coronavirus,27 Feb 2020 12:54
Covid-19, the new coronavirus, is on the verge of spreading across the world. Large clusters of cases are emerging outside China in South Korea, Italy, and Iran, and the Centers for Disease Control and Prevention (CDC) expects severe disruptions to occur within the United States. More than any recent pandemic, the coronavirus poses new global challenges. As part of its recently announced $2.5 billion push for vaccines, treatments, and protective equipment, the U.S. government must also make the “crash” development of an inexpensive, point-of-care, diagnostic kit for use in clinics and homes a high priority so communities can quickly detect and contain the disease.
For reasons we discussed earlier, vaccines can’t be developed quickly enough: They will not be available to the public for at least a year, said Francis Collins, the director of the National Institutes of Health. Complicating matters, manufacturers capable of producing the coronavirus vaccine in large quantities have yet to commit themselves to producing one being developed by the NIH, according to Tony Fauci, director of the National Institute of Allergy and Infectious Diseases.
In the meantime, the best measure is to test symptomatic patients to prevent or slow the spread of the virus. Testing can also pinpoint “hot spots” where community-wide measures like social distancing (having people avoid others, for instance, by working at home) and home isolation (requiring people with the Covid-19 to stay at home) can be considered. China is already implementing this strategy.
Testing at a broader, global scale may be necessary, however, and would require a point-of-care “rapid” diagnostic kit. We made the same case for combating the less-widespread albeit tragic Ebola and Zika crises. Such broad testing cannot depend on specialized equipment and a relative handful of centralized labs; people need to be tested in clinics and perhaps even at their doorsteps. Our most recent models indicate that in order to control coronavirus within a year, 80% of symptomatic patients would need to be tested and isolated within a day of symptoms appearing. This is consistent with our earlier published modeling for Ebola.
Currently, most pandemic-prone diseases, including coronavirus, are diagnosed by polymerase chain reaction (PCR), a molecular technique that often requires special laboratory machines and highly trained technicians to operate them. PCR tests are difficult to scale or decentralize. Bill Gates points out that portable versions of these molecular diagnostic machines need to be distributed throughout Africa to prevent the spread of coronavirus.
However running the test machines also requires a consumable test kit, and the number of coronavirus cases in China has exceeded its laboratory testing capacity due to a shortage of PCR testing kits. Consequently, China has had to resort to using CT scans as a hospital-based ra
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