The Herman Trend Alert

August 12, 2020

Solving the COVID-19 Testing Crisis

As deaths in the United States surpass 160,000 and the number of cases has now exceeded 5 million, we still have relatively too little testing going on. As you should know by now from these Herman Trend Alerts, without adequate testing, our control of this raging infection is impossible. I define adequate testing as testing in sufficient numbers with results timely enough to allow us to identify positively infective folks and trace their contacts to stop the spread. But onto this horizon arrives some great testing news.

The Sad Truth about Our Testing

As I covered last week, it tuns out we have been chasing tests that were "too sensitive." So here is the full story: people who have a very low viral load may still be infected, but they are unable to spread the virus to others, so it does not really matter to us or to them whether they are identified. The sensitive PCR tests we thought were necessary are not; and in fact, having a test that is only 50 percent as sensitive as most of those we are using, is just fine, because it picks up the folks we need to worry about---those who can and will spread the infection to others---and does not recognize those who cannot.

Cheap Paper Tests Have Been Around for a While

Back in May, a company called Sherlock Biosciences received an emergency use authorization from the US Food and Drug Administration for a special COVID-19 detection kit---special because it was crafted using the advanced gene-editing technology called Crispr. Developed by MIT's McGovern Institute for Brain Research and The Broad Institute, a genetics research center affiliated with both Harvard and MIT, the test is both simple and fast. Known as "Sherlock," the test is inexpensive and easy-to-deploy. Sherlock uses CRISPR, short for Clustered, Regularly Interspaced Short Palindromic Repeats, a gene editing technique covered in detail in a previous Herman Trend Alert. The beauty of Sherlock is that it bypasses the need for traditional reagents and swabs. Imagine having a test so reasonable that you could afford to test your whole family---every week.

Imagine a Test with Immediate Results

The internal mechanism of the test is pretty complicated. The really cool think about this test is that when positive, it causes a bioluminescent display to appear on any material like paper---no additional materials necessary. This testing may be done in the home in the office or even outside. I cannot wait until this test is available to all; it will be very welcome.

Other Tests Recently Approved

Advances in COVID-19 testing technology are happening quickly and that is a very good thing. Two other more conventional tests recently received Emergency Use Authorizations (EUAs) to move forward: one from Alpha Genomix Laboratories and the other from Solaris Diagnostics, but both of them use swabs and seek to identify positive infection from nasal secretions. To date, the FDA has issues EUAs to 210 tests with these include 171 molecular tests, 37 antibody tests, and 2 antigen tests.

Next Week: Pool Testing then on the 26th, Acknowledging Vaccine Progress

I know I said last week I would cover pool testing and developments in vaccines, however, I have run out of space, yet again. Thus, I will cover pool testing next week in greater detail. Then, the following week, I will cover the advancements in vaccines including the supposed Russian vaccine, Putin just announced. Thanks for your patience with me, during this very challenging time for us all. "See" you next week.

Again, special thanks to my new friend Craig McDermott and MedCram.com, a site where, if you have the time and you can handle the sometimes-complicated science, you can learn a lot.

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Read this Herman Trend Alert on the web: http://www.hermangroup.com/alert/archive 8-12-2020.html

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