We are still talking about COVID-19. Just as a point of clarification, COVID-19 means “corona virus identified in 2019”. It does not mean the 19th identified corona virus as some have claimed. The CDC also calls COVID “corona virus disease” but this a simplification.
I wanted to talk about the state of testing at the moment (mid April 2020). This information is as accurate as possible at the time of this writing and could easily be irrelevant in a couple of months. We hope testing improves dramatically soon. We will have to see.
Testing is harder than it sounds.
The summary is that testing is harder than it sounds and some very smart people have been working on this since the onset.
It will take time to get good stats on the infection and death rates from this virus. If trends hold, we probably won’t see the best data until next spring. These things take time. You will hear some say that some deaths related to COVID-19 were from other causes and that is probably true. Also true is that many will die of the virus and not be counted until later as well.
First let’s start with some COVID-19 basics. The next blog we will return to talking about steps you can take to protect yourself from this and other viruses.
1. The primary areas attacked in COVID-19 is the lower respiratory system and red blood cells. The result is the development of ARDS (acute respiratory distress syndrome). Some involvement of neurologic tissue has been reported but this does not appear to be as common or severe at the time of this writing.
2. SARS-CoV-2 (COVID-19) can cause important lung problems of adults regardless of age but the elderly with some other health issues are more at risk.
3. SARS-CoV (Severe Acute Respiratory Syndrome) epidemic of 2003 infected 8000 people worldwide in 8 months. SARS-CoV-2 is estimated to be 1,000 times more infectious than SARS-CoV or any other corona virus and infected more than 120,000 people in less than 3 months.
4. Current public testing of COVID-19 seems very inadequate with way too many false negatives (and maybe some false positive according to some authors). A false negative means you are tested and told that you don’t have the virus when in fact you do. According to an early study coming out of China, in hospitals with a confirmed SARS-CoV-2 diagnosis, the most reliable evidence of the virus was in bronchoalveolar lavage fluid and was found in 93% of cases. A tube is inserted into a smaller airway of the lungs to collect samples for help in diagnosis of lung diseases. This procedure is the most accurate for COVID-19 but its invasiveness makes it inappropriate for use on the mildly symptomatic or an asymptomatic public.
5. Next most accurate source of fluids to check for the virus is in sputum. 72% in the study who were known to be COVID-19 positive checked out as positive when looking at sputum. Nasopharyngeal swabs are probably about 50% to maybe 70% accurate. 29% of feces samples contained virus and blood only showed 1%. Urine tests were uniformly negative.
6. To put this in perspective, a state like California with about 40 million people with a hypothetical infection rate of 50% or 20 million people infected. If the testing rate is 1% or 400,000 people tested and at a detection rate of 50%, that means that 200,000 would be positive but test negative. Let’s say the testing improves to 90% and we hope it does, still 40,000 infected people would be missed.
7. Timing is everything. As the disease progresses, it tends to move south to the lungs from the upper respiratory tract.
The conclusion is that testing isn’t what we need it to be just yet. Again, we hope this situation changes soon and we have better, simpler and more reliable testing in the next few weeks. That will help each of us plan better for our own health and will help public health officials make better recommendations.
It is probably best to assume that more people are infected than not and take appropriate precautions, wearing masks when in public places, washing hands, and limiting social contact. That is what we are doing here at OVtiaminPro.