The Trouble with Testing
By Dr. Nick van Terheyden aka Dr. Nick
Twitter: @drnic1
Host of Dr. Nick: The Incrementalist – #TheIncrementalist
With a nod to “The Trouble with Tribbles” this week I am reviewing testing strategies in the context of getting back to work and responding to a question I received on LinkedIn. Guidance on who should get tested (and in some cases who is eligible to get tested as we remain under-resourced in the United States) is complicated and varied based on where you live, your job role/function, symptoms and your relative risk.
So how do you assess testing strategies for your business, your employees, customers, and vendors? First off you need to understand the two main types of testing.
Molecular Diagnostic Test – which looks for markers of the virus or fragments of the virus to be present. You may hear this referred to as a polymerase chain reaction (PCR) test – which is one of the methods used to carry out the test. Depending on the design of the test and what fragment the test is looking for can give false-positive results (a positive result in someone who does not have COVID19) and false-negative results (a negative result in someone who does have COVID19).
Antibody Testing or Serological testing – which looks for antibodies produced by the body in response to the virus. This test also has false positives and false negatives, as well as the lack of specificity since the test, may detect antibodies to coronaviruses in general not specifically the SAR-CoV-2 virus. We also don’t know what level confers any immunity to an individual. There is much to consider when considering serological testing as you can see in these guidance notes from the NY Department of Health on the subject.
If you want to understand some of the complexity of test results and the sensitivity and specificity you can model test results and outcomes on various populations in this simulator here. We are seeing plenty of options emerge – this one from the CLEAR biometric ID company that has jumped into the space with a “Healthpass” solution. As of today this is a biometric identification of an individual combined with a health questionnaire and possibly a temperature reading which is a simple form of automation for allowing access and while it may comply with the minimum regulatory requirements does little more.
But what else do you need to think about? Some areas that are important to consider:
- How long the test can take, the error rates
- What are you testing for and why (is this more than personal info vs actionable info)
- Which test (Virus/PCR) and antibody
- Sensitivity and Specificity
- Exposure and risk of having the disease (likelihood of testing positive)
Then what do you do with the results from testing? Suffice to say – this is a complex area and we need to accelerate the #Incremental steps necessary to enable the faster transformation to allow individuals and business to not just survive but thrive in the changing world we inhabit.
Reach out to me at bit.ly/DrNickHelpMe if you’d like my help.
This article was originally published on the Dr. Nick – The Incrementalist blog and is republished here with permission.
