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Here's why COVID-19 testing is important 

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Testing will be crucial in returning to some semblance of normalcy amid the COVID-19 pandemic, according to El Paso County Coroner Dr. Leon Kelly, who is also serving as part of the Public Health team during the pandemic response.

But based on performance by the nation’s health care system during the coronavirus crisis, assuming sufficient tests will be available seems like hitching your wagon to a falling star

When COVID-19, the disease caused by the novel coronavirus, began spreading in the United States, tests were woefully lacking and turnaround time exceeded 10 days. Test results for the patient who became the state’s first fatality didn’t come back until hours after she died March 13.

“The reality is, testing is important because it drives decisions of how to care for people,” Kelly says. “If you show up at a hospital and you have symptoms, they do the test and want [results] to come back quickly to decide how to treat you.”

Hospitals became jammed because labs were swamped and couldn’t push out results quickly enough, forcing health care providers to treat everybody as if they had the illness. That meant a high demand for other resources, such as personal protective equipment and ventilators.

“Why are we burning through PPE?” Kelly says, “this is part of the reason why. Fire departments, law enforcement, EMS, hospitals, everybody had to act as if these people had it. If we had gotten tests back the next day, we wouldn’t have to take these huge precautions.

“The goal is not to stop people from getting it. The goal of this is to limit the rate of the spread, so we do not overwhelm hospitals’ capacity to deal with it,” Kelly adds. “By slowing the spread, we can spread it out over time and not have it so everybody shows up at the hospital at the same time. That’s when you get catastrophic results, massive numbers at the hospital and massive deaths.”

Controlling the spread will rely on the ability to test. Kelly says the number of tests has grown significantly in Colorado and locally, and turnaround time for results has been trimmed to within 48 hours from the state lab and within a few days from the Federal Emergency Management Agency test site in Colorado Springs. Commercial labs also provide results quicker today than weeks ago. In addition, both of the city’s hospital systems have upped capacity at their own labs.

“Now we are able to, day to day, do our maximum amount of testing,” he says.

Robust testing will enable certain restrictions on daily life to be relaxed, though at-risk populations should remain in isolation longer, he says.

Testing will inform authorities of outbreaks that could more quickly be controlled, he says.

But not everyone should be tested. First, Kelly says, while some asymptomatic people who are infected will test positive and can spread the virus, others may be infected (and infectious) but test negative, though they could later test positive in the course of disease.

Also, some who have the disease and show symptoms might not test positive because the virus has dropped farther down into the respiratory tract where test swabs of the nose or throat can’t reach, says Phoebe Lostroh, a microbiologist teaching at Colorado College and associated with the National Science Foundation’s screening of COVID-19 research proposals.

Lostroh, who raised questions about how contact tracing was performed after a local bridge club member died of the virus, has since become involved in the local and state campaign against COVID-19.

Her chief mission now is to analyze the efficacy of a specific test to determine whether the state and county should stock up on it. She’ll study its record of returning false positives and negatives.

“How many times will it miss someone who has it, and how many times will it say someone has it who doesn’t?” she says.

Kelly says the future of testing lies in antibody tests. The idea is for people who have had the virus and recovered to donate plasma to be used in sera that would help others ward off COVID-19.

That’s Lostroh’s second assignment: Find out more about bringing such a convalescent serum program to Colorado Springs.

“You can donate your blood in Denver but you can’t locally,” she says. “We want to find a way to move ahead locally.”

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