Covid-19 Testing

Let me explain the power of testing in a real life maritime scenario.

I run a COVID19 screening program for a fleet. So far it has been 100% successful. It has even screened out all colds, flus, and other common respiratory infections. The aim of the program is not to eliminate the chance of infection, but greatly mitigate it, and the plan is working very well.

But like any COVID19 plan it relies chiefly on self-isolation. Mariners have to self-isolate 14 days before going a vessel.

If on-demand testing was available for mariners, we could reduce the self-isolation to seven days. A week before sailing, the mariner would take the test, and then start self-isolation. Obviously, if they tested positive for the virus, they would not sail. If they tested negative they would already be in self-isolation for a week, and therefore not contract the virus.

All of this greatly reduces the chance of COVID19 getting on a vessel, infecting most of the crew, and causing the vessel to be quarantined at the cost of $$$$$$$$$$$.

Seven days of self-isolation is preferable to 14 days. People often say, Well, the mariner will just get infected traveling from home to the departure port. My answer is, we’re doing crew changes right now and we’re not seeing that. Of course, we have great, responsible crews so we’re blessed that way.

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So you wrote all that but still not a single word on what provisions of the Defense Production Act you think the President should invoke to increase the production of testing supplies. I’m beginning to think you haven’t even read it…

’ The Act contains three major sections. The first authorizes the president to require businesses to accept and prioritize contracts for materials deemed necessary for national defense, regardless of a loss incurred on business. The law also allows the president to designate materials to be prohibited from hoarding or price gouging.[2] The law does not state what would occur if business refuses or is unable to complete request on time. However, any person who performs any act prohibited or willfully fails to perform any act required by the Defense Production Act may be charged with felony that results in a fine up to $10,000 or imprisoned for up to one year or both.[3][4] The second section authorizes the president to establish mechanisms (such as regulations, orders or agencies) to allocate materials, services and facilities to promote national defense. The third section authorizes the president to control the civilian economy so that scarce and critical materials necessary to the national defense effort are available for defense needs.[5][6][7]

Are there plants that manufacture testing supplies that are closing because they are running at a loss or fear running at a loss? Are there plants closing because of worker infections? Are there plants closing because they fear increased union activity or worker lawsuits due to the necessary working conditions?

There are not. In fact, all plants that manufacture testing supplies are running at maximum capacity and reaping record profits. None have closed, nor have plans to close. The logistics and timeline are such that seizing other plants by government force and re-tooling them to make testing supplies doesn’t make sense.

You would think that people would have learned their lesson from the ventilator debacle. Remember how NY needed 30,000 ventilators and the Federal Government was hoarding their stockpile in an attempt to murder innocent New Yorkers? Turns out they didn’t need anywhere close to that number. They were a minimum of 26,000 off.

Don’t be so eager to have the government seize private businesses and control them. Maybe take a little time and look at the logistics of the situation. The Feds could come down to Interbay and seize 4 cargo ships sitting against a dock right now, compel their crews to come aboard with no screening, load them with Q-tips and send them to a test production facility. That would accomplish squat, but they could say they were ‘Doing Something’. It amazes me how eager so many people are to give up their rights during this challenge. You’re begging the government to seize private property by force with absolutely no inkling of what they would accomplish by doing so.

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I would like to see that backed up factually, please.

This information isn’t that hard to obtain, and I suspect you didn’t even attempt to look, but here you go.

Sounds like they reflect their boss.

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I’ll take this one please. I need, masks, shields, gowns, diagnostic tests (including swabs and reagents. Why do they insist on parsing these things?) and serum/antibody tests for starters. Chop chop.

Personally, until such time as I produce a positive test for antibodies (maybe) or receive vaccine, I’ll be needing a minimum of two diagnostic tests per month. There seems to be an availability gap.

"TITLE III – EXPANSION OF PRODUCTIVE CAPACITY AND SUPPLY Sec. 301. PRESIDENTIAL AUTHORIZATION FOR THE NATIONAL DEFENSE. [50 U.S.C. App. § 2091] (a) Expediting Production and Deliveries or Services (1) Authorized activities—To reduce current or projected shortfalls of industrial resources, critical technology items, or essential materials needed for national defense purposes, subject to such regulations as the President may prescribe, the President may authorize a guaranteeing agency to provide guarantees of loans by private institutions for the purpose of financing any contractor, subcontractor, provider of critical infrastructure, or other person in support of production capabilities or supplies that are deemed by the guaranteeing agency to be necessary to create, maintain, expedite, expand, protect, or restore production and deliveries or services essential to the national defense. "

It’s helpful to quote reply when trying to make a point, as it’s not clear what you’re responding to. Having re-read most of the forum posts, I don’t see where anyone requested a list of Bio-Meds in the business of manufacturing Covid19 testing.

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A test is at heart a method. It may be associated with a particular machine and/or have special unique ingredients. There may be a test kit which facilitates it.

Reagents are stock chemicals, not usually bought from the same people as the test kits.

Swabs are sampling devices – doctor office etc items. Typically the lab would never see them until they come in with samples on them.

Yes. I think most people know those things. The point I am trying to get at is why they insist on separating these things out. Without ALL of the elements you don’t have a “test”. You only have some of the components.

You attempted to infer that I was posting false information. You are provided with a comprehensive list of COVID-19 testing manufacturers. If you’re insinuating that one of those companies is underproducing and needs to be seized by the Federal Government under the DPA and compelled against their will to produce more of something select which one and why.
Don’t make snarky claims demanding something be backed up factually then backpedal when you are provided with facts.

What is your argument? Do you know what infer means?

Quite well.
My argument is that there are no provisions under the DPA that currently need to be invoked to increase testing supplies.
What’s yours?

Speaking as a former lab guy it makes lots of sense to me – different sources, different supply-chain problems or not, and different users. The test itself is the exotic bit. The rest is infrastructure.

But as the Churkendoose said, it all depends on how you look at it. :slight_smile:

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The issue is the utility of the DPA in manufacturing testing supplies for COVID19. Governors have said again and again that more supplies for testing are need. You ask…

Answer (from the citation which you have kindly provided):
a) The law also allows the president to designate materials to be prohibited from hoarding or price gouging
In essence, the materials must be delivered at a fair price. Personally, I have never heard of a manufacturer going backwards on a federal contract.

b) The second section, authorizes the president to establish mechanisms (such as regulations, orders or agencies) to allocate materials, services and facilities to promote national defense.

Let’s look at your statement:
In fact, all plants that manufacture testing supplies are running at maximum capacity and reaping record profits. None have closed, nor have plans to close.
In an emergency, imagination and creativity are needed. During WW2 the Singer Sewing Machine company made .45 pistols. The Ford Motor Company made B24 Liberator planes. The Johnson & Johnson Company makes cotton swabs, which are very like testing swabs. I’m sure they’d be happy to talk about switching production to testing swabs. Has anyone spoken to them? There was a company in Alaska announcing they were beginning making testing swabs. Have the feds talked to them?

J & J might tell the Feds, Sure, at $100 per swab. At which point the Feds can say, How about $20 swab, and you still make a 1000% more than you would on a cotton swab, and we’re all happy? To me, that’s the way the DPA would work. Sure the government can lean on the company a little, but what company goes backwards on a government contract, really? But the way, at my company we’ve had government contracts. We’ve seen the money. If Uncle Sam wants to lean on us, my guess is we’d listen.

You mention
… seizing other plants by government force and re-tooling them to make testing supplies doesn’t make sense.

and

When has seizing U.S. factories by force been necessary? Singer and Ford weren’t “seized” by the U.S. government in WW2. I haven’t heard of any company seized or confiscated under the DPA, either. The Military industrial Complex seems to have thrived quite well since 1950. When the DPA has been used, it seems to me companies under government contract were compensated quite well for their troubles.

You bring up the ventilator “debacle”. Let me tell a sea story…
Many decades ago we had a fire on one of our boats. The boat carried the one SCBA and two bottles of air legally required for that class of boat. The crew had typical USCG f/f training. The fire gutted the ship. A complete rout. Luckily, no one was hurt. Right then and there, the captains said such a thing wasn’t going to happen again. Now each ship has a minimum of 5 SCBAs and 25 bottles of air. Every f/fighter has their own turnouts. The fleet has its own f/f training center, where superior training is carried out annually. When we had another major fire a decade after the first, the crew put it out in 15 minutes flat, because they had the equipment, and they had superior training.

Now, by your logic, the expense and maintenance of all this equipment between the first fire and the second must have been wasted, because it was not used. And liferafts are a waste, because they will likely never be used. Yet we know they are not a waste. The “debacle” would be not to have them. The USA should have had 40,000 ventilators sitting on the shelf on January 1st, because this emergency we are dealing with now–the occurrence of a unusually deadly respiratory illness-- has been predicted for some time now. Just as fires and sinking are a predictable danger on a ship.

My hope is that those 40K ventilators are completed, stored, and maintained, ready for the next outbreak. Along with filter masks and other PPE medical people will need. Just like SCBAs and life rafts on a boat. And by the way, all that production keeps people employed, and money circulating in the economy.

You and I have a philosophical difference about the usage of the DPA in the present emergency, I understand and respect your view. I just view things differently. IMO, this administration’s usage of the DPA has been slipshod. It said in March it was going to use the DPA for testing supplies. Then it didn’t. Then it “invoked" it again last week–or it didn’t, because where are the contracts, or executive actions? I truly don’t understand the lack of transparency for what seems to me to be a simple thing. Why do I call it simple? Because POTUS45 quickly invoked the DPA and signed an executive order for meat production after news that meat production might go down. Why not this speed and clarity for testing supplies?

(By the way, I don’t think the federal government will be confiscating those meat plants. Also, I wouldn’t be surprised if the workers in those plants, some of which had COVID19 shutdowns, call for increased testing.)

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I don’t know about that as many likely don’t have proper documents. Smithfield is Chinese owned so I am sure Chairman Xi is happy. Tyson is a major political contributor so their employees in congress are happy. I don’t worry about running out of bacon so it’s a win, win, win.

That’s the real question I think. The question about using the DPA can be debated all day but that still leaves the question as to why the federal government isn’t doing more and what could they be doing?

Not just testing but test and trace.

Massachusetts, Utah and North Dakota are among those working on the kinds of comprehensive strategies that public-health experts agree are needed to arrest the coronavirus’s spread and lift the social-distancing measures that have shuttered much of the U.S. economy.

“Even if the curve does flatten, we won’t be able to go back to work and school and regular life unless we chase the virus down much more significantly,” said Joia Mukherjee, chief medical officer of Partners in Health, a nonprofit working with Massachusetts to expand the state’s capacity to trace contacts of Covid-19 patients.

The question is how quickly the efforts that have begun can advance with beleaguered diagnostic testing programs across the U.S. still facing shortages of swabs, chemicals and other supplies that severely limit capacity at many labs.

https://www.bloomberg.com/news/articles/2020-04-11/states-prepare-test-and-trace-programs-to-reopen-their-economies

Test and trace becomes progressively more difficult and less useful with each case of community spread that you have. It also becomes more difficult with each increase in asymptomatic transmission period, and with each increase of percentage of cases that are completely asymptomatic.

Many people have a poor understanding of the difficulties inherent in developing and implementing a test for a novel virus. One of the issues that people tend to overlook is that there are going to be, by necessity, a certain percentage of false positives and false negatives in a test of this kind. Make the test too sensitive (essentially) and you will get too many false positives which makes it less useful. Make the test less sensitive and you will get too many false negatives. This is a decent paper explaining some of the challenges in a relatively easy to understand format. https://mbio.asm.org/content/11/2/e00722-20#sec-2

It seems intuitive to test everyone boarding a closed system like a ship before sailing, especially a ship like a fishing processing vessel with a large number of crew. After all, once everyone is tested you won’t get the virus aboard, right? The problem is with each increase in the number of people boarding you get a higher chance of a false negative coming aboard. Testing for anitbodies is difficult because the antibody tests tend to be cross reactive to other coronavirus strains. RNA testing for asymptomatic people may not be accurate.

So you use up a lot of resources for progressively less and less gain with every increase in difficulty. These resources could be used in areas where exclusion is more vital and risk of mass transmission is higher, like nursing homes, hospitals, ground transportation and air transportation. The wider the availability of testing is the more tests, PPE, and lab time get used up because someone wanted peace of mind that isn’t actually peace of mind.

That’s why people who are actually working out the logistics of this are leaning more towards things like human waste stream testing. Knowing the percentage of active RNA strains and antibodies in your neighborhoods waste stream is less calming than looking at a piece of paper that says ‘Negative’, but it’s more useful.

Testing alone is obviously not going to be a silver bullet.

The White House has repeatedly expressed confidence about states’ ability to do enough testing to begin a phased reopening of the economy. In a briefing last Thursday, President Trump said he disagreed with comments by Anthony Fauci, the top government infectious disease expert, that “we are not there yet” with the number of tests and the capacity to perform them. “No, I think we’re doing a great job in testing,” the president said.

But the new state-by-state review reveals a far more fragmented picture: 31 states and the District of Columbia were doing too little testing last week to identify most infected people in a timely manner

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Here in New Zealand we have started testing waste streams in treatment plants to check progress on eliminating the virus.

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absence of social distancing measures the average infected person transmits to only 2 or 3 other people throughout the entire course of the disease. Fleeting interactions, such as crossing paths in the grocery store, will be substantially more common and substantially less likely to cause transmission. If the apps flag these lower-risk encounters as well, they will cast a wide net when reporting exposure. If they do not, they will miss a substantive fraction of transmission events. Because most exposures flagged by the apps will not lead to infection, many users will be instructed to self-quarantine even when they have not been infected. A person may put up with this once or twice, but after a few false alarms and the ensuing inconvenience of protracted self-isolation, we expect many will start to disregard the warnings.