April 3, 2020
By Dr. Pamela Payne-Foster
Most of us have heard about Coronavirus (COVID-19) as a full-blown pandemic throughout the world. The main reason for the swiftness and enormous morbidity and mortality associated with the disease is that it is NEW: the scientific, research and clinical communities have not seen this particular virus before and are learning about it as the pandemic unfolds. Along with learning about the virus is learning how it spreads, how long the incubation period is and how many people are infected. An additional complication is that currently there is no cure for the virus.
So far, we believe virus spreads through respiratory droplets in the air, and that people can spread the disease for as long as two weeks, even if they show no symptoms. The answer to how many people might be infected will depend on how well we can develop tests to catch the disease early enough to prevent complications (usually respiratory) and to conduct surveillance of entire populations.
Treatments are currently being tested, and work is underway to develop a vaccine (which would potentially protect populations), but these medical advances may take up to a year or two to become available.
In the meantime, COVID-19 testing remains the primary tool we can use to tackle the pandemic, but because we are so early in the pandemic we have only rough data on the actual prevalence of the disease throughout the world. Currently, most of the COVID-19 testing kits are more diagnostic and directly measure the virus in order to better triage patients who need early supportive treatment. That means that as of now, testing is only being performed for those who have symptoms or have been in contact with a confirmed COVID-19 case. The test can be done on respiratory samples obtained by various methods, including a nasopharyngeal swab or sputum sample. Results are generally available within several hours to multiple days.
Here in the U.S., at the beginning of the epidemic, only the Centers for Disease Control and Prevention and state health departments had COVID-19 tests available. Today, more private companies are developing test kits, there is increased distribution to hospitals and primary care providers, and laboratory sites are able to get results back faster. This has all been possible through emergency policies by the federal government and special emergency rules by the Food and Drug Administration. Plans have been announced for more point-of-care testing with even faster results.
It is believed that in the near future, tests that measure antibodies made against the virus will be developed. This will allow for more widespread testing of the entire population in order to better manage strategies to decrease the spread of the disease and better manage the epidemic.
Dr. Payne-Foster is a professor of community medicine and population health at The University of Alabama College of Community Health Sciences. She is also deputy director for community outreach for the College’s Institute for Rural Health Research.
