Covid Journal 7: Why Abbott’s 5 minute COVID-19 Test Is Not The Game Changer We Need.

Is it me or are presidential press conferences turning into infomercials? There is a reason that the federal government doesn’t  want physicians accepting gifts from pharma. There is a reason that we all thought that direct to consumer advertising is a bad idea. When medical company reps speak with physicians, they are tightly bound by laws that limit them from making false claims about a product. A physician with bad information can not only harm people, but they can waste lots of money in the process. It would probably make good sense to have similar restrictions in place when a CEO speaks with leaders in DC who hold sway over billions of dollars. But then we wouldn’t be able to have the direct to consumer advertising that is President Trump’s daily COVID-19 updates. It’s no secret that any company would love business right now, but know what else they’d love? How about free advertising with a side of ‘Murica. 

What better place to do that than a nationally televised Presidential press conference with incredible ratings in the middle of a crisis, where no one literally has anything to do except watch television? I mean if you can’t expect a physician to critically appraise a new medical product in the face of free salami, you can hardly blame the President for going gaga when Abbott told him they would save his beautiful, amazing, beloved, best-ever in history economy by pushing out half a million tests. 

One can only imagine the President’s excitement when Abbott Labs informed him that they planned to produce 50,000 tests per day. Also they gave him one of his very own to play with.  My contacts in the West Wing tell me that not only is he testing anybody who comes to visit him, he also tests Mike Pence several times per day just so he can see the lights change color. 

But there may be a few details that Abbott’s CEO kept close to the chest, such as the fact that just because you make half a million tests, this does not translate to half a million real life people being tested. 

To put it in terms the President might relate to, they would have to explain it like this. Making a COVID-19 test is like making an Atari game. Even if I give you half a million Atari games, you can’t play any of them unless you also have an Atari console.  A few hospitals out there have Atari consoles and will be able to run these tests. (Yes I realize I’m mixing metaphors but just stay with me). As for the rest of the hospitals, well I’m sure that Abbott would be just super excited to sell them one at some point in the future. Right now though Abbott only has a few, and they’re going to a few designated hot spots. But if you know nothing else, just remember that Abbott is making the rapid COVID-19 tests, no one else is, you can buy one eventually, and if you feel at all nervous about this plan please relax and listen to this soothing recording of Michael Bolton’s greatest hits. 

So really, what Abbott sold the administration is an imaginary number based on the potential tests they could make, not necessarily the actual number of tests that would be run. In their press conference on 4/8/20, Dr. Birx admitted as much, stating that the number of tests run are nowhere near the numbers that Abbott suggested. But more than selling the President on a plan, what they really sold was alot of future ID Now consoles. And in the end, isn’t that what’s most important?

Deep Ramachandran, M.D. is a Pulmonary, Critical Care, Sleep Medicine physician, founding CHEST Journal Social Media Editor, and co-Chair of ACCP Social Media Work Group. He blogs at Caduceusblog. He is on twitter @Caduceusblogger.

Covid Journal 5. This Graph Shows Just How Fast Coronavirus is Moving in North Carolina.

It was beautiful weekend here in North Carolina. There was that magical rebirth in the air that only comes with Spring. The kind that makes you want to sit out on the porch with a glass of iced tea, keep the tv off and pretend that the world is doing just fine. After all, the daily and cumulative average of all COVID-19 tests in North Carolina had remained steadily, and somewhat reassuringly below 5% for the past few weeks.

But a look at the numbers on Saturday quickly showed the danger in that kind of thinking. Positive tests increased significantly here to 7.19% on Saturday, March 28. Naturally, I did what any semi-sentient being would do when faced with a catastrophic problem to which they can offer no solution. I ignored it and hoped it would go away. “Maybe it’s an outlier. Let’s see what it looks like tomorrow.”

But Sunday brought no relief. Positive tests on that day more than doubled to 16.36%. What’s equally disturbing is that testing here is significantly delayed. Our inpatient Coronavirus tests are taking about 8 days to return. The swabs sit and wait to be processed for 7 days, and the results are released the next day. Assuming that this is going on in other hospitals in the area, this suggests that the tests that are being reported today may actually have been performed on patients several days ago, or even a week ago.

This projection estimates that NC will have enough general beds to take care of COVID-19 patients, but there will be a shortage of about 300 ICU beds. Area hospitals including ours have been working hard to prepare for this by expanding our bed capacity. I am hopeful that if the number of patients we see falls within projections we will be able to handle the surge. But it will not be easy.

Deep Ramachandran, M.D. is a Pulmonary, Critical Care, Sleep Medicine physician, founding CHEST Journal Social Media Editor, and co-Chair of ACCP Social Media Work Group. He blogs at Caduceusblog. He is on twitter @Caduceusblogger.