Spit on the Paper?

Here’s a promising path to fixing the “not enough testing” problem that Virus Watchers seem to obsess over.

The test, according to this article would allow you to spit on a piece of paper and have a positive or negative result in a couple of minutes.  And be cheap.

I think much of the chatter and hand-wringing about testing in the way we’ve been approaching it is unrealistic nonsense. Our current approach to testing doesn’t seem likely to work.

When the virus was first detected spreading in California, the announced goal – which just about everyone supported – was “flatten the curve”. No one wanted our medical system to be overwhelmed by a flood of cases at the same time. And no one imagined that we would “defeat” the virus, just spread the infections out over time so the medical system could handle it. And so lockdowns were imposed to flatten the curve.

Since then, with only a very few exceptions, all across the country, the curve has been flattened successfully, even with the recent upturn in hospitalizations. (Here in my small county, even with the most recent spike in hospitalizations, only 20 of 369 beds are occupied by Covid-19 patients, and only 7 of the 53 available ICU beds. The curve here is, and always has been, very flat.)

Lockdowns were imposed and about a month later, the goalposts moved.

The governor then announced that he would be keeping lockdowns of various kinds in effect until five additional goals had been achieved:

Q: What are the six indicators the state will use to measure when the lockdown will end?

A: (1) the ability to monitor and protect communities through testing, contact tracing, isolating, and supporting people who are positive or exposed.

(2) the state’s ability to prevent infection in older or unhealthier people more at risk for severe COVID-19.

(3) for hospitals and health systems to handle surges.

(4) the ability to develop effective therapeutics — effective treatments to ease symptoms and help patients recover — to meet the demand.

(5) for businesses, schools, and child care facilities to support physical distancing.

(6) for the state to have confidence it can re-impose restrictions and even the stay-at-home order, if necessary.

Of course, these are unattainable goals.

There are about 40 million people in California. There’s no conceivable way we could implement “testing, contact tracing, isolating, and supporting people who are positive or exposed”.  No one really knows, but some say that there are ten times as many people with the virus as have tested positive in our current programs.

Earlier this summer, the governor bragged that the state would soon be testing 60,000 – 80,000 per day. If his projections are right, it will take 500 days to test everyone in the state… just one time! And, since asymptomatic spread is very likely a significant part of the process, you cannot rely on testing only those with symptoms. We’ll never achieve the governor’s #1 criteria.

I’ve been tested three times so far since May. (Mostly because the state threatened to take away the county’s testing capability unless it tested more people. The county has been asking everyone interested to come in for a test to get the numbers up.) The actual test is easy and quick for the patient, but the test process is cumbersome, too complicated and takes too much time to get a result. And those results have uncertain accuracy. And, since I didn’t pay anything out of pocket, it’s probably costing the taxpayers a lot.

We’re not going to test our way out of the disease with the current system. So something like the “spit on the paper” alternative might change that part of the problem. Or something else that is appropriate for the scale of what’s being sought here.