Our schools are closed. The farmers market is suspended. Spring sports are not happening. And our grocery stores look like this:
Like many residents, I'm torn between enjoying the sun, or anxiously pacing around the house and getting teary eyed over the #SeattleWeGotThis hashtag on Twitter. The historians say we can cope by writing. So here goes.
Last December, I thought I had the flu. I was vaccinated in the fall, but still, with the feverish shivers and runny nose, I felt sick, and flu was the easiest microbe to blame. A friend of mine from the University of Washington suggested I sign up for the Seattle Flu Study (SeattleFlu.org).
He said they’re sampling as many people in the Puget Sound Area as they can, and they’ll tell you if you have the flu. They may even sequence your sample! He was really excited since his test came back positive.
I went to the website and signed up.
Soon afterwards, they sent me a home sampling kit: a tube of sterile saline with an ID label, a sterile cotton swab, and a pre-paid mailing box. I swabbed the insides of both nostrils, stuck the swab in the tube and mailed it back.
My sample turned out to be negative.
Meanwhile, the Seattle Flu Study continued collecting samples and testing them for flu. This sample collection activity left the group really well prepared when SARS-CoV-2 arrived in mid-January.
Naturally, they sought to test their samples for the new virus. But, as detailed in the New York Times (1), all the official permission-givers said “no.” Luckily, the Seattle Flu researchers did test some samples for the new Coronavirus and found one of the first instances of community transmission in a high school student.
Since the flu study worked with research labs, not clinical labs, the FDA wouldn’t approve their tests.
Interestingly, their institutional review board determined that,
“… it would be unethical for the researchers not to test and report the results in a public health emergency”
Even so, the study got shut down again. [Update - the Seattle Flu Study is testing samples again - but they're not allowed to diagnose COVID-19 since they're not a clinical lab]
Interestingly, when the H1N1 pandemic happened over a decade ago, the FDA did allow labs to develop their own tests (2) and community molecular diagnostics played an important role.
Perhaps those lessons should be reviewed.
References:
1. Sheri Fink and Mike Baker, New York Times, Mar 11, 2020 https://www.nytimes.com/2020/03/10/us/coronavirus-testing-delays.html?searchResultPosition=1
2. Nowak, J. A., & Kaul, K. L. (2009). The role of community molecular diagnostics laboratories in the H1N1 pandemic. The Journal of molecular diagnostics : JMD, 11(5), 369–370. https://doi.org/10.2353/jmoldx.2009.090132