Michael Mina joins TWiV to reveal why frequent and rapid SARS-CoV-2 testing is more important than accuracy, how a daily $1 rapid test could control the pandemic, and why group testing works.
Hosts: Vincent Racaniello, Rich Condit, Kathy Spindler, and Brianne Barker
Guests: Michael Mina
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Download TWiV 640 (63 MB .mp3, 104 min)
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Links for this episode
- Michael Mina on Immune 26 2:46
- White House bypasses CDC (NY Times) 5:06
- Test sensitivity is secondary to frequency and turnaround time (medRxiv) 6:31
- Group testing for SARS-CoV-2 (medRxiv) 39:29
- Consider the cycle threshold value (Clin Inf Dis) 33:16
- MERS-CoV spike nanoparticles protect mice from infection (Vaccine) 1:21:34
- CoV spike protein nanoparticles induce neutralizing antibodies in mice (Vaccine) 1:22:30
- Letters read on TWiV 640 1:00:49
- Timestamps by Jolene. Thanks!
- Kiki’s Comments
Intro music is by Ronald Jenkees
Send your virology questions and comments to email@example.com
Michael Mina talks about an op ed in the New York Times. Do you have a link to that text?
https://www.nytimes.com/2020/07/03/opinion/coronavirus-tests.html – which has links to E25Bio, Sherlock Bioscieces, etc.
God! I hope someone gets the FDA’s resistance together and we can get on with semi-normality.
I was very excited by Michael Mina’s description of a $1., 15min to result, spittle based test. As Dr Mina observed, although such tests are not appropriate for clinical use, they are ideal from a public health perspective. Would such tests require FDA approval? If not it seems like a perfect opportunity for using Kickstarter to create the tests, save the world and become the world’s first TWiV-ionaire.
Thanks for your consistently fascinating discussions.
Re Episode # 640 with Michael Mina
Ebola treetop person here…
In listening to Dr. Michael Mina’s daily rapid turnaround testing idea, and because the FDA has not yet approved it, I had a very naïve idea. Since he’s an Assistant Professor of Epidemiology at Harvard T. H. Chan School of Public Health, could Harvard link up with a biomedical company that’s already producing these tests and actually conduct them on a daily experimental basis using Harvard students? If those data could be used to show the FDA the efficacy of the daily testing, perhaps the FDA could then approve Dr. Mina’s testing proposal. Hell (bleep), the FDA allowed hydroxychloroquine with ZERO efficacy data as a Covid treatment.
Perhaps Dr. Mina has already considered doing this with a PhD student and I missed the mention in the episode.
Thank you for all you do,
p.s. If this is a stupid idea, please don’t read it on the podcast.
Well… uh…jeez.. that’s a wrap.
Let’s get this done and get back to our lives.
Can I stop reading Virology textbooks now?
I’m in. Just a science enthusiast, but let us know if there are any actionable items that we can all do to help this cause
HOPE springs eternal – THANK you!! I listen to every podcast during my power walks – and then provide updates to my friends! I’ve been an RN for 40+ years and am wondering if I’m too old to take up virology!!
THANK you for all that you do – this episode was amazing!
I emailed my representatives as well as my local health department. And I’m telling everyone I know. Quick, low-sensitivity COVID-19 are the key to my kids going back to schools so I can listen to TWIV in peace!
I love this episode! I sent it and the preprint to my department head and he forwarded the email to a bunch of higher up people at my university. Let’s hope they take this seriously. Great work!!!
MIT announced collaboration
with 3M on a paper based test
Suggestion: Break the 1:46:05 episode into “episodelettes” for those of us who are interested in an individual topic?
Vince, Rich, Mike — Can someone reach out to me. I’d like to introduce your test to the Army’s Futures Command, MRDC (Med Research Dev. Command) and many more. This is a game changer. My email is firstname.lastname@example.org
Michael’s discussion was great! I have no experience in his testing world and he did a great job of helping me understand his argument.
Is there a paper/article/written summary of what’s presented here on cheap testing?
If so, would it be possible to add a link?
This episode with Dr. Mina is awesome – I work at at University of MN and see that the inexpensive testing option would make a big difference in opening here. I have sent the info to elected people in MN plus MN Dept of Health, U of M president, U of M Medical School Dean and UMN CIDRAP. Thanks so much.
It’s now 21st July and I haven’t seen this interview discussed anywhere else.
I’m neither a virologist nor epidemiologist but Dr. Mina’s claims on transmissibility
period and practical approach to testing and turnaround times are the most
positive developments I’ve seen so far. I’ve been sending a link to this episode
to as many people as I can. Reading between the lines, the Toni Fauci interview
indicated he was on top of this but I was expecting Vince and Rich to question
him harder about it. Maybe politics and delicate commercial horse trading
prevented a full scale public debate at this stage. To Vincent Rancaniello and
the others on the TWIV panel, I cant tell you how much I value your work
during (and before) the pandemic. I’m just a carpenter in Australia but you inspired
me to attack the microbiology and immunology text books and I’m totally hooked and never miss an episode of TWIV.
The final listener’s question from Anon, the beauty parlour worker, was fantastic.
It’s really great to know such Americans exist. You’re a terrific person, Anon.
Many are saying that the combination of the flu and COVID will make things worse in the fall. I’ve been looking at the CDC weekly influenza activity and surveillance for years and have never seen the summer numbers crushed to the single digits. How can we mount a flu outbreak if it isn’t being seeded right now? Even the southern hemisphere (check out Australian number) has barely any common flu.
Can we get the articles that the speakers are referring to in this episode.
Can there be any inhibition of taq polymerase due to high concentration of RNA when samples are pooled? Is it possible or too far fetched?
Michael Mina’s comments – wow. As a non-biologist this sounds incredibly useful.
Can we buy this test anywhere?
It’s a sad commentary on our society that high signal to noise information like this is buried. This should be what we hear on the news tonight and in the White House briefings. Hopefully we’ll see these kinds of tests very soon.
Regarding your comment in episode 640, Tony Fauci has said he earlier said it was not necessary to wear a mask, and it was based on best available evidence. When more evidence was available indicating that masks are useful, he changed to recommending masks. It’s a good example to the public that science is based on evidence and that knowledge is not immutable but should always be subject to revision. It’s also a good refutation to the people who say that scientists don’t know what they are talking about when they update their recommendations.
I loved listening to this podcast! Like the hair stylist, I am deeply interested but untrained in science. I am a college graduate who evidently have acquired critical thinking skills in spite of myself.
Are transcripts of segments available?
I wish more people involved in decision making re to reopening businesses and schools would have the information presented in Michael Mina’s contribution in layman’s language for easier understanding and impatient listeners.
Thank you so much! Best investment of time on this subject I have ever made.
Mary lib guercio, ordinary citizen
This was very interesting and hopeful.
Great show on possible breakthrough with fast turnaround testing! How about links to the pre-prints which may be published by now. Plus links to the companies that have the tech to make these quick turn tests?
As an idea to get these tests out, how about going abroad with them? Surely poorer countries with high prev. of CV19 would be interested?
Some of the info is here in the NYT article: https://www.nytimes.com/2020/07/03/opinion/coronavirus-tests.html
More available at the excellent Medcram daily Youtube videos by Dr. Roger Sehuelt. His Medcram 98 has links to the preprints and more. Here: https://www.youtube.com/watch?v=h7Sv_pS8MgQ&t=29s
This was a very interesting program with very valuable ideas, but the idea of self-testing at home has, at least two problems: it relies on an honor system — people testing positive self-quarentining; and, test results are not transmitted to the agency collecting data about the virus.
I would like to thank all of you for your continued efforts to provide accurate and updated information about the present pandemic. I am in the medical field (“only an epileptologist”), but not in infectious disease, and have had little direct contact with patients with COVID-19, given my niche specialty. Nevertheless, I listen to pretty much all your podcasts, and feel so lucky to have found an entertaining and reliable resource for valuable information to guide me through this strange time. I am still blown away by Dr. Mina’s discussion in Episode 640, and have been ruminating on his comments for the past 2 weeks, and wondering whether greater awareness of the technology he discussed could lead us to greater control over this pandemic. I have 2 teenagers, and one of my biggest concerns at this point is their schooling, and the likelihood that schools here in Seattle will provide only remote learning in the fall. I want to do whatever I can to try to promote the safe reopening of schools. To that end, I spent my morning drafting a letter which I sent to the the Governor of WA, the Mayor of Seattle, both my WA state representatives, and the Superintendent of the Seattle Public Schools. I tried to send it to Speaker Pelosi, but she only accepts email messages from those in her district. Too bad; I absolutely love her. I tried to make the letter non-technical, and I certainly hope it contains no inadvertent falsehoods, I will include a copy of the letter below, not to be read or responded to by the TWIV team (unless, god forbid, it contains errors), but for reference, in the event that you are collecting sample letters so that others can lobby their own state and local officials to look more closely at the utility of this type of testing.
Best to the TWIV team, and thanks again for your invaluable analyses and insights. It is rare to have a resource such as yours in this difficult time.
I am writing with regards to testing for SARS-CoV-2, the virus responsible for the COVID-19 pandemic. I would like to draw to your attention the fact that there presently exists a form of testing for the virus which is noninvasive, affordable, and has a rapid turnaround time. I believe that this type of testing has the potential to radically alter the course of the pandemic, as we await the development of an effective vaccine.
This form of testing was discussed on the podcast This Week In Virology on 7/15/2020 (episode #640) by Dr. Michael Mina, and the salient information was distilled into a 17 minute video on MedCram, which can be viewed on YouTube at https://www.youtube.com/watch?v=h7Sv_pS8MgQ.
The most important points regarding this type of testing are that:
1. It is quite sensitive for the detection of virus at the levels at which people are potentially infectious
2. The technology has already been developed (Dr. Mina’s paper on the utility of this type of testing is in the Journal of Clinical Microbiology (J Clin Microbiol. 2020 Jul 23;58(8)) and focuses specifically on the test developed by Abbott (Abbott ID NOW))
3. It is simple to administer, and essentially involves spitting on a strip of paper
4. It has a turnaround time of approximately 10 minutes
5. It is cheap, probably on the order of $1 per test, so can be done on a frequent basis for the purpose of surveillance
This type of testing can enable our society to much more effectively detect the virus in those individuals who are potentially infections, so that those individuals can then pursue quarantine and avoid spreading disease. If we can pursue this avenue of testing in a widespread fashion, it would, if used with appropriate quarantining, likely result in a dramatic reduction in the local spread of SARS-COV-2. If this type of testing can be pursued in school age children, it might allow our children to be able to resume attending classes in person; ideally, all children would be required to test daily, and would need to have a documented negative test to attend class.
I am in the medical field (a neurologist specializing in epilepsy), but have no connection to Abbott, nor any vested interest in the company. Neither do I have any relationship to Dr. Mina or to anyone in his research group. My interest in this technology stems only from my desire to do my part to try to gain control over this pandemic so we can all resume some semblance of our previous lives.
I am grateful for all your efforts to help guide us and our children through this difficult time.
With Warm Regards,
I copied your list of highlights to sent to my state health director. I hope you don’t mind.!
It surprised me at 48:00 that the hosts were so surprised. Have we not known of rapid tests since the beginning? Does SK and JP not have 10-15 min tests?
I felt like he was arguing against an imaginary enemy, the media, the FDA, the NIH. The answer as to why we aren’t doing this is very simple. There is no national leadership and no national policy and no interest in testing from the top. Maybe that’s “just politicizing it,” but that is it is. Today the WH said “it is what it is” but that “it’s under control.”
There is one simple place to look if you want to know why we don’t have more widespread, faster testing. It’s not lack of knowledge, I’m a literal no one. HS only, no degree, but I can read.
Thank you for this episode. I have emailed my local health director as well as my governor, state senator, and state health director.
Our state, Louisiana, just announced that we will be partnering the Rockefeller Foundation to improve testing, along with 5 other states. I have asked them to push for this testing modality and sent links to this episode plus Dr. Mina’s twitter account and Washington Post Op-Ed.
Does EUA prevent a laboratory from providing CTs for clinical use or research use. For instance, retro active review of patients charts?
S D F
Manager Infection Prevention Control & Epidemiology
I’ve sent this to my local school board, where we’ve decided to begin the k-12 year in a virtual setting. I hope we can all influence those in positions of making decisions to explore the concept of frequent, inexpensive testing and the compounding benefits it provides to our societal health, economy, and sanity.
Regarding returning students to in-person learning and specifically on the Health Committee report, I would strongly urge the School Board, CCPS, and VDH to include testing procedures, not just evaluating published test results, in the plan. Specifically, I ask that you investigate information regarding the utilization of lower sensitivity but rapid results tests. See the website rapidtests.org, this article in Harvard Magazine (https://harvardmagazine.com/2020/08/covid-19-test-for-public-health), or listen to this podcast (https://www.microbe.tv/twiv/twiv-640/). It boils down to using inexpensive, at home, saliva-based, testing strips that provide testing results in 15 minutes rather than relying upon test results that take days to receive and more complex contact tracing. Imagine every family (maybe using a pooled spit test) taking the test Monday/Wednesday/Friday mornings, getting a negative result, sending the picture/submitting the result into app, and then going about life following physical distancing guidelines. Positive results would mean the family quarantines and likely before the virus has progressed to the point of transmissability. Other organizations (employers or extracurricular organizations) would also benefit from this frequent testing and the spread of the virus should be extremely reduced. The value to working parents, businesses, and the commonwealth should well exceed the costs of the tests, and while the state should provide these tests to everyone, I believe many of us would happily donate/cover our costs. Please review this concept and advocate for moving towards this type of public-health screening to rapidly reduce the spread of the virus and allow us to return to school in a safe way, hopefully before the widespread availability of vaccines.
Who’s going to pony up the 5 bucks a day? It might not sound like a lot to you, but it’s half my grocery budget!
How do we get people to do this, and how do we know if they have? Where I work, there are people who try to dodge a simple temperature check. I would not rely on them to either use a daily test or heed the results.
I’m wondering if someone can tell me the “burst” size of the virus, how many cells get infected in moderate disease & what is the total of virus produced? I’m trying to make a very rough calculation of how many CV have been produced in the pandemic. Crazy? Probably but what a major piece of evolution to be able to explain to the public. From 1 virus to ???
Where can we order these quick test!
Is there a way to get the text transcript from this episodes? Kiki’s notes are great but I’d love to see a transcript for the podcast/video. Thanks
Go to the episode on YouTube.com/profvrr. Next to the save button below the video are three dots. Click on them and click ‘open transcript’. The transcript will open in a window to the right of the video. It can be copied and pasted elsewhere.
It’s been “a coupla months” – could it be possible please to ask Dr. Mina to return with an update? Clearly, for no discernible reason, his “this fixes everything” idea hasn’t been implemented. But there must be stories, updates, reasons to convey about this. It would be great to hear from him again if possible. Thanks.