Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Argh. This indicates the CDC change in testing guidance is political. Heaven help us.

https://www.cnn.com/2020/08/26/politics/cdc-coronavirus-testing-guidance/index.html

No discussion on the Abbot card test? Just approved by FDA.

Abbott wins U.S. authorization for $5 rapid antigen test
Abbott Laboratories said it won U.S. marketing authorization for a portable coronavirus antigen test that can deliver results within 15 minutes, Reuters reported.

The test, which will sell for $5, is about the size of a credit card and does not require additional equipment, the news agency said. It also uses a less invasive nasal swab than traditional lab tests, Reuters reported citing Abbott executives.

Abbott expects to ship tens of millions of tests in September and up to 50 million tests a month beginning in October, the news agency said. ā€”Huileng Tan

Also, Scott Gā€™s thoughts on where we are -

ā€œThings are going to change I think very quickly in terms of what we have available to us and technology to combat this.ā€ @ScottGottliebMD says lateral flow tests could ā€œreally change the equationā€ for coronavirus screening. https://ā– ā– ā– ā– /PB2hrlQPhU https://ā– ā– ā– ā– /7eLmQrEqFM

@suzyQ7 ā€“ pardon my ignorance ā€“ does this test tell you if youā€™re infected, infectious, or have antibodies?

Great to see progress, but $5 for a single use test still seems like a lot for the average American to use daily, doesnā€™t it? I was hoping weā€™d see something like $1 a day but I guess Iā€™m asking for too much.

Iā€™d love to understand the use case this particular test ā€“ is it intended for daily use to screen people going to schools and workplaces and such? If so, who pays for it?

This test is not intended for home use. It needs a swab and specific procedure to doā€¦ but it does not need a special machine. therefore it is really designed to be used for surveillance testing at businesses, airport, schools etc. Where it can be administered by someone medical/technical (say a school nurse). itā€™s not the paper strip antigen test that we are waiting for, but itā€™s much more accurate than those. I can see colleges or elementary schools using these for surveillance- say, weekly or biweekly. The results come back in 15 minutes, which is fantastic. I can see airports really implementing something like this.

Found this link: https://www.engadget.com/binaxnow-covid-19-test-card-navica-034507602.html

The test is administered by health professionals. 15 minutes for results. I know thereā€™s already a rapid test ā€“ maybe this one is more accurate or is it just the fact that they can produce so many that is a big leap?

Edited to add: cross posted with you @suzyQ7 ā€“ tks for the helpful insights!

@AlmostThere2018 ā€“ I believe that the earlier Abbott 15 min test required specific machines to process the samples and each machine required a set # of minutes to process a sample. I also thought that early test was very inaccurate.

Why would the ā€œaverageā€ American want to test daily? (Folks who work from home and rarely venture outā€¦)

@bluebayou ā€“ well, until COVID, most of us left the house every day - be it the office, stores, church, the gym, wherever! :slight_smile: And given 40% of transmission happens when thereā€™s no symptoms, until thereā€™s a vaccine, if there were affordable and easy home tests (like a paper strip test Iā€™ve read about) I would think the responsible thing to do would be to test every day you leave your house so youā€™re not out there infecting others. County health departments could send them to homes or pass them out at distributions center so that cost/access is less of a barrier.

But this planā€™s success is contingent on lots of folks using such a test and heeding the results. That might be more than most our fellow citizens are up for, alas. Seems like itā€™d vary a lot by community. Of course, the vaccine will also be contingent on lots of folks actually agreeing to get it.

Sigh ā€“ is it 5:00 yet?

I have a friend who is a doctor who is part of the Moderna vaccine trials. He reported his reaction to the shot:

"Thursday - got the shot ~10am. Shoulder was aching by that afternoon, outright hurting that evening.

Friday - soooooo tired. I slept 14+ hours. Shoulder ached far worse, like I had been punched very hard. The slightest headache. Did I mention, I was tired? Maybe some mild body aches too.

Saturday - had a 50k on the books. I could barely run. So I walked. 30+ miles of walking. At one point, the study nurse texted to check in. When I told her I was doing a 50k and had decided to walk the whole thing because I could not remotely run, she responded that she would just try again another time. Still some shoulder pain. Some slight headache. I also got some pretty good back and neck aches by that evening, not what I would expect from the 50k.

Sunday - slight shoulder pain, still weak and tired, and achy in places that should not ache from the 50k. Maybe a bit perkier. Boy did I sleep well.

Monday - shoulder pain is almost gone. Still achy. Boy did I sleep well.

Tuesday - pretty much all better.

Booster shot coming in about 3 weeks."

If the vaccine works, even at 60% efficiency, itā€™s worth a few days of not being able to run a 50K.

Iā€™ve been trying to find out more about the new Abbott rapid antigen test. Will it be used for screening purposes at schools, stadiums, businesses?

I found this puzzling quote in an otherwise relatively informative article in the Wall Street Journal:

ā€œ . . . intended to be used for patients within seven days of feeling coronavirus symptoms.ā€ ???

Not helpful. By the time someone is ā€œfeeling symptomsā€ two of their three most contagious days have passed. The day of symptom onset is the third most contagious day, likely followed by the next seven. So a post-symptom test, up to seven days later, does little to stop the spread of Covid in a community/family/office.

Did they put that line about symptoms in there due to the new CDC testing guidelines? (The White House leaned on the CDC to minimize asymptomatic testing, despite the fact that we need to test asymptomatic people to keep those who are positive from infecting others.) :confused:

This quote was also discouraging because it says you need a prescription to get the test (from Abbottā€™s announcement):

Itā€™s great that a school nurse could perform the test, but useless if they will only do so on a symptomatic person with a prescription.

WSJ article: https://www.wsj.com/articles/abbotts-5-covid-19-rapid-antigen-test-gets-emergency-use-status-from-fda-11598485933

Abbottā€™s media announcement: https://abbott.mediaroom.com/2020-08-26-Abbotts-Fast-5-15-Minute-Easy-to-Use-COVID-19-Antigen-Test-Receives-FDA-Emergency-Use-Authorization-Mobile-App-Displays-Test-Results-to-Help-Our-Return-to-Daily-Life-Ramping-Production-to-50-Million-Tests-a-Month

Iā€™m wondering with the Abbott test if perhaps the real point is that weā€™re heading in to flu season. Someone calls/shows up at their doctorā€™s office, clinic, etc., with symptoms that could be COVID or flu. This test would allow said person to be tested for both at the same time. Just a thought?

Oh, yes, the doctor would agree with you! He actually thought it was a good sign he had such a strong reaction to the vaccination.

When I got the Shingrix shot I had regional swollen, tender lymph nodes with terribly wide spread body muscle pain worse to the arm of injection site and a low grade fever, the booster caused none of this except very mild arm muscle pain.
I took it as a good sign too.

Yeah, I get the interest of the upper middle class (which predominates on cc). But the ā€œaverageā€ American household makes ~$60k per year. No way an average family of four can even afford a $1.00 daily test.

Agree, but if you have planned events in advance, you may want to schedule vaccines that may have those effects* to avoid conflict with those events.

*For example, among existing available vaccines, consider Shingrix.

If each of the four people goes out to a place where they may expose others every day (therefore needing to use the $1 test), that would be $1,460 per year. For comparison, the CARES Act stimulus included $1,200 per individual (< $75,000 annual income) or $2,400 per married couple (< $150,000 annual income).

Probably the bigger issue (across income levels) is that doing this is mostly an altruistic act (i.e. something you do to protect others), and many people are not altruistic or caring for others enough to do so, even if they got the book of test strips for free.

@bluebayou ā€“ I agree ā€“ did you not see where I suggested county public health departments could distribute the tests ?

@ucbalumnus ā€“ yep ā€“ too many folks think itā€™s a hoax or if they do get a positive they might ignore.

Of course, thereā€™s also the reality that some folks who test positive donā€™t want to lose their wages and need to feed their family. Thatā€™s a true concern and horrible choice to have to make. What we really need is emergency $$ specifically for families who test positive so they can feel okay about staying home.

My cousin just forwarded me something and asked me to pass it on as well. Itā€™s information from someone on the ā€œInsideā€- a Registered Nurse. This is part of what this ā€œnurseā€ has to say:

This kind of stuff just infuriates me. Many people trust nurses and believe what they tell them.

I responded to my cousin with the following,

Cuz, I donā€™t know where this ā€œRNā€ is getting her information, but the stuff about masks is patently false. Iā€™m an OR nurse and wear a mask for up to 12 hours a day with no adverse effects; have been doing this for years. Doctors and nurses who work in ORs, procedure rooms, transplant units, cancer wards, and infectious disease units all over the world should be dropping like flies if this were true, but of course they havenā€™t. This ā€œRNā€ might want to check her sources because she is spreading falsehoods.

That was the diplomatic response, and not the one that first came to mind.

Maybe you should reply with the video from Jason Harrison, a registered nurse who demonstrated how wearing one, two, and three surgical-type masks did not change his blood oxygen saturation (he had his finger in a pulse oximeter the whole time).