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Why is testing so limited?


Teaching3bears
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In my state there is a private company that has developed its own test and partnered with the medical school hospital--as I understand things, the limiting factor is the amount of necessary chemical reagents; some are apparently hard to get right now. They're testing up to 2000 people per day now though, which is way up from what it was when they were trying to use the very limited supply of CDC tests.

The CDC' s test development and distribution was severely flawed from the beginning.

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It's just that if they could test everybody, they could ask those with a positive test to isolate for 2 weeks and those with a negative test could work and go out in public and the economy would be less hurt and there would be less transmission.

On Shark Tank, when there is no money to manufacture a product quickly enough for demand the sharks just throw money at it.

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LSU has been able to get permission to run tests in their PCR lab at the vet school. There are a lot of universities that have the lab equipment needed if they can get the materials and funding. But without the reagents, even if they get approval to run the tests (and have people willing to do so-there is still a significant risk to the lab workers in doing this testing even in the best lab set up)

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hotspot here - in our area it was originally because the CDC required all "official" testing to go through them.  they dismissed any other test kit, so even our major medical school wasn't "good enough" to have credible results (according to the CDC.)

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I listened to a whole podcast recently about how tests are developed and what a "kit" means and why it's taking a while . . . but I can't remember what the show was. It would have been something from NPR.

Edited to add: I think it might be this one.

As I recall, though, a "kit" is really just a set of instructions for how to mix up the right substances and a list of the materials a lab needs to do the testing. It's not like it's an actual, physical box of items.

 

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WHO offered tests back in January and they were turned down. The CDC developed it's own tests from scratch and they didn't work. So then they developed new tests from scratch and those worked, but production has been very slow because some of the materials needed are in short supply. The other issue is the level of PPE needed for healthcare workers doing the testing. We don't have enough PPE. And again supply chains are not helping. We could have ramped up production back in January, but didn't. We could have ramped up production in February, but didn't. We could have ramped up production at the beginning of March, but didn't. We have finally started ramping up production. It could have been a federal mandate back when the writing on the wall was very obvious back at the beginning of March, but of course there wasn't.

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It’s a variety of things that make the actual test tricky...you have to use specific swabs (not cotton, not wooden shaft). It’s the same swabs we use for the flu test. So you can imagine how they would run low when you have the same person you might want to swab for both. If I was to collect a sample at my office it has to be put on special viral media. That’s not easily available and not something we typically have. It has to be frozen and stay frozen until it gets to the lab. It’s an RNA test so can only be done in certain labs, it’s not a point of care test like ones that we can do bedside like strep or flu. The lab that has to do the testing has to have reagents to process the sample before it can be run. I assume when they talk about “kits” that’s what they mean is those reagents for processing the samples. But I’m not sure about what the kit means exactly. It’s not something that gets sent to a doctor’s office, other than the viral media we would put the sample in. 

I’m not sure how to address why we are so behind with testing without getting political. And I’ll just leave it at that. 🙂

 

 

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