HomeMy WebLinkAboutA Colorado Ski Community Planned To Test Everyone For COVID-19. Here’s What Happened. _ Kaiser Health NewsCOVID-19
A Colorado Ski Community Planned To Test
Everyone For COVID-19. Here’s What Happened.
By Christie Aschwanden •APRIL 10, 2020
In late March, residents of the Colorado town of Telluride and surrounding San
Miguel County stood in line, along marked spots spaced 6 feet apart, to have
their blood drawn by medical technicians wearing Tyvek suits, face shields and
gloves for a new COVID-19 test.
While the Centers for Disease Control and Prevention’s tests for the virus that
causes the respiratory illness have been in short supply since the outbreak
began, this was a new type of test. It wasn’t to see who was sick right now. It
was an antibody test that would assess who had been exposed and how
widespread the virus was in the community to inform decisions about managing
the outbreak.
When part-time Telluride residents and United Biomedical Inc. co-CEOs Mei Mei
Hu and Lou Reese had offered to provide their company’s newly developed
COVID-19 antibody tests for free to not just Telluride, but all of San Miguel
County too, more than 6,000 of the county’s estimated 8,000 residents jumped
at the chance.
“People really want to be part of it,” said Donna Fernald, a home health nurse
who was tested the first day.
The widespread testing was an experiment in this community best known for its
tony ski resort and summer music festivals. But it also served as a model for
what, perhaps, could be possible everywhere to guard against the spread of the
disease.
“This was a gift and an opportunity,” said San Miguel County spokesperson
Susan Lilly.
That was the original plan, anyway. But on Tuesday, the grand experiment with
bold aspirations appeared to fall apart. Lilly put out a statement announcing that
testing was being “delayed indefinitely due to United Biomedical Inc.’s reduced
ability to process the tests due to the COVID-19 pandemic.” Lilly declined to
comment on the decision.
The test that Hu and Reese’s company had promoted as “fast — results in two
hours” had slowed to a virtual halt. The company had initially told the county to
expect results within 48 to 72 hours after the samples arrived at the company’s
New York lab. Results from tests conducted March 26 and 27 were announced
April 1, but results from subsequent tests have still not come in.
A San Miguel County Department of Public Health and Environment press
release quoted a company statement that blamed the delay on operations and
the majority of staff being located in New York, where the pandemic has hit
especially hard. The press release issued Tuesday said the company is aiming
to resume processing the estimated 4,000 outstanding tests from the first round
of testing.
But with only a fraction of the results in so far, and additional testing in question,
the COVAXX testing appears to be yet another example of the chaotic response
to the coronavirus crisis gone wrong.
A Different Kind Of Test
The test that Hu and Reese donated to the Telluride community is an antibody
test developed by COVAXX, a newly formed subsidiary of their New York-based
United Biomedical. It’s one of more than 30 commercially available tests without
Food and Drug Administration approval under flexible rules adopted to address
the COVID-19 pandemic. So far only one antibody test has received official FDA
approval — a test made by Cellex, which uses just a pinprick of blood and
produces results in about 15 minutes.
Antibody tests are fundamentally different than the CDC swab tests currently
used to make official diagnoses. Where the swab test looks for the virus’s
genetic material to determine active infections, an antibody test looks for
antibodies in a person’s blood that show an immune response to the virus that
causes COVID-19. Robert Garry, a virologist at Tulane University School of
Medicine, said the test can’t tell whether the person is currently sick or
infectious.
The plan in Telluride was for participants to be tested twice, two weeks apart,
with the COVAXX test because it can take a while for someone infected to show
up as positive when measuring antibodies.
The COVAXX website claims its test has 100% sensitivity (that’s the test’s ability
to find antibodies to the virus) and 100% specificity (a measure of how good the
test is at differentiating this novel coronavirus’ antibodies from other antibodies).
But, Garry said, no test is perfect. And creating an antibody test for the virus
being called SARS-CoV-2 is “tricky,” he said, because it needs to distinguish
among several seasonal coronaviruses. Furthermore, he added, the COVAXX
test is a peptide assay, which he said typically is not very sensitive.
“We know 100% is an almost impossible bar to reach,” Garry said. “It kind of
raises some red flags.”
In an interview with KHN before the Telluride program stopped, Hu said that “I
always hesitate when I say 100%,” but she said that the company validated the
test against 900 samples collected before the COVID-19 outbreak, with no false
positives. She added the test also correctly produced positive results from blood
samples that have been verified as positive through other tests.
Theoretically, having antibodies to SARS-CoV-2 could make a person immune
to the virus, but how robust this immunity is and how long it might last remain
open questions. The big promise behind testing a whole community is that if one
can identify people who have been infected and recovered (or never gotten sick
in the first place), one can safely send them back to work or out in the
community, Reese said.
“It’s absolutely my goal to make this standard for how we get the country back to
a new normal,” Reese had said before the test was suspended. “If we tested
everyone in the whole country and were prepared to do it twice, you would know
exactly when you would be back at functioning — everybody back at work.”
Reese isn’t alone in his excitement. Hedge fund billionaire Bill Ackman invested
an undisclosed amount of capital into COVAXX through his Pershing Square
Foundation, and bestselling author and XPrize founder Dr. Peter Diamandis is
listed as part of the COVAXX leadership team on the company’s website.
Diamandis presents a fawning interview with Hu and Reese in a widely shared
YouTube video, which does not disclose his relationship with the company.
Neither responded to requests for comment.
Testing Results
In all, about 6,000 of San Miguel residents were tested at three locations across
the county, which covers about 1,300 square miles. As of Monday, only 1,631 of
the tests had been processed, with eight (0.5%) of them deemed positive, 25
(1.5%) “borderline” and 1,598 (98%) negative. Borderline results indicate the
person may be in the early stages of producing antibodies, Lilly said.
Yet the single tests alone can’t provide a clear picture of how many people have
been exposed.
As of Thursday, a total of 11 cases in San Miguel County had been identified
with standard swab tests. Officials continue to recommend that all residents
practice social distancing and that those experiencing symptoms practice further
isolation to prevent the potential spread of COVID-19.
One way to look at this attempt at large-scale testing is that “everybody’s getting
together and trying to do something cooperative and innovative,” said George
Annas, director of the center for health law, ethics and human rights at Boston
University School of Public Health.
“If you wanted to be cruel, you could say this is a publicity stunt,” Annas said.
The program certainly won COVAXX a lot of good publicity, along with gratitude
from local residents — at least initially.
And a resort town in Wyoming is following suit. John Goettler, president of St.
John’s Health Foundation in Jackson, said his organization is spending “less
than $20,000” on COVAXX tests for about 500 health professionals and first
responders. Goettler said Jackson resident Dakin Sloss, a hedge fund owner
listed as another member of COVAXX’s leadership team, helped secure the
tests. Testing is set to begin next week, and the test will be processed at a local
lab, rather than in New York.
But in Ouray County, adjacent to San Miguel County, officials decided against
such testing even before the Telluride suspension.
The cost “would shoot a hole in my budget for at least the next two years,” said
Ouray County public health director Tanner Kingery.
But that wasn’t the only concern, Kingery said. It would have required a large
supply of precious masks and other personal protective equipment, he said,
while potentially exposing health care workers and community members to the
virus.
Dr. Andrew Yeowell, an emergency room physician and Ouray County EMS
medical director, also was concerned that negative tests might give people a
false sense of security. If people with negative tests felt emboldened to go out in
the community and interact with others, he said, it could undermine the county’s
advisory to stay home.
“If you’re having symptoms or feel sick, stay home,” Kingery added. “That
guidance doesn’t really change if you have a positive test.”