US Can Soon Do 75,000 Tests a Day, But What Does That Mean?

Mish

US coronavirus testing capability will soar to 75,000 per day by the end of the week. But key questions remain.

How Long Will the Coronavirus Lockdowns Go On?

Here's the key question of the day: How Long Will the Coronavirus Lockdowns Go On?

It will soon be clear why Covid-19 can’t be allowed to rage through the country untamed. The intense restrictions—telling Americans to stay inside in New York, California and other states—are necessary.

For this to work, the U.S. will need widespread testing to know where and to what extent the virus is spreading. Testing capacity has increased significantly in the past few weeks thanks to relentless efforts from public, academic and private labs such as Quest and LabCorp. Producers of testing kits are also working overtime. A new test developed by Cepheid can be deployed in a doctor’s office.

By the end of next week, the U.S. will have the capacity in place to screen more than 75,000 people a day.

Another step: serological surveillance, which means blood tests to detect antibodies developed to fight the novel coronavirus. These antibodies confer immunity and can reveal whether a person has been exposed. If a sizable portion of a local community has some protection, authorities can be more confident in relying on less invasive measures. Once deployed, serological tests are cheap, straightforward, and easy to scale.

One strategy would be to infuse convalescent plasma—antibodies from the blood of patients who have recovered from Covid-19. This could help boost the immune response in those recently infected. Arturo Casadevall of Johns Hopkins outlined such an approach in these pages last month. Another approach uses antiviral drugs to target the virus and block its replication. Pharmaceutical companies are pulling antiviral drugs off the shelf and testing them rapidly.

Perhaps the most promising option for now is antibody drugs engineered by biotech companies that target features on the virus’s surface. This strategy was used with success against Ebola. These medications can be given as a prophylaxis to prevent infection for doctors or older populations at high risk of exposure, and can also be used on infected patients. Regeneron developed one such treatment against Ebola. The company has a product in the works to target Covid-19 that could be ready as soon as this summer.

The above article was a WSJ Op-Ed written by Dr. Gottlieb, a resident fellow at the American Enterprise Institute, and a board member of health-care companies. He was commissioner of the Food and Drug Administration, 2017-19.

Two Key Fundamentals

  • Population of the United States: 327 million
  • Testing Capability: 75,000 Per Day

Basic Math

327 Million / (75,000 / Day) = 4,360 Days

In about 12 years, we can test everyone.

Hooray?!

How a Boy’s Blood Stopped an Outbreak

Here's a technique that appears more promising: How a Boy’s Blood Stopped an Outbreak

It isn’t every day that a school physician’s work gets published in a medical journal. But it happened in 1934, and the story contains a lesson for the coronavirus epidemic.

A Pottstown, Pa., boy identified as C.Y. was exposed to measles. The boy was quarantined in the Hill School’s infirmary; he developed a severe case of measles but recovered. Yet he infected two other students, who exposed others.

Fearing a wider outbreak, the school doctor, J. Roswell Gallagher, took serum from C.Y. (as well as some from a public-health lab) and administered small amounts to 62 boys at risk. Serum can be extracted and prepared from a simple blood draw. Only three of the 62 boys developed measles—all mild cases. This was a remarkable victory against a highly contagious disease. The episode was important enough to warrant publication the following year in the American Journal of Public Health. (Decades later, Gallagher pioneered the field of adolescent health. He died at 92 in 1995.)

How did it work? The simple explanation is that patients who recover from an infectious disease often produce antibodies that can protect against later infections with the same microbe. This immunity can be transferred by giving serum to those at risk of infection.

In the early 20th century, physicians realized that they could prevent certain infectious diseases by taking serum from recovered patients and administering doses to those at risk of infection. This approach was used to stem outbreaks of measles, polio and mumps. Modern medicine continues to use antibodies from human serum to prevent certain infections such as rabies and hepatitis B.

If the FDA (Federal Death Agency) and CDC insist on years worth of trials, how many will die while waiting?

Mike "Mish" Shedlock

Comments (35)
No. 1-12
LawrenceBird
LawrenceBird

The S. Koreans did not test everyone yet have the situation under control without lock downs. Look at the NY results so far - 85% that got tested are negative. And these are people who thought they had it. We are going to kill the economy out of paranoia

Greggg
Greggg

stillCJ
stillCJ

Editor

Really Mish, you think we need to test everyone right away? Only people showing symptoms need to be tested and few of those will be positive. Of course a week later any tested person could become infected. It is silly to suggest testing everyone every week. As long as people showing symptoms can be tested it is good, and besides the ability to test more every week should be on the increase.

St. Funogas
St. Funogas

We've made it through every pandemic in the past 500 years without testing a single person, and without shutting down a single economy. It's beyond incredible how far out of hand this whole thing has gotten. The economic fallout is going to dwarf the actual disease problems by a factor of 100x, at a bare minimum!

Realist
Realist

Testing and tracing early enough to make a difference is the key. The US did neither, even though they had 2 months of advance warning.

Italy, has come to the realization that it could have started there in November, and they had no idea at the time. That is why they were overrun with cases before they even had a test to use.

Some countries, such as South Korea did an excellent job of testing and tracing at an early stage. Even then, they do not have it completely under control. But they avoided becoming Italy.

Regarding proper testing of treatments and vaccines: if you don’t properly test, you can end up causing more harm then good. That’s why you have to do small trials with a variety of test subjects. A treatment might help a person with a mild case while killing a patient with a severe case.

If you don’t take the time to properly test, you can end up with a bigger disaster.

Realist
Realist

Trump praised the promise of using chloroquine (a drug used for malaria) to treat covid. The next day there was a run on chloroquine in Nigeria. That evening there were at least two recorded deaths from chloroquine poisoning.

CzarChasm-Reigns
CzarChasm-Reigns

In a perfect world, the 75,000/day test capacity is rapidly deployed where needed, used prudently, and we eliminate one of many supply/demand issues confronting our medical heroes on the front lines. It is a small victory, but a victory nonetheless.

IMO, the FDA & CDC should simply enact public testing on those that have been informed & are willing.

Times are a changing. And we must adapt. And, as always, time is of the essence.

Stuki
Stuki

"In about 12 years, we can test everyone."

75,000/day by end of week doesn't imply more cannot be done by the end of next week.....

At some level of testing, testing ability ceases to be the weakest link, though. Then alleviating other bottlenecks become number 1 priority.

crazyworld
crazyworld

WHAT IS THE RELIABILITY OF THE SWAP TEST?

What did happen to these informations given on Chinese videos by at least one Chinese doctor (one month ago approximately on ZHENG tweets) about the fact that the nose swap test gave a lot of false negative. He pretended that when using a blood test he got much more positive results.? He was treating around 40 patients with Covid-19 diagnosed as per their lungs scans (they used portable scanning machines for detection amongst other means) but only 5 were covid-19 positive with the swap test, when almost all of them were positive with the blood test.
Have they improved the sensibility of these swap tests used in Europe and US?

If the swap test is still so unreliable that is one more reason to make a severe containment besides the fact that it is as of now impossible to test the whole population as shown correctly by MISH calculations.

Furthermore, everybody refer to the improvements in China but not one Western country is able to make as severe a containment than in WUHAN as an example.
I saw the Cuban medical team ( EBOLA) disembarking to assist ITALY and I saw the Chinese team ( COVID-19) disembarking in ITALY for the same purpose. The Cuban medical team upon arrival in the airport of a country severely infected like Italy were NOT WEARING A MASK (unlike all Chinese personnel ) The Chinese will hopefully teach Italy how to contain the virus (provided they listen and act accordingly)

Herkie
Herkie

Consider. 75,000 tests per day means it would take 4,466days to test everyone in America. This would be worse than useless. When they can test all 335 million of us in 3 days they will be able to isolate those infected from those uninfected, and the real problem is many infected will still show as negative till they are actually pretty sick. It will help but not alleviate the need for distancing.

George Phillies
George Phillies

The number per week is going to keep ramping up a great deal. Only testing people with symptoms an epic fail, because the disease can be asymptomatic and still carried.

yellowman98
yellowman98

You don't need to test everyone in the US.

I'm not an epidemiologist or in public health, but I think the idea is you can still control it with targeted testing based on contacts, location or symptoms for highly targeted isolation.

South Korea has the most extensive testing, and they have achieved reasonable control without large-scale shutdowns of schools and businesses. As of March 8, South Korea tested about 3500 per million people, where as the US had only tested 5 per million people! Instead of highly target testing, thorough contact tracing to capture and isolate every possible case, we have relied on blind, indiscriminate mass isolation as a strategy. (Google "Business Insider Coronavirus test per capita" for the reference)

So to get to South Korea's level in the US, you would need 3500 x 330 tests for the 330 million people in the US, or about 1.2 million tests. At 75,000 tests per day, you'd only need about 15 days. That will keep it from spreading too, but at a huge cost to our economy.

It's a bit detailed, but this thoughtful article (especially 2nd half) lays out nicely the strategies different countries have used in each country with cost-benefit analysis, weighing society costs of life and money of each option. It also discusses a path out, or exit strategies for dealing with CoronaVirus. You can dispute the all the actual numbers, but it's the ideas and concepts that are highly important.


Global Economics

FEATURED
COMMUNITY