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Virus testing to increase after snafus slowed U.S. response

U.S. Vice President Mike Pence said Wednesday the U.S. is supposed to see increased testing for COVID-19 this week, but only after the federal government received criticism for its initial outbreak reaction, which hurt the response efforts of local health jurisdictions in Washington and the U.S.

The first test kits sent out last month for the virus that causes coronavirus disease 2019, or COVID-19, had flaws and sometimes gave faulty results.

Those flawed kits meant that states had to ship their tests to the Centers for Disease Control and Prevention in Georgia, which could mean waiting five days for test results, according to The Seattle Times. It wasn’t until late last week that Washington, and other states, got the ability to test for COVID-19 at its state laboratory in Shoreline.

“It dramatically slowed down testing until now,” said Chunhuei Chi, the director of the Center for Global Health at Oregon State University in Corvallis, Ore.

COVID-19 is caused by a member of the coronavirus family and is a close cousin to the SARS and MERS viruses that have caused outbreaks in the past.

There have been at least 80 confirmed cases of COVID-19 in the United States, according to the CDC, and the disease has killed 11 people in the U.S. At least 39 cases are in Washington, where 10 deaths have occurred, with the majority from a long-term care facility in Kirkland. Clark County is awaiting results on eight tests for COVID-19, and the results should return this week.

Clark County Public Health Officer Dr. Alan Melnick told The Columbian on Tuesday that he wouldn’t be surprised if all eight tests return negative, since there are lots of respiratory illnesses circulating now. Cowlitz County has had three negative tests, according to The Daily News.

Since there were testing problems initially, fewer carriers of the virus were identified, which hurts containment efforts, said Paul Drain, an assistant professor in the Departments of Global Health, Medicine (Infectious Diseases), and Epidemiology at the University of Washington.

Melnick told The Columbian Tuesday “it would have been great if there were more testing early on.”

Danielle Koenig, a spokeswoman with the Washington Department of Health, told The Columbian in an email that the state had tested 99 samples from 56 people as of March 1. Their testing capacity is about 200 specimens per day now, Koenig said, and the state is working with commercial labs to increase testing capacity.

“We are keeping up with the requests,” Koenig said.

Another problem area for testing has been the federal guidelines that allow a person to get tested. Initially, tests were only given to people who had contact with a case or had traveled to an area with exposures. To get a test without meeting either of those thresholds, a person had to have a subjective or confirmed fever with a severe acute lower respiratory infection, such as pneumonia, requiring hospitalization and no other explained diagnosis, such as influenza, according to the CDC.

Restrictions lifted

On Wednesday, Pence lifted all restrictions on testing, and made it so patients would only need a doctor’s request. He also said that about 2,500 test kits for more than 1 million individual tests might be available this week, according to the New York Times. Another million tests could be manufactured weekly after that, although some legislators expressed skepticism about the government meeting those numbers.

Drain said the country’s initial response highlights larger problems in the American health care model. He referenced a SARS outbreak in the early 2000s, and a MERS outbreak in 2012 as opportunities to learn how the U.S. could have better prepared for COVID-19.

“What’s been lacking in all of this is not necessarily that we’ve done a poor job in the last four months, but that we’ve done a poor job in the last 10 years,” Drain said.

Drain also said hospitals in the American health care system need to do a better job of working together. He said health care has become too fragmented. This, in part, stems from the fact that American medicine puts treatment before prevention, setting its model up around that, Drain said. For example, he said, you’ll make more money as a surgeon treating cervical cancer, than as a physician administering HPV vaccines, which can prevent cervical cancer.

“It’s the structure we’ve established in this county,” Drain said. “It’s quite backward compared to most other countries in the world.”

Chi said the U.S. has made strides since its struggles with early testing, but stressed that “we are way past advanced planning because we are in it.” He said the influx of confirmed cases recently isn’t necessarily because the disease is spreading rapidly, but because testing capacity is increasing.

“If we are not testing, we don’t have confirmed cases,” Chi said. “We will be seeing many more cases. They were there before, but we didn’t know.”


Source: https://www.columbian.com

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