is simply no testing, making testing so difficult that most don't get tested till late, or delays causing test results to come back late.

Essentially, no one gets notified in the USA today w results IN TIME to really act to limit spread.

Lets get inexpensive rapid tests BUILT and distributed by the govnt (or w govnt help) to people's homes, works (if appropriate), schools,etc

An infectious case caught is potentially 10's-1000's of cases prevented

This is how we stop this pandemic

In the comments, @IHoward1749 (sarcastically) hits nail on head:

"It’s obviously more important to let those 888 people go to work, school, or family gatherings than forego certainty of identifying [all] 897"

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More from @michaelmina_lab

23 Nov
Rapid Antigen tests are very sensitive at Ct < 30

Above which-too little live virus to detect

Ppl worry transmission could occur at Ct > 30 and thus missed by Ag test

Transmissibility is NOT BINARY
Possible at 34? Yes
Likely? No.

This graph helps place Cts in context!

1/ Image
(If do not see the full graph above - please click on it)

Easy to forget Ct values are LOG scale

They place as much emphasis on an increase of 1000 viral particles as they do an increase of 1,000,000,000!!

But when we change from a Ct scale to a scale that shows the number of viruses withouth "zooming in" on the low end, we see just how stark a different 20-25 is versus 30-35.

Read 8 tweets
22 Nov
@DrEricDing @VirusesImmunity @PeterHotez This is a great question

The vaccine is not necessarily a more trusted source of immunity. Both an infection AND a vaccine are likely to induce good immune responses. All of the information we have suggests that immunity to infection for this virus is... well... as expected

@DrEricDing @VirusesImmunity @PeterHotez However, to the questioners point, we are hoping the vaccines will induce potent and long lasting immunity. The vaccines are designed specifically to direct our immune response to look in the right spot - vs searching all over the virus...

@DrEricDing @VirusesImmunity @PeterHotez The leading vaccines are all designed to induce, primarily, an antibody response that specifically blocks virus entry. To do this, they display a piece of the spike protein - the key to unlock entry into the cell.

Read 15 tweets
20 Nov
Right... lets keep focusing on PCR lab based medical testing for a public health war

A public health test with a:
-24 hour delay is just OK
-48 hour delay really losing its use
-72 hour delay almost irrelevant for transmission
-96 hour delay - waste

2/ We have to recognize that the tools we need to fight this war are sitting right in front of us.

Blocked by a medical enterprise that can't see a forest, just trees

A government that fails to recognize the gravity of the situation we are in

3/ Some people say rapid antigen testing is not good enough. "Some infected people might slip by!"

First: Essentially everyone is "slipping by" right now. People are either tested post-transmissible stage or getting results too late to act.

Most are just not getting tested!
Read 12 tweets
19 Nov
South Dakota

68,671 cases
Pop: 885,000
HIGH test +ve %; i.e. not nearly enough testing

I'd be surprised if catching >1 in 5 cases

If so, does 68,671 => 343,000 cases?

And if so... 39% infected...is SD nearing Herd Immunity?

Should serosurvey much of SD to understand if so.
Note: It's tough to know what the true detection rate is. Is it 1 in 2, 1 in 5, 1 in 8 detected?

We don't know for sure.
Either way... SD has a LOT of it's pop infected.

Since it's one of highest per capita states, will be imprtnt to monitor this state
And no - I am NOT suggesting herd immunity as an option. I'm simply stating the numbers up there and suggesting that we monitor to better understand what has and what will happen.
Read 4 tweets
18 Nov
For anyone wondering what a best-in-class rapid antigen test looks like. This is the @AbbottNews PanBio rapid antigen test.

If you lift up the plastic top (which is cheap) it is a simply paper strip (that white part with the red line)....

These are exceptionally cheap w/ very good accuracy to detect people when they are carrying infectious virus

Extremely easy to use
Simple design

I suggest a model where you reuse the plastic shell (like contact lenses) and just change the paper strip. Simple.

It is really unfortunate though that this particular test is NOT sold in the US. It is sold outside of the United States.

Nevertheless - this is to show that THESE TESTS EXIST.

The US Government should be making them in the 10's of millions daily.

Instead, Americans are dying
Read 4 tweets
18 Nov

• NO lockdowns
• NO waiting for vaccines
• Reverses cases in weeks

A true public health approach focused on the ppl

To end the public health *WAR* we are in.

RAPID At-Home COVID Testing for All

This Plan works WITH the people and meets them where they are.

It works WITH all the other public health approaches we are already taking - it does not replace them

It is bold and and ambitious - and addresses the fact that we are actually in a war with a virus...

It is time the government STOPS the nonsence of treating this like scattered medical problems to be addressed medically

We MUST address the pandemic as a public health problem - with the RIGHT TOOLS - only then will the medical issues resolve

Not the other way around

Read 15 tweets

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