A Journal of the Plague Year (26)

April 11, 2020

Some disparate snippets today. First, on the virus testing front. In Britain, testing has been in notoriously short supply since the beginning of this crisis and shows little sign of improving even now. That said, some significant change may be in the offing.

One of the major holdups to rapid and widespread testing is that tests take too long to analyze and this analysis must be done in laboratories. What is urgently required is a do-it-yourself test that can be done by unqualified people at home, if necessary, and give the results in minutes or hours.

It seems like the biomedical brains at Imperial College London have been hard at work:

Imperial College London’s Regius Professor of Engineering, Chris Toumazou FRS, is working with clinical researchers to test a rapid, lab-free PCR test that detects COVID-19 and delivers results in just over an hour….
The Lab-in-cartridge rapid tests – based on Professor Toumazou’s DnaNudge consumer DNA testing innovation – have been clinically validated after a successful initial trial on COVID-19 patients and are continuing to validate on larger patient groups.

Further,

A key advantage of DnaNudge’s solution is that the RNA polymerase chain reaction (PCR) test requires no sample handling and is able to deliver processing outside of a laboratory environment – using DnaNudge’s patented and miniaturised “NudgeBox” analyser, which can be used anywhere.

This in itself is a huge advantage over other testing protocols making it essentially an off-the-shelf item. Results could be transmitted via smart phone to a laboratory data center. The next requirement is an antibody test to find out what part of the population has been exposed and may never have become sick. Once exposed, one is likely immune, at least for quite some time.

The testing fiasco in Britain is the result of an over-centralized behemoth of a government-controlled testing system stifled with regulations.

The same is true in the US, that bastion of free enterprise. Help has been immediately available from hundreds of laboratories and biotech companies. Many of them have been stymied by the red tape of over regulation–possibly justified in “peace-time” but a ball and chain on productive companies willing to help in a “war-time” situation.

In an article in City Journal, The FDA Graveyard, it is pointed out that:

… When researchers in Seattle tried doing early testing on their own in February, they were ordered to stop because their lab wasn’t federally certified and they hadn’t used the proper consent forms in collecting samples. As the researchers scrambled to get emergency approval, they were delayed for weeks by anachronistic rules, like the refusal to accept an emailed application because it needed to be submitted on paper, by mail, along with a copy on a compact disk or a plug-in computer drive.
It wasn’t until mid-March that the FDA, under White House pressure, finally gave private labs emergency dispensation to provide tests without the agency’s prior approval. But then it put up a new roadblock, when several companies launched tests (which they said were being sold at-cost, with no profit) for consumers to use at home. The FDA promptly declared that its emergency dispensation didn’t apply to at-home tests, forcing the companies not only to stop selling the tests but also to destroy the samples they had collected.

Note that it was pressure from the White House i.e., President Trump, to get with program, pronto.

The quickest way to get effective tests and masks to hospitals and the public—and to sort out the ineffective ones—is to rely on the free market’s vast pool of decentralized knowledge. Consumers routinely buy products more complex than tests or masks without relying on a federal guarantee of effectiveness. Researchers, doctors, hospital administrators, manufacturers, merchants, and consumers can process and share far more information than any agency in Washington, and they can do it a lot more quickly—especially in a pandemic.

Precisely. The Center for Disease Control and the FDA in the US have been sorely lacking in imaginative responses to emergency situations. They are both due for a radical review after this thing is over.

In Germany, everyone has health insurance, but hospitals are run mostly privately.

Hospitals are called Krankenhäuser. There are three main types:
• public hospitals (Öffentliche Krankenhäuser) which are run by the local and regional authorities;
• voluntary, non-profit making hospitals (Frei gemeinnützige Krankenhäuser) run by churches or organisations run by the German Red Cross;
• private hospitals (Privatkrankenhäuser),

divided up approximately one-third each. All of these and biotech laboratories in industry are able and capable of running everything required for antigen and antibody tests. That is one reason why Germany can carry out vastly more testing than Britain, and, until recently, the US. The rapid change in testing in the US is a result of the empowerment of America’s arsenal of good ole Yankee know-how and technology in private industry.

There’s a lesson here for Britain.

Rebel Yell

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