TWiV 656: See, it can be done!

August 23, 2020

Daniel Griffin provides a clinical report on COVID-19, surgeons Lisa Smith and David Bruce detail how they have helped their Chattanooga community during the pandemic, then we discuss racial and ethnic disparities among COVID-19 cases, no more premarket review of laboratory developed tests by FDA; and emergency use authorization of convalescent plasma is on hold.

Hosts: Vincent Racaniello, Dickson DespommierRich Condit, and Brianne Barker

Guests: Daniel Griffin, Lisa A. Smith, and W. David Bruce

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Download TWiV 656 (85 MB .mp3, 141 min)
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Intro music is by Ronald Jenkees

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8 comments on “TWiV 656: See, it can be done!

  1. Karen Lawson, MD Aug 23, 2020

    A list of the companies the surgeons from Tennessee discussed would be extremely helpful. Either a link or simply the item with the manufacturer data would be great

  2. Jennifer H Aug 23, 2020

    Very happy to finally hear some cause for optimism! Sincerely wishing that every state and school district gets on board quickly with frequent rapid testing as we go into the fall and flu season. As someone watching from the unmitigated experimental control group that is Florida, while I applaud our local county response I am angry that our state and federal pandemic decision-making has been political instead of scientific. Thank you TWIV!

  3. Hear hear… I’m so impressed. It’s just a matter of leadership at this point and time.. I’ve learned so much in the last six months… can we all put these learnings to use and policy going forward?

    This is just Lisa and David’s story, I think, one of many throughout the country and world where people are finding ways (Israels’ low prevalence pooled testing, Russian vaccines that are risky – likely unethical – but bold and appreciated and even China’s hardcore – freedom stifling social (and data suppressive??) control.) People and cultures are telling their stories to the CoVid microphone.

    Hearing stories gives me hope and cheer. This particular one – is very American. I am proud of Lisa and David. Thanks for sharing this.

    And yes… trials before policy and guidance… thank you Daniel. Pamphlets may not have data to support their worth indeed. I salute your skepticism. The emasculation of the FDA is travesty.

  4. David E Levy Aug 24, 2020

    Super interesting show, as always, particularly the segment from Chattanooga. But their reported testing results raised a question — we know that PCR is orders of magnitude more sensitive than antigen testing, which has alway raised an issue in my mind as to the merits of testing people for virus levels by PCR that are far below those required for infection. But David Bruce reported that in his school testing, he found an absolute correlation between antigen testing and PCR, both positive and negative. Isn’t it surprising that there were no antigen-negative cases that were PCR positive, due to the enormous difference in the relative sensitivities of the two tests? Does this mean that most (all?) PCR-positive tests are actually in the infectious range that is detected by the antigen tests? Would love to hear your thoughts.

  5. Duncan Idaho Aug 24, 2020

    Awfully pro athletics in education.
    It might be best to abandon that approach.
    I swam and played basketball in school, and a girlfriend won three gold medals in the olympics, so I do have some perspective.
    Lose it- degrading the educational process is not needed.

    Fast and frequent testing- yes!

  6. Jason Poe Aug 28, 2020

    Thanks for putting together such an uplifting podcast. This was so refreshing to hear at a time when so many communities (including mine) have become fractured over the COVID response. While the school testing described is impressive, it is disheartening to know that this level of screening will not be available to most American school children, especially in public schools.

  7. Adam Summers, CLS, MLS(ASCP) Aug 31, 2020

    Greetings, TWiV!

    I’m a clinical laboratory scientist living life at the interface of fact, emotion, and politics – in other words, choosing a SARS-CoV-2 testing platform. In the rural hospital I oversee, we already use Abbott ID NOW for other pathogens and have a guarantee of substantial reagent allocation for SARS-CoV-2 testing. It is our only real path to bringing testing in-house, reducing turnaround from days or weeks to an hour or less. Our challenge is that California and local public health officials are convinced that the ID NOW – specifically this device, by name – is insufficiently sensitive and cannot be used except for diagnostic testing of symptomatic patients. They have put this opinion out as fact, in writing, despite my protests that their opinion mistakenly places sensitivity above all other considerations and my efforts to show that their own sources (such as guidance at FDA.gov) does not support their conclusions. I would love to present a strong case with references about why their conclusion needs to be revisited. Clearly Dr. Griffin has accumulated an impressive and convincing bibliography on this subject. Could that be shared in some way? It would empower clinical laboratorians like me to cut through political and emotional biases that have gotten in the way of providing the most rational, meaningful service to our patients.

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