So I think of rapid daily tests in two camps so you have the nespresso camp. These are going to be machines that you have to go out and buy and you have to buy capsules that are proprietary to that instrument and yeah they could probably be connected to the web. But they're a big machine and that is immediately going to limitits distribution and utility, but it will probably do areally good job relatively speaking. What I really want to see for these tests is is not an espresso model - that's good if we get them cheapI just don't believe we can get them cheap and distributed in the in the tensor hundreds of millions.
I want the the instant coffee version that every single person around the world can easily get that there's no frills, they're not connected to the internet, there's no buttons but it does the job and the job, in this case, is to tell you if you're detected as positive. So both of these things can exist today but the FDA is really pushing for this model over here, the Nespresso model.I love that coffee analogy because the cheap coffee still has plenty of caffeine in it, it still does the job. That's exactly right and in fact it probably has more caffeine a lot of times and you know the frequency that you use it.
You could drink 18 cups of cheap instant coffee a day for relatively no price and you'll end up getting more caffeine than you would if you drink one cup of Nespresso. This is a tool that's sitting in front of us right now that the government and the feds and everyone should be putting billions of dollars into ensuring that every person has these tests in their home and recognizing that this is a way forward. So the companies that could develop these tests right now won't for regulatory reasons and the companies that are saying okay we'll go by the regulatory book and try to do this. They don't have a test that is going to necessarily pass musteras a diagnostic test, and again we don't want these as diagnostic tests.
We really want them as public health interventions that canserve to practically in a couple of weeks rapidly transform epidemics and diminish them.Saying that these are not sensitive completely misses the point, the important thing to recognize to really make sense of this. We have to think of the biology that underpins these infections and the biology of what happens with the virus when it grows inside of you.
The virus starts at anywhere around let's say 10 viral particles permilliliter per swab that somebody gets it will start growing and then by the time it gets to about a thousand particles per swab. The pcr tests thereally good sensitive pcr tests that are expensive and hard to get they will start to detect the virus at around let's say a thousand but the important thing is these rapid tests might not detect a signal until. The virus gets to say ahundred thousand so for most people they would think oh that's not good I would rather the test that detects that a thousand instead of a hundred thousand.
But actually the important thing here is to know that most people when they're transmitting this virus. Their viral loads by the time they're transmitting are up at a millionor a billion or even for some people a trillion and then it will sort of persist for weeks potentially or months even in some people at very low RNA levels. It's after people are well beyond their transmissible period that we're actually seeing the loss of sensitivity of these as says these rapid tests will kind of be a filter to only be able to view people, who areactually transmitting infections.
The good thing is that they'll tell you at the time that you take it whether you're transmitting and that will allow you to make decisions, that will tell you okay I don't want to go to school today, I don't want to go to work today, I don't want to go into this restaurantand. So it will start to very rapidly stop the transmission chains so we don't have to go find everyone who has any virus signal in their nose at all. We just need to find the people who at this moment in time are at greatest risk for transmitting.
This is where I think frequency of testing becomes so much more important than the sensitivity because if somebody's taking a test every single day by the time, the virus passes a hundred thousand you'll detect it on that day versus if you're just using a PCR test. Every three weeks you know that you're very likely to misswhole infections since most of them are a symptomatic.I think we have a few opportunities in life to truly change the course of an epidemic that's killing potentially eventually millions of people on earth and continuing to infect millions of people just in the united states here.
I think that there's an exciting grounds well of support and I encourage people to get as involved as they can because as much as you'd be supportive of helping to push vaccines through, if the government wasn't already pushing that very hard. I think we should all be considering this with the same urgency that these things need to get pushed through as much as any vaccine and it's just not as readily palatable by the politicians and everyone. So l think the more support we can get the better.
No comments:
Post a Comment
wgdyrj@gmail.com