Are Inconsistent Practices Driving Inconsistent Results

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I have to share this story as I think it perfectly defines the challenges we are experiencing as a Nation with COVID-19.

My occupation as a healthcare worker has potentially exposed me to many infectious diseases throughout my career. In the trauma center in San Antonio I was routinely exposed to potential blood bourne diseases such as HIV and hepatitis, other respiratory diseases such as tuberculosis – which I actually got and had to undergo treatment for, along with the day to day pathogens that we share the world with, just like everyone else. So when COVID-19 popped up on the radar as a healthcare professional in the industry for over 28 years I didn’t really give it much thought (and I still don’t – before you pass judgement, keep reading!)

From the very beginning of the pandemic I knew it would only be a matter of time before I had to cross paths with the latest nemesis wreaking havoc across the globe. What perfect timing, what a perfect disease to politicize, what a perfect pathogen to bring life as we know it to a screeching halt. 100 to zero in 45 days and in America, that’s about how long it took for the Constitution to be shredded – and the fear that was cast upon our society had American’s lining up by the thousands to hand over their freedoms that only 1% of them fought to preserve and protect. They had no equity buy in so they just gave it back… but that will be another post, now back to the COVID….

So we have a disease that is very real, very deadly (to what degree we don’t actually know) and we are collapsing economies and destroying businesses and livelihoods over it; and yet we still have very little empirical data to back up what we are doing and why. To better understand this disease, and it’s actual impact on our society, we need to start at the beginning of the data collection, and that’s where the problems start….

TESTING – The crux of the issue here:

To date, I have been tested 5 times at 4 different testing centers – and you want to know what – I have had 4 ½ different testing experiences! This should concern everyone – as someone with a very basic experience and training in disease surveillance it concerns me! As I started to investigate this over the last week, in talking to acquaintances that have also been tested, I am finding that my 4 different experiences were just as different as theirs. So how can we trust what we think we know about a disease that is crippling everything about our life’s, if at the very first link in the chain of investigation, the processes are so varied and subjective in nature? How can we know the truth behind COVID-19 if we cannot trust the information being published? I think this is what has Americans concerned and furious.

In America, by and large the medicine we practice is “evidence based”, this meaning that diagnostics, treatments and protocols are based in evidence – we do what we know works on the large scale – this helps to keep costs down if you do what you know works. The same holds true in medical surveillance. So although COVID may be new, the testing and specimen collection processes should not be – and they should be consistent.

Large q-tip type swab versus fine specimen brush; anterior nasopharyngeal swab both sides for 5 second versus posterior nasopharyngeal swap for 5 or 10 seconds versus throat swab; swab by nurse versus patient guided swabs, these are the types of variances that I have personally witnessed or have had reported to me from first had accounts – there is no consistency in the data/specimen collection.

HealthLine reported in August of this year that even the CDC states that the PCR test, considered to be the gold standard in COVID testing, can have a 29% false negative rate. The antigen test, that can be processed much quicker, runs up to a 50% inaccuracy rate.. These results should come as no surprise, as the mass rush to market of tests for a disease that has never been seen before, and the inconsistent sampling practices that we are seeing. (’t-always-better-experts-worry-about-rise-of-rapid-Covid-19-testing)

To close this week’s rant, take personal responsibility and ownership of your healthcare in the midst of this healthcare crisis. We don’t fully know what we are completely dealing with, and although the experts are “learning more every day” it is apparent there is still a lot to learn here. Maybe they should start by going back to the basics and evaluate the processes from beginning to end!

Stay Frosty (and safe!)

-Doc J

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