By ANISH KOKA, MD

The great pandemic is wreaking havoc, we are told, because the nation is not testing enough.  The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow the country to restart the economy and do it safely. 

The White House has been a mini laboratory for this testing strategy.  Everyone who comes into contact with the President and Vice President is tested daily.  This is supposedly what allows everyone to sit in meetings together and generally carry out the essential business of the country.  But over this Mother’s Day weekend members of the White House spent their time scrambling to track down contacts of Katie Miller, the press secretary of the Vice president who tested positive.  And contacts were left unclear about what exactly to do.  One official started self-quarantining, while another did not. 

If the White House has trouble with a mass testing, and contact tracing strategy, one wonders how this may work nationwide with thousands of new cases per day.  While it would be tempting to blame administrative incompetence for the difficulties in the most important household in the land, the real difficulties lies with inherent limitations to tests that need to be understood before getting on the testing bandwagon.

RT-PCR

The type of test the world has been doing most often is based on knowing the genetic sequence of the RNA virus using a PCR test.  PCR stands for Polymerase Chain Reaction, and it is used to directly detect the presence of the virus itself.  The other type of test is an antibody test, used to detect the presence of disease fighting antibody proteins the body makes in response to attack from the virus and that persist for weeks, months or even years after the infection

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