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Webinar recap: Lab testing methods for COVID-19 & respiratory illnesses

See highlights of our full-length webinar, "Point-of-care testing methods for COVID-19 & respiratory illnesses," including the different testing methods available and their impact on patient care.

Speaker:

  • John D. Harris, Vice President of Strategic Accounts, Laboratory, McKesson Medical-Surgical

Full webinar transcript:

Hi, everyone. My name is John Harris and I'm the Vice President of Strategic Accounts, Laboratory for McKesson. And today we're going to be talking about point-of-care testing methods and resources for COVID-19 and respiratory illnesses. So, just two quick learning objectives for today. We're going to be talking about the SARS-CoV-2 terminology and then we're going to discuss the different types of testing methods that are available for COVID-19.

So, really quickly, let's give just a quick overview of what SARS-CoV-2 or COVID-19 means. So, oftentimes, those two phrases are used interchangeably. SARS-CoV-2 means Severe Acute Respiratory Syndrome Coronavirus 2, and that is the virus that causes the coronavirus disease or COVID-19.

So, you'll hear and see those things oftentimes used interchangeably and you may receive some test kits into your clinic space that may have either one of the two terminologies on there. Just know that those are the same things and those are used interchangeably. So, what we're going to talk about today is point-of-care testing for COVID-19.

And so these are tests that are performed while the patient is in house. And really one of the main advantages is the time gained and the time to result is going to be increased. So, you're going to have a better diagnosis, hopefully, a better treatment plan by having a faster test in your office while the patient is there.

And once again, these are simple platforms that run these tests. So, it should be a good solution for your point-of-care testing needs. So, just a couple key selection factors when you're really looking at SARS-CoV-2 testing. First of all, what are the needs of your patients and your practice? What are the goals you're trying to achieve?

What are the needs of your patient population? It's always the first thing you should start out with. And really, what are the need and performance characteristics of the test that you're looking at? So, what are you trying to accomplish with your technology? And really, you want to understand the testing options that are available, both today and in respiratory season.

So, what do we currently have on the market, potentially what's coming, and then from a supply chain standpoint, really inspecting the availability of those products and then really potentially look at a consideration for diversification of your testing platforms once you figure out what your testing algorithm looks like. So, the first test we're going to talk about today is molecular testing.

This is one that you've probably seen in the media or on the news. But this is a newer technology to the point-of-care space. But essentially, molecular tests tell us if a patient is actively infected with SARS-CoV-2. They detect the presence of RNA that's in the respiratory samples of the patient.

And if the viral RNA is detected, then it suggests that the virus might be present. And so, generally, these types of testing, the molecular platforms, are the most sensitive and specific tests that are available. And then they have a rapid turnaround time.

So, the point of care options really has a turnaround time of minutes to hours. And then once again, the downstream result for that is you can assign appropriate therapy if you have that better result. And then patient satisfaction around these products tend to be up as well. So, a traditional molecular that you may have seen in the past is really highly sensitive, highly specific, but typically performed in your larger laboratory space.

So, these units used to be very large, very bulky, and only performed a more of a moderate or highly complex status. And then the turnaround times tend to be a little bit longer on these platforms as well. And then once again, depending on how you're getting your sample back, your results for the practice may take longer as well.

So, now, these molecular analyzers are available at that point-of-care space. So, the units on the left-hand side of your screen are point-of-care molecular units and the units on the right-hand side of your screen are what we would call an antigen-based technology. And so, I think the illustration in the middle of the screen is nice that shows really when you can replicate that RNA and get really sensitive and specific.

You're going to get a better outcome and a better result, typically with our molecular platform. So now we're going to move into viral antigen testing. And these are the tests that you're probably most familiar with and that you most see in the practices for which you service.

And so, viral antigen tests quickly detect the fragments of proteins that are found on or within the virus by testing samples collected from the nasal cavity using swabs. So, think about your rapid flu kit or your rapid strep kit. These are the type of technologies, some type of technology that this COVID-19 test is using.

So, available since the 1980s, this is some older technology. And it's really the most common that you see in the clinic space and the nonacute space. But the sensitivity on these platforms really vary. So, when you're looking into the influenza testing, depending on the sensitivity and specificity of the test, it can maybe be unreliable, and then all of your group A strep results need to have some sort of culture confirmation.

Whereas on a molecular platform, your results are more highly sensitive and specific and your strep results do not need any sort of culture confirmation. So, when you're looking at COVID-19, these are definitely good tests. They're accurate tests but not as accurate as the molecular product. And then the last type of testing that you'll probably hear about and you'll see is serology or antibody testing.

And so serology testing detects the antibodies that show a patient has been exposed to the virus. So, according to the CDC, it typically takes about one to two weeks for a patient to start developing antibodies. So, because of this delay, the CDC has recommended not using this for a diagnosis of COVID-19.

The way this test also differs from molecular or antigen testing, this is an actual blood draw. This test is a moderately complex test and they are looking for antibodies within the blood. So, when COVID-19 first, kind of, entered into our markets, it really was like the Wild Wild West when it came to antibody testing.

The FDA reported that there were over 250 developers bringing products into the market. And so, that created a really big problem with the accuracy of the test, with the sensitivity and specificity within those tests, cross-reactivity within those tests. So, the FDA in May really came out with some new guidelines and really gave companies a 10-day window to submit for their emergency use authorization, otherwise, it would be pulled from the market.

And the FDA has gone through a rigorous process to ensure that any test that comes to market underneath an EUA status meets certain sensitivity and specificity guidelines for antibody testing. The other thing about antibody testing is that at this point we really don't know what the impact of the antibodies are.

We don't know what long-range antibiotic resistance could mean. And so for that fact, once again the FDA and the CDC has said not to use this as a frontline test. So, if you have any questions or want to know more information about COVID-19 or any of the products that we discussed in today's webinar, please go to mms.mckesson.com for any more information.

And thank you very much.


Full length webinar originally aired on July 9, 2020

© 2020 McKesson Medical-Surgical Inc.