Op-EdOpinion

ELLIS: Ongoing Challenges with Testing for COVID-19

As of now, there is no clear proof that the antibodies that develop after being infected with COVID-19 offer any protection from future infections. Even if these antibodies will protect you, no one knows what antibody levels are needed to protect against reinfection.

As evidenced by the man in China who was the first confirmed case of being infected a second time, we need to accept that there is much we need to understand about COVID-19, in order to protect ourselves as best as possible.

As pointed out in an earlier column, as summer comes to an end, the prospect of a flu season during the coronavirus pandemic is a frightening thought for many health experts.

Six months after the start of the pandemic, we are seeing tens of thousands of deaths, and thousands of people experiencing horrible effects from the virus even after surviving! And yet, we seem to be as far away from understanding this COVID-19 virus!

Now, in what could only be called a “mind-blowing” decision, the CDC has just issued guidance that says, “If you have been in close contact (within 6 feet) of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms: You do not necessarily need a test unless you are a vulnerable individual or your health care provider or state or local public health officials recommend you take one.”

REALLY?!

It has been barely a month, since the CDC, themselves, confirmed that 40% of all COVID-19 cases in the United States are in people who don’t know that they are infected. In other words, asymptomatic people. Up until now, the guidance stressed the importance of testing people who were in close contact with infected people. Now, without explanation, this is no longer recommended.

As recently as June, the CDC’s advice was, “Because COVID-19 is highly transmissible and can be spread by people who do not know they have the disease, risk of transmission within a community can be difficult to determine. Until broad-scale testing is widely implemented, or we have a more comprehensive and precise measure of disease burden, states and communities should assume some community transmission or spread is occurring.”

Go figure! The whole purpose of doing testing is to reduce the rate at which someone infected comes in contact with someone not infected or reduce the probability of infection if there is contact. The more a person interacts with different people, and the longer and closer the interaction, the higher the risk of COVID-19 spread. So can someone help me to understand why, all of a sudden, the CDC is changing course in midstream, and now discouraging testing?

Hospital and death records show that Black people, Latinos, and Native Americans are disproportionately suffering and dying from severe disease; nationwide, Black people are dying at 2.5 times the rate of whites. Black and brown communities face higher rates of diabetes, heart disease, and other conditions that worsen the COVID-19 prognosis. People of color are also more likely to live in crowded neighborhoods and have low-wage, essential jobs where social distancing is difficult or impossible.

As reported recently in The Washington Post, “many scientists say such infection bursts — probably sparked by a single, highly infectious individual who may show no signs of illness and may unwittingly share an enclosed space with many others — are driving the pandemic.” It’s no secret that Black and Latino people are more likely to live in densely populated inner cities and neighborhoods, in cramped, multigenerational homes, exposing them to more people, thus more opportunity to infect or be infected. On top of that, the same families are, in essence, being forced to send their children back into schools, only magnifying the potential for children and young people to expose older relatives.

There are two reasons, and only two reasons, to conduct COVID-19 testing during this pandemic: to confirm that people with symptoms are actually infected with COVID-19; and to detect the virus in people who have been infected, but don’t know it, because they don’t have any symptoms.

The London School of Hygiene and Tropical Medicine has estimated that just 10 percent of people may be responsible for 80 percent of novel coronavirus cases! So what is it that the CDC is saying to the rest of us?

There’s not a lot more “evidence” we need to see from the ever-changing guidelines; the neglected communities who have carried a disproportionate burden of the infection, sickness, and the deaths; or now the seemingly blatant ignoring of the need for testing in light of the obvious vulnerability, to realize that in many ways, we — as we historically have been — are on our own.

Remember, I’m not a doctor. I just sound like one!

Take good care of yourself and live the best life possible!

Ellis is a visiting scholar at The National Bioethics Center at Tuskegee University and a fellow at Harvard Medical School Center for Bioethics.

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