COVID-19 testing

"The Centers for Disease Control and Prevention has been caught on numerous occasions engaging in statistical manipulation in order to drive up a perpetual state of fear among Americans – all with the aim of coaxing people to get the Covid-19 ‘vaccine.’ But one thing the CDC appears entirely unwilling to do is to document the ways that natural immunity has made the vaccines redundant at best, and harmful at worst, for those who were previously infected."

"Why wait for someone to develop symptoms before testing?"

"[T]he 500 million tests the administration is distributing are not nearly enough, many experts say, especially for families who have children in school and parents back at work. “It’s good, but it’s really just a drop in the bucket,” said Dr. Eric Feigl-Ding, an epidemiologist and senior fellow at the Federation of American Scientists. "Considering that we need to test millions and millions of people regularly, 500 million tests is about one and a half per person. It’s really negligible.”"

"According to the Director-General of the WHO, the choice to abandon systematic testing and contract tracing, which were effective in Korea and Taiwan, was a major mistake that contributed to the spread of the virus in virtually every country. The ultimate cause of this alarming delay were strategic choices."

"The WHO's recommendations were very clear: states must not abandon systematic screening and contact tracing of anyone who tests positive for the virus."

"Three years ago, experts were saying that bat coronaviruses could become a new pandemic. Almost two months ago, experts were saying that the new virus in was potentially a global threat. One month ago, experts were saying that it was likely to be pandemic, and the White House's response was that this was under control, despite the fact that the US's lack of testing was demonstrably giving a false picture of the extent of infection. This was foreseeable, and foreseen, weeks and months ago, and only now is the White House coming out of denial and heading straight into saying it could not have been foreseen."

"But as of right now and yesterday, anybody that needs a test — That's the important thing. And the tests are all perfect. Like, the letter was perfect. The transcription was perfect. Right? This was not as perfect as that but pretty good."

"No, I don't take responsibility at all, because we were given a set of circumstances and we were given rules, regulations and specifications from a different time."

"Peter Alexander: How are non-symptomatic professional athletes getting tests while others are waiting in line and can't get them?"

"Market signals were clear: There’s no profit in preventing a future catastrophe. [...] One effect is the shockingly belated and limited testing, well below others, making it impossible to implement the successful test-and-trace strategies that have prevented the epidemic from breaking out of control in functioning societies. Even the best hospitals lack basic equipment. The U.S. is now the global epicenter of the crisis."

"A reliable test to see who has been infected without showing symptoms — and so could be moved to the recovered group — would be a game changer for modellers, and might significantly alter the predicted path of the pandemic, says Edmunds. To stress the need for such a test, a team at the University of Oxford, UK, led by theoretical epidemiologist Sunetra Gupta, has suggested that the pattern of recorded deaths in the United Kingdom might fit a range of SIR models, including one that assumes millions of people have already been infected but haven’t shown any symptoms. Only tests that reveal such past infections can show what’s going on in reality."

"That White House Coronavirus Task Force met today. It was reported to us that, at this moment, more than 746,000 Americans have tested positive for the coronavirus."

"Remember that, a month ago, we had done 80,000 coronavirus tests in America. This weekend, we cleared more than 4 million. And we’re currently testing more than a million Americans a week. We fully expect to actually have tested more than 5 million Americans before the end of this month. But at the President's urging, we’re going to continue to scale that testing and then work with governors to make sure that they can manage and implement and deploy that testing in the manner that will most support their efforts to move their states forward. Remember that the testing that is contemplated in the Guidelines for Opening Up America Again, for phase one, are testing people that have symptoms that may be coronavirus, and then also having the testing resources to deploy to vulnerable communities: nursing homes or other vulnerable communities that we have identified as needing additional –what is called "monitoring" or "surveillance testing"."

"We believe we have the testing today around the country that would allow any state in America to move into phase one if they've met the other criteria: fourteen days of consistent declines and strong hospital capacity, so that their system would not be overwhelmed in the event of a flare-up. But we’re going to be working with governors tomorrow on the subject of testing and supplies. And as the President said again this evening: We’re here to help. We’ve forged a partnership with governors around the country, and tomorrow we’ll be building on that partnership to hopefully arrive at the day that we can make sure governors around the nation have the best advice and the best resources to put America back to work."

"Secondly, the president made it clear to us that we were to make sure the hospitals in impacted areas had the resources and the equipment that they needed to be able to save as many lives as possible. [...] But testing has been a focus of ours as well, from very beginning. And it's the reason why the president, early on, brought in this vast array of commercial labs that took us from 80,000 tests one month ago to now four million tests as of yesterday. And as we'll make clear again to governors tomorrow in our weekly conference call, we look forward to continuing to partner with governors all across the country as we continue to scale testing. Because we really believe that, while we're doing 150,000 tests a day now, that if states around the country will activate all of the laboratories that are available in their states, we could more than double that overnight and literally be doing hundreds of thousands of more tests per day in a very short period of time."

"Just so we're very clear, when the president outlined his guidelines for opening up America, we laid out a plan for both -- for when and how we thought it was best according to our best scientists and advisors for states to be able to responsibly and safely reopen. And we believe today as Dr. Birx has said, as Dr. Fauci and others have said, is that there is a sufficient capacity of testing across the country today for any state in America to go to a phase one level which contemplates testing people that have . And also doing the kind of monitoring of vulnerable populations in our cities, in our nursing homes that we ought to be watching very carefully for outbreaks of the coronavirus. But we believe working with the governors, as we'll continue to partner with them, that we can activate labs around the country and that states today, if the governor so chooses, have sufficient testing to be able to move into the testing contemplated in phase one."

"And we also have deployed a team from Walter Reed that over the last two weeks has been calling every single laboratory in the country that can do coronavirus testing. And tomorrow we'll be presenting all of those details to governors so that they can activate those tests in their state."

"Admiral Brett Giroir of the spends all of his time coordinating testing deployment and resources deployment from . And what we're making clear to governors, and I want the American people to know, is that we will continue to do that. While the president has made it clear that we want the governors to implement testing and deploy testing where they deem it's most appropriate in their state, we're going to continue to fully partner with states around the country to increase the supply, to make sure that they have the reagents and the test kits necessary to perform those tests. But I want to say again, it is truly -- it's a tribute to the president's leadership that early on in this process he brought in the top commercial labs in the country. They formed an alliance. And we went from one month ago to 80,000 tests being done to four million tests being completed as of yesterday. We'll continue to increase that. We'll continue to make governors aware of that."

"In any health care crisis, we want to make sure the health care workers at the local level have the resources they need because it's locally executed. It is state managed. But it's federally supported. And the federal government at the president's direction will continue to support governors as they deploy the testing resources in the time and manner of their choosing. But we believe today, as Dr. Deborah Birx has confirmed, is we have a sufficient capacity of testing today for any state in America to move into phase one and begin the process of reopening their state and their economy."

"I've seen that report in the papers this morning. And I know that HHS is making inquiries. But we believe those issues were resolved on that particular test by early February. But it's important for your viewers to know that that test, the slow lab-based test that is typical for CDC and labs would never have been able to meet the needs of testing in this coronavirus epidemic. That's why President Trump was so right when he brought together these commercial labs and formed a consortium. And literally took us from -- at that time in February we had done some 20,000 tests total across the country. Now we've done more than four million and we believe we'll have done more than five million tests before the end of this month. None of that would have been possible without the president's leadership, without the innovation, without the incredible efforts of companies like Roche and Avid Laboratories. And the American people can be confident that whether it is supplies, whether it is testing, we're going to continue to make sure that our governors, our state health care officials and most especially our health care workers have the resources and the support they need. But I want the American people to know that sitting here this morning we really are seeing encouraging signs because of what the American people have done, we believe we are slowing the spread."

"We believe that under the phase one criteria that we have a sufficient amount of testing at that level to allow states to begin to responsibly reopen. And literally doing more than 150,000 tests a day now, a number that we believe we could double once we activate all the laboratories around the country, we're confident that that would enable any governor who's otherwise met the criteria of 14 days of declining cases to be able to have the testing capacity sufficient to monitor people that may have symptoms so we can identify them and do contact tracing and also deploy the resources to vulnerable populations, nursing homes and particular vulnerable populations in our city to ensure that we don't see a resurgence of the coronavirus. So yes, we think we've laid a strong foundation for testing for phase one and we're going to continue to expand testing going forward for the nation in the weeks and months ahead."

"So we’ve done 1,670,000 tests. Think of that 1,670,000 tests. And we have a great system. Now we’re working with the states in almost all instances, but we have a great system. And the other thing that we bought a tremendous amount of is the hydroxy chloroquine. Hydroxy chloroquine, which I think is, you know, it’s a great malaria drug. It’s worked unbelievably. It’s a powerful drug on malaria and there are signs that it works on this, some very strong signs and in the meantime it’s been around a long time. It also works very powerfully on lupus, so there are some very strong powerful signs and we’ll have to see because again, it’s tested."

"I want them to try it. It may work, and it may not work. But if it doesn’t work, it’s nothing lost by doing it. Nothing. Because we know long-term what I want. I want to save lives, and I don’t want it to be in a lab for the next year-and-a-half as people are dying all over the place. In France, they had a very good test. They’re continuing. But we don’t have time to go and say, gee, let’s take a couple of years and test it out, and let’s go and test with the test tubes and the laboratories. We don’t have time. I’d love to do that, but we have people dying today. As we speak, there are people dying. If it works, that’d be great. If it doesn’t work, we know for many years malaria, it’s incredible what it’s done for malaria. It’s incredible what it’s done for lupus, but it doesn’t kill people."

"I think I read yesterday a report that we’ve done more than everybody — every other country — combined, we’ve tested more than every other country in the world even put together."

"The only reason the U.S. has reported one million cases of CoronaVirus is that our Testing is sooo much better than any other country in the World."

"Donald Trump: And you have to understand: When we took over, the cupboards were bare. And the thing that — frankly, it’s not as tough as the ventilator situation. We’re the king of ventilators. But what we have done is — on testing, we’re doing numbers the likes of which nobody has ever seen before. And I told you, the President of South Korea, President Moon, called me to congratulate me on testing. And we did more tests than any other country anywhere in the world. And I think they told me yesterday a number — if you add up the rest of the world, we’ve done more testing. And it’s a higher quality test. So I think we’ve done a — I think the whole team, federal government — we built hospitals for you and others."

"If people want to get tested, they get tested."

"If we didn’t do any testing, we would have very few cases"

"When we have a lot of cases, I don’t look at that as a bad thing — I look at that in a certain respect as being a good thing because it means our testing is much better. ... So I view it as a badge of honour, really,"

"Yeah. I tested positively toward negative, right? So, no, I tested perfectly this morning, meaning—meaning I tested negative... But that’s a way of saying it: positively toward the negative."

"To one extent or another, the volume of new cases coming in is a reflection of a great success in expanding testing across the country."

"Cases up only because of our big number testing. Mortality rate way down!!!"

"It’s fading away, it’s going to fade away."

"We have got the greatest testing program anywhere in the world."

"We’ve done too good a job."

"You know testing is a double-edged sword. ... Here’s the bad part. When you test to that extent, you are going to find more people, find more cases. So I said to my people, ‘Slow the testing down please.’"

"Now we have tested almost 40m people. By so doing, we show cases, 99% of which are totally harmless."

"For the 1/100th time, the reason we show so many Cases, compared to other countries that haven’t done nearly as well as we have, is that our TESTING is much bigger and better. We have tested 40,000,000 people. If we did 20,000,000 instead, Cases would be half, etc. NOT REPORTED!"

"As NFL players arrive at training camp this week, each person will be given a wearable smart tag that will monitor the physical distance of their interactions and for how long they occur. Inside the NBA’s bubble, the sound of beeping indicating social distancing has been compromised, has become part of the new normal. Kinexon’s SafeZone tags are the latest tool the NBA and NFL are using to monitor social distancing and also to provide contact tracing in the event a player tests positive. It’s all part of the new reality as sports leagues are investing their money and resources into tools to allow them to return to action safely."

"The timing couldn’t have been worse. In March, just as Thailand’s coronavirus outbreak began to ramp up, three hospitals in Bangkok announced that they had suspended testing for the virus because they had run out of reagents. Thai researchers rushed to help the country’s clinical laboratories meet the demand. Looking for affordable and easy-to-use tests, systems biologist Chayasith (Tao) Uttamapinant at the Vidyasirimedhi Institute of Science and Technology in Rayong reached out to an old acquaintance: CRISPR co-discoverer Feng Zhang, who had been developing an assay for the coronavirus inspired by the gene-editing technology. Within days, Uttamapinant received starter kits from Zhang’s lab at the Broad Institute of MIT and Harvard in Cambridge, Massachusetts, and tested them on samples from a hospital in Bangkok. “The kits are quite cheap and work well,” says Uttamapinant, who hopes to get the test approved for clinical use by the end of the year. He has teamed up with biochemists in Thailand to produce the testing reagents locally, with Zhang on standby for support. “This effort to produce everything locally will have a lasting impact on infectious-disease monitoring and diagnosis in this part of the globe,” says Uttamapinant."

"Epidemiologists say mass testing for SARS-CoV-2 — requiring millions of tests per country per week — is the most practical way out of the current crisis. It allows officials to isolate those who test positive, limit the spread of disease and help to determine when it is safe to relax restrictions. But countries are struggling to ramp up testing. One reason is that the standard test to detect SARS-CoV-2 — based on a mainstay lab technique called the reverse-transcription polymerase chain reaction, or RT-PCR — requires trained personnel, specific chemical supplies and expensive instruments that take hours to provide results and are often available only in labs that provide routine, centralized services. This limits the number of tests that can be done, especially in developing countries. Even in wealthy regions such as the United States, providers have reported a severe shortage of test kits and required materials — from nose swabs to chemical reagents — because of supply-chain problems. Scaling up reliable tests quickly has proved challenging, too: early RT-PCR tests developed by the US Centers for Disease Control and Prevention malfunctioned, for example, leading to a series of delays."

"The most promising way to perform large numbers of tests, says Mitchell O’Connell, a biochemist at the University of Rochester in New York, will be to use a mix of methods that rely on different instruments and supply chains so that a sudden worldwide demand won’t deplete any key materials. “Any new technology that is able to expand the number of tests that we can do is good news,” he says. If those tests are ready soon, it would be good news for the current pandemic and for future outbreaks. Many of the assays in development could be readily adapted to an emerging pathogen once its genetic sequence is decoded, says Isabella Eckerle, a virologist at the University of Geneva in Switzerland. Eckerle says that, even though the ideal test doesn’t yet exist — one that is accurate, rapid, inexpensive, and easy to use and scale up — “there are many things in the pipeline that could be useful.”"

"Several other tests are based on a technique called loop-mediated isothermal amplification (LAMP), which also works at a constant temperature and has been used to identify viruses such as Zika. LAMP relies on two enzymes — one to convert the viral RNA to DNA, and another to copy DNA — as well as a set of four to six short primers designed to recognize different snippets of the viral genome. These fragments not only help to get the copying started, as in RT-PCR, but also allow newly copied DNA strands to form looped structures that can be amplified much more rapidly than in standard PCR (see ‘Loop the loop’). It is less accurate, however, and only a few dozen samples can be run at a time. Because the technique doesn’t need special instruments, it can be used in the field and in regions that lack advanced equipment, including remote areas and refugee camps, says Vicent Pelechano, a genomics expert at the Karolinska Institute in Stockholm, who co-developed a LAMP-based assay for SARS-CoV-2. “All you need is a test tube containing the primers, a pipette, a hotplate and a pot of water,” he says. A single test would cost about $1 — not counting labour. In the lab, Pelechano and colleagues’ LAMP-based test could detect as few as 10 copies of a SARS-CoV-2 genome in no longer than 40 minutes1. The researchers then tested the assay using samples from 248 people with confirmed coronavirus infection, and could detect the virus nearly 90% of the time2. Pelechano acknowledges that the test might turn out to be less accurate for some samples, such as those contaminated with blood. But in some places, the trade-off in accuracy could be worth it. Low-income countries and war-torn areas don’t have enough PCR machines to perform the standard diagnostic test for coronavirus, says Nabil Karah, a clinical microbiologist at Umeå University in Sweden. Karah is working with other scientists and with Pelechano’s team to bring their LAMP-based test to Syria to increase local testing capacity."

"In early March, as diagnostics struggled to keep up with the spread of coronavirus across the United States, chemical engineer Howard Salis felt compelled to help. To speed up testing, he decided to try a powerful sequencing approach that had revolutionized the pace of genomics research. About three weeks later, Salis’s team of synthetic biologists at Pennsylvania State University in University Park came up with a way to test samples from nearly 20,000 people in one run. Their method adds individual ‘molecular barcodes’ to clinical samples before pooling them and using next-generation sequencing to decode them all at once. The barcodes then allow the researchers to identify which samples tested positive. Other teams have released details of similar mass-testing approaches, including the biotechnology start-up firm Octant in Emeryville, California, and researchers at the Broad Institute3. Because DNA sequencers can read out hundreds of millions of DNA snippets at once, researchers estimate that sequencing-based tests could be used to analyse up to 100,000 samples in one run. By contrast, a standard PCR machine can test just dozens or hundreds of samples at the same time. But these sequencing tests take time — at least 12 hours — and require specialized equipment in centralized facilities. Getting millions of samples delivered to those facilities isn’t trivial."

"Another way researchers are trying to bring testing to the masses is to devise assays that could be used in temporary testing facilities, drive-through testing centres and even in people’s homes. At least two teams are taking advantage of the gene-editing technology CRISPR to power such tests. For example, researchers led by Zhang have developed a coronavirus assay that can be run in a single test tube in about an hour4. But it still requires heating the sample to about 65 °C, and it’s not as sensitive as a PCR-based assay. “That’s okay, because it’s much easier to use,” Zhang says. When tested multiple times on samples from 12 people infected with coronavirus, the assay detected the virus on nearly every occasion. The test builds on an approach that Zhang co-developed in 2017, called SHERLOCK5, which relies on the ability of the CRISPR machinery to home in on specific genetic sequences. Researchers program a guide molecule to latch on to a particular stretch of the SARS-CoV-2 genome. If the guide molecule finds a match, a CRISPR enzyme generates a signal that can be detected either as a fluorescent glow or as a dark band on a paper dipstick (see ‘Cut and detect’). On 6 May, the US Food and Drug Administration (FDA) authorized a SHERLOCK coronavirus assay for emergency use. The test is made by biotechnology firm Sherlock BioSciences in Cambridge, Massachusetts (of which Zhang is a co-founder), and the company has partnered with a manufacturer to mass-produce the kits. (See also ‘Coronavirus assays assessed’.)"

"Guozhen Liu, a bioengineer at the University of New South Wales in Sydney, Australia, says that technologies such as CRISPR could be “a game changer” in the current pandemic. Thanks to their ability to quickly and precisely identify genetic snippets, these approaches “can find a needle in a haystack”, Liu says. They use different reagents from RT-PCR-based assays — useful when there are shortages of chemical supplies for standard tests — and they can be designed to target any pathogen. For example, a team led by computational biologist Pardis Sabeti at the Broad Institute created rubber ‘chips’ about the size of a smartphone that can search 1,000 samples for a single virus, or 5 samples for a panel of 169 viruses that are known to infect humans8."

"Even once a test is working beautifully in the lab, it still faces an arduous journey to mass usage. The first challenge is to verify performance, because quality can vary. “It’s a Wild West out there for assay development,” says Catharina Boehme, chief executive officer of the Foundation for Innovative New Diagnostics (FIND), a non-profit group in Geneva that is collaborating with the World Health Organization and the University Hospitals of Geneva to assess hundreds of SARS-CoV-2 testing options. Most RT-PCR-based tests that FIND has evaluated perform just as well as the gold standard does, whereas antigen tests have so far fallen short of expectations, Boehme says. Another hurdle is scaling up the assays for mass production. Given this constraint, Boehme thinks it is unrealistic that all the new tests will be deployed before the end of the year — although a small number might be. But once they are available, they could work alongside the gold standard to push countries closer to the target of millions of tests per week — and prepare the world for the next pandemic."

"Vocalis, a voice-analysis company with offices in Israel and the United States, had previously built a smartphone app that could detect flare-ups of chronic obstructive pulmonary disease by listening for signs that users were short of breath when speaking. The firm wanted to do the same thing with COVID-19. People who had tested positive for the coronavirus could participate simply by downloading a Vocalis research app. Once a day, they fired up the app and spoke into their phones, describing an image aloud and counting from 50 to 70. Then Vocalis began processing these recordings with its machine-learning system, alongside the voices of people who had tested negative for the disease, in an attempt to identify a voiceprint for the illness. By mid-summer, the firm had more than 1,500 voice samples and a pilot version of a digital COVID-19 screening tool. The tool, which the company is currently testing around the world, is not intended to provide a definitive diagnosis, but to help clinicians triage potential cases, identifying people who might be most in need of testing, quarantine or in-person medical care. “Can we help with our AI algorithm?” asks Tal Wenderow, the president and chief executive of Vocalis. “This is not invasive, it’s not a drug, we’re not changing anything. All you need to do is speak.”"

"Something extremely bogus is going on. Was tested for covid four times today. Two tests came back negative, two came back positive."

"Municipal wastewater is a composite biological sample of an entire community with each member of the community inputting biological specimens every day. It is therefore no surprise that wastewater has been tapped as an epidemiological tool to gauge aspects of public health, such as narcotic usage, the reemergence of poliovirus, and infection rates of viral and bacterial diseases. COVID-19 has accelerated the interest in wastewater-based epidemiology (WBE) due to the fact that SARS-CoV-2 genes are detected in the feces of many infected individuals. More established epidemiological tools used to track cases in a community have been hindered during the COVID-19 pandemic by diagnostic kit shortages, asymptomatic or mild cases that do not encounter the medical system or delay seeking medical attention, and the lag times between testing and reporting. As a result, public health officials and administrators have had to make critical decisions about opening or closing communities with limited surveillance data. Scientists, engineers, public officials, and the general public, are optimistic that WBE could provide additional data on COVID-19 infections in a community. In fact, the United States Center for Disease Control has established the National Wastewater Surveillance System as a framework for using WBE to inform the response to the COVID-19 pandemic. Recent published studies have reported SARS-CoV-2 detection and quantification in sewage. Based on these reports, numerous entities/organizations across the globe and across scales are moving to implement WBE. It remains to be seen how the data generated from wastewater surveillance should be interpreted or will ultimately be used to make public health decisions. Potential uses include informing on the presence or absence of COVID-19 in a community, similar to polio surveillance; tracking trends over time to project infection trajectory in the coming days; or even using the SARS-CoV-2 concentrations in wastewater to estimate prevalence in a community. The latter application requires a clear understanding of fecal shedding dynamics over the course of the illness, which is not yet established."