In early September, the College of American Pathologists (CAP), hosted The Rapidly Changing COVID-19 Testing Landscape: Where We Are/Where We Are Going, the first in a series of virtual media briefings. Leading pathologists offered insights and straight talk on: the latest in testing and advocacy efforts; a new survey addressing Americans’ understanding of testing; where we are with testing as schools continue to reopen and athletes may or may not return to sport. The event was also streamed on Facebook Live.
To review the full session please visit: https://bit.ly/2YWrhJa
“We know the testing environment changes daily,” said CAP President Patrick Godbey, MD, FCAP, laboratory director, Southeastern Pathology Associates and Southeast Georgia Health System. “As pathologists on the frontlines of testing, we are able to address today’s current challenges, advancements that have been made, and how vital testing is in all areas of life. We continue to advocate for all patients and members of our profession to ensure the best and most timely care and quality of diagnostic results.”
Moderator and panelist Valerie Fitzhugh, MD, FCAP, associate professor and chair (interim), Department of Pathology, Immunology and Laboratory Medicine, Rutgers New Jersey Medical School, Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School reinforced the CAP’s commitment to testing. “Just last week, the CDC and FDA amended testing guidelines,” she said. “As pathologists we stand firm on the importance of testing and certainly being tested if people think they have been exposed to someone who has the virus.”
Bobbi Pritt, MD, FCAP, chair of the CAP’s Microbiology Committee, professor of Laboratory Medicine and Pathology; chair of the Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota addressed the rapidly changing testing environment. “There seem to be new tests coming out every week and sometimes every day,” she said.
Dr. Pritt expanded on all COVID-19 testing including the polymerase chain reaction (PCR or molecular) test to be used when someone may be currently infected; and serology or antibody tests that determine prior exposure to the virus. “Testing has become faster and more easily performed,” said Dr. Pritt. “In particular, antigen tests are simpler to conduct and less expensive. While not as sensitive as molecular tests, they may become more widely available given the demand on testing.”
She also addressed changes in specimen collection including nasal swabs versus saliva and the role of pool testing to help save on reagents. By taking small amounts of different patient specimens, pathologists can test the pooled specimen once, and report out any negative results, thus saving on reagents.
“If results are positive, then additional testing needs to be performed to determine which of the pooled specimens are actually positive,” added Dr. Pritt. “This technique has been used in other settings such as blood donor screening, but it has not been widely used for testing respiratory specimens, and thus the process is relatively manual. It is vital for the pathologist to determine whether pooled testing is appropriate for the individual setting and patient population.” Dr. Fitzhugh added that Rutgers University has developed a saliva test that has now been used widely and with great success.
When asked about what is new and on the horizon, Dr. Pritt added that specimen collection can now be done at home, where the patient collects his or her own nasal swab or saliva specimen and mails it to a qualified laboratory for testing. “This method allows patients to collect a specimen in the comfort of their own home, without the need to go to a health care facility. We anticipate that eventually the patient will be able to perform the test at home as well, much we as now do with home pregnancy tests.”
With the flu season around the corner, Dr. Pritt concluded that “we are continuing to develop the right strategies and ensure we have the right testing quantities. There are also tests that can detect multiple viruses in one test and I think we’ll see more of that this fall.”
