Relying on testing to ward off virus put White House at risk

EARLY in the coronavirus pandemic, President Donald Trump put his faith in a toaster-sized machine that could spit out test results in a matter of minutes.

In late March, Trump hailed the launch of Abbott Laboratories ID NOW test at a Rose Garden event and embraced its widespread use at the White House to keep the deadly virus at bay. The president often skipped his own administration’s public health recommendations on mask wearing and social distancing, explaining that everyone’s tested around him using the Abbott device.

His strategy was no match for the virus.

The president’s announcement that both he and his wife, Melania, had tested positive, threw the final weeks of the presidential campaign into disarray.

The reliance on a rapid test, with its limitations, unfortunately gave the White House and its staff a false sense of security that they were in control of the virus, said William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine.

“You cannot rely on that test to create a barrier between you and the virus,” he said, adding that people have to wear masks, do social distancing and not go to all these rallies.

While rapid tests can help contain the spread of a highly contagious virus, they were not designed to be used in isolation. A negative result merely captures a snapshot in time and doesn’t guard against infection soon after. And a person may be infectious for days before the amount of virus in their body registers positive on a test.

Krutika Kuppalli, an assistant professor and expert on infectious diseases at the Medical University of South Carolina, said not enough is known about how these rapid tests perform in people who are asymptomatic.

Trump was playing with fire and it was really a matter of time before something like this was going to happen, she said. Even if Trump had been around someone who was sick, wearing a mask could have prevented him from getting the virus.

The White House said in a statement Thursday that Trump takes the health and safety of himself and everyone who works in support of him and the American people very seriously and that the administration followed guidelines for limiting Covid-19 exposure to the greatest extent possible.

Doubters and defenders

An Abbott spokeswoman said the companys ID NOW test for the coronavirus — used by more than 11 million Americans since regulators approved it for emergency use in March — yields reliable results. The company referred questions about its use in the White House to the Trump administration.

The gold standard in diagnostic testing is known as polymerase chain reaction, or PCR, testing and is performed in a laboratory. But these tests can take hours or days to process. Abbott’s ID NOW device offers two major advantages: a quick turnaround on site and portability.

The Abbott test, which involves putting a nasal swab in a liquid solution and heating it to amplify genetic material from the virus, produces results in 13 minutes or less.

In a pandemic, the world needs all types of testing for different settings and stages of the virus, including lab-based testing and rapid point-of-care testing, Abbott said in a statement.

Despite Trump’s enthusiastic endorsement of the Abbott ID NOW test, some researchers have raised doubts about its accuracy.

In May, a New York University study said the Abbott test could be missing a third to nearly half of positive cases. That same month, researchers at Columbia University Irving Medical Center found that the ID NOW test identified only 73.9 percent of infectious samples.

The US Food and Drug Administration acknowledged there were concerns about potential inaccurate results from ID NOW in May. The agency said it had received 302 adverse event reports as of Sept 30, including numerous reports of false negatives _ results showing patients were not infected when they actually were.

In its authorization of ID NOW for emergency use, updated last month, the FDA warned that more testing may be warranted to confirm initial results.

In a statement on Friday, Abbott said the NYU study was flawed and rife with limitations. The company said its device produces results similar to lab-based methods and that even the most sensitive tests can post false negatives depending on the infection cycle in a person’s body and how much virus they are shedding.

A company spokeswoman said no test detects the virus immediately after the person becomes infected.