We need more coronavirus tests — full stop. Last week, the National Institutes of Health announced a $1.5 billion competition to speed up the development and distribution of new tests. Even before this announcement, research labs all over the country had been working on all of that.
One of the people creating new COVID-19 tests is Dr. Loren Wold, with whom I spoke. He’s director of biomedical research in the College of Nursing at Ohio State University. His lab developed its own chemical for testing samples. They’re 3D-printing nasal swabs and packaging tests by the thousands. The following is an edited transcript of our conversation.
Loren Wold: When a test is done, a swab is taken of the patient. The swab is then placed into a test tube that contains a liquid, and we call that media. The interesting thing is that the media that’s in these test tubes is in extremely short supply. My colleagues became creative at Ohio State and developed their own, and we have to then put that into individual sterile tubes. We have to label them, categorize them, and then that’s placed into a bag with instructions and a swab that is then taken to the multiple testing sites throughout the medical center at Ohio State, but also throughout the state of Ohio, to the prison systems, etc.
Molly Wood: How many have you produced?
Wold: We’re doing about 9,000 to 10,000 per day. Our total is around 75,000 that we’ve done in the last two weeks. We’re only going to be ramping up. The governor announced that we’ll be on tap doing 135,000 per week by the end of May.
Wood: That is a lot. Is that doable?
Wold: It’s a lot. It requires a lot of people. We’re calling in volunteers from colleagues’ labs, we have nurses that aren’t working on the floor that are coming in to volunteer. We have graduate students, we have staff that are coming in to help. We’re teaching people how to use pipettes who’ve never used them. It’s not an extremely difficult process, [but] it just takes labor force and time. We have a lot of people working very long hours to do this, because there’s not a lot of places that have their own type of media that they can produce.
Wood: Fundamentally, that was part of my question. Why is your lab able to do this? I know that there are labs and schools around the country that are attempting to create new tests, but certainly not at this scale. What is it about you guys that made this possible?
Wold: We have several colleagues that are actually investigating the virus. They work with the live virus, they have pre-clinical models, they’re doing clinical studies. This is their expertise. However, they’re extremely busy with developing a vaccine. We have colleagues that are investigating these types of viruses. They’re able to help us make the media, but they don’t have the time to actually do the preparation of the kits, because they’re out working to finalize the antibody testing and to come up with the actual vaccine.
Wood: The swabs have been in short supply, [so] you’re 3D-printing your own, right?
Wold: Yeah. We’ve just started ramping up that process because, as you’ve heard, they’re difficult to get. We’ve started the process of doing injection molding and 3D-printing of the swabs, which of course comes with its own challenges. Once you go to actually sterilize the swab, it’s difficult [because] certain plastics don’t tolerate that high temperature well, so we’re working through a lot of logistics with that.
Wood: Certainly, you’re not producing tests at a scale that’s going to cover the country, but the governor seems to think it’ll cover the state. What is making it so difficult to produce this amount of tests elsewhere?
Wold: Really, the rate-limiting step is the tubes that we use. They’ve been extremely difficult to get. Our goal was to order one million tubes, and when we requested that from the supplier, they laughed at us. It’s difficult, and the problem is, if we were to make our own tubes, it actually would take much longer than waiting for the supplier to be able to deliver. They’re going so fast that when you call the supplier and say, “Do you have 100,000 tubes?” They’ll say yes. By the time they go to buy them, they’re already gone.
Wood: When you look forward, and you think about how many tests the United States is going to need to be able to safely reopen the economy, what’s your prediction? What’s your sense of how long this realistically might take?
Wold: I will tell you that we’re working on a 12- to 18-month plan. That scares me, because I think that we all want to get back to normal life, but I don’t know when we’re going to see life like it was before. It’s definitely going to be at least a year of testing being done. The question is, do employers test all of their employees before they’re able to come back? I was talking to clinical colleagues who said that the problem is, if you go to a test you’re going to find positive people that are asymptomatic, but then they’re not able to work, and with the workforce being reduced, that itself has its own ethical challenges. I think we’re going to be faced with this for at least a year, and hopefully not longer.
Related links: More insight from Molly Wood
Although testing really is ultimately the key to tracking the spread of this virus and preventing it from spreading further, it’s still really hard to find and understand information about it. The U.S. is currently testing a little over 1.5 million people per week, according to data compiled from state records. Experts say we’ll likely need at least double that for people to safely return to work and school. The state data is being compiled by the COVID-19 Tracking Project, which was launched by The Atlantic and is now a volunteer organization of people crawling state and local public health repositories for any numbers they can get.
Last week, Johns Hopkins University, which has been the go-to for data around hospitalizations and deaths, also launched a hub for testing information that describes the different types of tests that are available, compiles state by state information and answers questions about where tests are available and where they’re not.
Last week, I asked you whether you’d be willing to install an app on your phone if your employer said you had to use it in order to come back to work. The responses were extremely rational:
A lot of you made that same differentiation between your device and their device. Ronnie Goodlund said he’s “very unwilling to infect my iPhone with such an app. Possibility: Separate small dedicated appliances to hold such an app, completely separate from your smartphone. You would load only the identifying information you choose, as well as the app (with whatever personal identifying data it requires), which would do its reporting to the government, and to lurking hardware & software developers. Something you could take with you when you leave the house, and to take to a workplace.”
And Brandi Van Pelt said, “I would absolutely be open to the idea of my employer requiring me to download a contact tracing app on my phone, especially considering David [Sapin’s] statements that reinforce the anonymity of the app, and the fact that it could potentially save lives and help at least slow the spread of the virus. ”
And because I love my fellow tech questioners, this is from Martin Kappeyne: “Regarding the COVID-19 Proximity App that Apple and Google are rolling out (and there are probably more) I would like to see some scientific data on how well this app works.” He asked about the Bluetooth signal, the data to show it’s actually measuring 6 feet, then asked how well the tech could handle plexiglass screens, cubicle walls or even stucco.
Finally, before I go, I’m going to point you to a blog post by cybersecurity researcher Bruce Schneier. We’ve had him on the show before and he’s been quoted a lot on digital contact tracing recently. He wrote about it Friday to expand on a quote he gave to Buzzfeed, in which he said, “My problem with contact tracing apps is that they have absolutely no value.” The blog post has more details, but he basically said the problem isn’t even privacy. It’s a problem of both false positives and false negatives, and the fact that without cheap widespread testing, what are you even going to trace?
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