By Debbie Teofilo
Special to the Sun
The State of California holds the key to unlocking the Kern County economy after the pandemic shutdown. How quickly it can re-open will be determined by meeting state criteria, including having low infection rates and the ability to continually monitor and trace active cases to avoid future spreading of the virus. It is essential to have enough testing readily available in all areas of the county in order to meet these state requirements.
The Kern Valley Healthcare District (KVHD) announced at its Board of Directors meeting on May 6 that it has been asked by the Kern County Public Health Services Department to be the operator of an ongoing COVID-19 testing site for the Kern River Valley (KRV) area. This county-sponsored location will be one of nine testing sites throughout the county to meet state requirements for vigorous monitoring of the disease.
Free testing will be made available to everyone in the KRV, even those without symptoms, but it is most important for those who are symptomatic or believe they may have been exposed to the virus. As social distancing restrictions begin to lift, it will be critical that new infections are discovered quickly so those patients’ social contacts can be traced and isolated to prevent further disease transmission.
The KVHD test will be a nasal swab sample that only detects active COVID-19 infections; it will not detect antibodies in those who have already recovered from the disease.
The testing site at Kern Valley Hospital is expected to open later this month as a drive-through center. Tests will be given by appointment only several days a week with the schedule to be adjusted as needed after demand is determined. Test results will likely be available within 12 to 48 hours depending on how busy the labs are in processing specimens from the other collection sites. Once the start date of the KRV testing site has been determined, KVHD will present all its operational details to the public.
Development of screening tests for the COVID-19 virus is a rapidly evolving science with new tests constantly being unveiled. The test method most widely used for reporting purposes is known as PCR; this is the respiratory sample that will be used by KVHD. It detects an active infection by searching for and analyzing part of the genetic code of the virus. This makes the process complex and time consuming, but it assures accurate detection of a COVID-19 virus.
The second method is a blood (serology) test which detects a past infection or prior exposure by finding antibodies the body had generated days or weeks after fighting a COVID-19 virus. Serology tests are useful in determining who has been exposed to the disease and who may have some immunity, but they are less useful in diagnosing an active infection.
These blood test results are fast, but they can give false negatives (the test can show negative when the patient actually has the disease) or false positives (antibodies can be labeled as being from COVID-19 when the patient actually encountered another type of virus). This unreliability can require a second more accurate PCR test to confirm the results.
KVHD CEO Tim McGlew explained one reason they will be using the nasal PCR test instead of the blood test is that “the accuracy of these (blood antibody) tests needs to be improved before they can be relied upon. I want to do testing that the community can feel confident about.” All tests can make errors, and they also may not be able to detect COVID-19 at the very earliest stages of the disease, so McGlew cautions the public to maintain social distancing and good hygiene and to re-test as needed.
A third type of test was just given an Emergency Use Authorization by the FDA on May 9. It can confirm an active COVID-19 infection by detecting proteins (antigens) on the virus. Automated results are available within 15 minutes on-site with standard equipment and no specialized training. But because sufficient amounts of these proteins need to be present in the sample for accurate detection, the World Health Organization has warned that this antigen test may generate many false-negative results.
However, if this fast new test or a similar one does prove to be reliable, it could be the key to reopening the country by making it possible to run the millions of daily tests needed for screening employees and schoolchildren. McGlew stated that if a new test performs as claimed with these advantages, they could be run at Kern Valley Hospital when supplies become available.