Tag: testing

Colleges adapt porn industry policies for safe reopening

July 2nd, 2020 by
graduation 879941 1280
Giving it the old college try

Top colleges are taking a page from the adult film industry’s playbook to ensure that they can reopen this fall and stay open, despite the COVID-19 pandemic. I applaud them for it.

As I wrote in early April (Let the porn industry reopen the economy):

Donald Trump, the CDC and much of the rest of the federal government have demonstrated sustained incompetence on getting testing going…

The obvious answer is to enlist the adult film industry in returning the economy to normalcy. The industry has operated a testing system successfully for years to stave off threats of infections from HIV and other sexually transmitted diseases.

I went on to describe the PASS system that had operated successfully for a decade, with frequent testing and follow-up. I encouraged employers to do something similar.

Employers haven’t really taken this on, but one sector of the economy is not only adopting this approach but taking it to the next level. Some high-end private colleges and universities are determined to return to campus this fall. Online classes are ok but they are a very poor substitute for the in-person experience and are frankly not worth the tuition.

Unlike some of our red state governors, certain college presidents are taking a cold, hard look at what it will take to make it happen. They aren’t relying on science and public health experts, not wishful thinking. And they have come to the same conclusions that the porn kings did.

Here’s what Colby College is doing (emphasis mine). They expect to spend $10 million this year.

Colby’s testing program… will require the participation of all members of the campus community—students, faculty, and staff. Students will be tested prior to arrival with test kits provided by Colby, and all community members will be tested three times during the opening weeks of the semester. Thereafter, everyone will be tested twice per week, a rate that scientific models have demonstrated will greatly limit the spread of the virus by detecting infections in individuals prior to them becoming contagious. To put this in perspective, we expect to administer roughly 85,000 tests in the first semester alone, a number that almost equals the total number of tests administered in the entire state of Maine since the start of the pandemic.

…Test results will be returned to the individual and the College within 24 hours, allowing for any required mitigation efforts to be instituted quickly. We have leased additional housing for quarantine and isolation of students, who will be provided with a range of support services, including facilitating their coursework, attention to medical and mental health, and food delivery.

And Brandeis?

Brandeis will provide high-frequency, mandatory COVID-19 testing to all on-campus community members…All students living in campus residence halls will be tested upon their arrival to campus, and students living off-campus will be tested at a designated time before the start of the fall term. There will also be mandatory testing multiple times per month for all students, faculty, and staff who either live on campus or who come to campus several times per week, whether or not they are symptomatic. This will enable us to quickly identify and contain any instances of infection on our campus. Those coming to campus less frequently will also be tested, though not as frequently.

Testing is part of broader plans, but it is the core and let’s us know they are dead serious. Both of these schools are working with the Broad Institute for testing.

Interestingly, some other colleges are wavering on testing or throwing in the towel with a move to online only. Good luck with that.

—-

By healthcare business consultant David E. Williams, president of Health Business Group.

Are we there yet? COVID-19 test and trace in MA still lags

May 19th, 2020 by
Image 5 19 20 at 9.45 AM
Can someone explain this to me?

What on earth does that slide mean? You know, the Massachusetts Testing & Tracing Strategy page from the highly anticipated Reopening Massachusetts plan. We were hoping it would provide some clarity and confidence, especially since testing and tracing are the only green lights on the reopening dashboard.

Unfortunately, the graphic raises more questions than it answers. Here are a few that come to mind.

  1. Why are we only using 1/3 of our available testing capacity now?
  2. What good is capacity if we can’t get the tests to the people most in need (symptomatic and high-risk)?
  3. How do we know if the actual caseload is declining if testing continues to be underutilized?
  4. By July, testing will be available for “all symptomatic individuals, even mild symptoms.” Does that mean having symptoms now isn’t enough to justify a test? Is it really true that testing won’t be available for asymptomatic individuals even by summer?
  5. According to the projection, we will be filling all of our available capacity at 45,000 tests per day in just 6 short weeks. However, at that level, we will still be well under the estimated capacity that public health and infectious disease experts are calling for (71,000100,000 tests per day). Why is this an acceptable target?
  6. By December, we still remain at the lower end of target capacity, and woefully under it in terms of daily tests administered. What is the plan for getting further ahead of the necessary testing for the ‘second wave’ – and to avoid making the same costly mistake twice?
  7. Comparing the testing projections in the plan and what many of us believe is required, should we conclude that the committee doesn’t believe the need for more testing is real?
  8. There are a variety of tests available currently – some accurate and some no better than a coin flip.
    1. What types of tests are included in these figures at the various timepoints?
    2. In July, is only RT-PCR with nasopharyngeal samples collected by healthcare professionals accounted for? Or are other tests and collection methods included?
    3. Other methods are mentioned in the December description, so does this assume that there is no use of antigen or sequencing based tests until then?
  9. If commercial entities increase the availability of at-home testing, how does this factor into the plan?
  10. So, thinking through all of this, how can we have a green status on testing capacity now? In July?  Ever?

We have heard repeatedly that adequate COVID-19 testing capacity and contact tracing would be necessary for the safe reopening of our economy.  Until these questions are answered it’s hard to be confident.

We hope that everything will work out for the best, but we also know that hope is not a substitute for a strategy. Some answers to these questions would be a helpful place to start.


By Surya Singh MD, president of Singh Healthcare Advisors and healthcare business consultant David E. Williams, president of Health Business Group

Is reopening Massachusetts really driven by public health data?

May 18th, 2020 by

Today’s much anticipated Reopening Massachusetts presentation has a page entitled, “Reopening will be driven by public health data.” But look critically at the dashboard and you’ll see that some rows must be missing.

reopening
Not ready for prime time

There are six indicators. Two are green (positive trend) and four are yellow (no real trend). None are red (negative trend). But even the two green ones are not that reassuring:

  • COVID-19 positive test rate is a reasonable indicator. All else being equal, a drop means less COVID-19 in the community. But if testing is expanded beyond people who are obviously sick, you’d expect the percent positive to drop. The metric I’d really like to see is No new cases
  • Testing capacity is also shown as green. But weirdly, the previous slide (which will be the subject of a subsequent post) seems to show we are only using one third of the available capacity, despite the fact that testing is not widely available.

Looking at the dashboard you’d see it’s not time to move forward. So what else is going on?

There must be considerations beyond public health, such as:

  • Financial stress on individuals, businesses and state and local governments
  • Political pressure
  • Mental health concerns
  • Societal resilience

You can see some of this in the reopening plan. For example:

  • Supposedly there shouldn’t be gatherings of more than 9 people, and yet religious services are allowed to restart now
  • Hair salons are reopening despite the impossibility of social distancing. Six-foot scissors, anyone?

I think it’s ok to show the extra rows on the dashboard and take everything into account more explicitly. It’s better than pretending they aren’t there.


By healthcare business consultant David E. Williams, president of Health Business Group with input from Surya Singh MD, president of Singh Healthcare Advisors.