News reports and Trump’s former campaign manager Corey Lewandowski have indicated the White House uses an Abbott labs test, which can provide results in 15 minutes. Lewandowski said in an interview on the “Today” show on Oct. 2 that he received such a quick-results test twice this week when seeing Trump.
Why didn’t the White House’s testing regimen prevent the president from becoming infected?
Rigorous testing procedures can help identify cases and reduce the risk of an outbreak, but can’t ensure that no one will get infected.
As Harvard epidemiologist Michael Mina explained on Twitter, frequent testing worked in the sense that the transmission chain “is severed.” But, he added, tests are “not prophylactics.”
“They alone cannot stop the test taker from getting infected. But can serve to stop onward spread from the tester,” he wrote. “To stop from getting infected, masks/social distancing are needed.”
It’s also important to recognize the inherent limitations in diagnostic tests. Even if someone tests negative, that doesn’t necessarily mean that a person isn’t infected — only that the test didn’t detect the presence of the virus at that specific time.
Given that it can take a few days or even longer for the virus to become detectable, a negative result means someone still could be infectious and other public health measures should still be taken.
The White House was reportedly using Abbot’s ID NOW test as a rapid test for screening staff. The test is a molecular test that looks for the viral genome in a nasal swab sample, but is faster and less sensitive than the standard PCR tests.
Mina said in an Oct. 2 press call that the test was very good — perhaps the best rapid test available. But no test is perfect, and the test is not actually designed to be used the way the White House deployed it.
The FDA’s EUA was revised in mid-September to specify that testing is intended to be “from individuals who are suspected of COVID-19 by their health care provider within the first seven days of the onset of symptoms.” In other words, the test is meant for those who have symptoms, not for surveillance.
What is the status of a COVID-19 vaccine?
There are currently four companies running phase 3 trials of a coronavirus vaccine in the U.S. One or more vaccines may be available by the end of the year or by early 2021 to select groups, assuming the trials go well and the shots are found to be safe and effective. Members of the general population who are not prioritized for vaccination, however, are not expected to be able to receive a vaccine until later in 2021.
The leading company, in terms of timing, is Pfizer/BioNTech, which has enrolled 35,469 participants in its trial and given 24,298 volunteers both doses of its mRNA vaccine as of Sept. 28. It is the only company that still claims to be able to have an answer on whether its vaccine is safe and effective prior to Nov. 3.
Moderna’s phase 3 trial of its mRNA vaccine has enrolled 27,232 participants as of Sept. 25, 15,454 of whom have received two doses. Moderna’s CEO said on Sept. 30 that the earliest he expected the company to be able to file an EUA with the FDA is Nov. 25, with a wider approval coming perhaps in March 2021.
Oxford-AstraZeneca’s viral vector vaccine trial is still on pause in the U.S. pending an investigation into a possible severe side effect in a volunteer in the U.K.
Johnson & Johnson’s vaccine, which also uses a viral vector, albeit a different one, began phase 3 testing on Sept. 23. It is the only candidate of the four to require only one dose and not to need subzero temperatures.
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