COVID-19 resurgence likely next winter, Cleveland Clinic pathologist says

Amid the COVID-19 pandemic, testing is a critical way for hospitals and health systems to monitor the spread of the illness. 

Gary W. Procop, MD, MS, MASCP, chair of the American Society for Clinical Pathology's Commission on Science, Technology and Policy, said positive steps have been taken toward more widespread testing, but more is needed to rein in the pandemic.

Dr. Procop, who is also vice chair and director of virology at Cleveland Clinic, recently answered questions from Becker's about how hospitals are prioritizing testing, how hospital laboratories are being affected and what future steps are needed regarding COVID-19 testing.

Editor's note: Responses were lightly edited.

Question: How are hospitals prioritizing testing to help save personal protective equipment?

Dr. Gary Procop: When an individual is characterized as a "person under investigation," healthcare workers must assume the patient is COVID-19 positive and utilize all the required PPE to remain safe.  However, if the patient simply has the common cold or another influenza-like illness, then the amount of PPE needed could be reassessed and often reduced. The quicker that the laboratory can provide test results that demonstrate the patient is negative for COVID-19, the more PPE that can be saved and repurposed to protect healthcare providers who are caring for patients with confirmed COVID-19. In this way, rapid testing will help preserve our limited supply of PPE.

Q: What effect do you think recent FDA clearances to increase production will have on the pace of the pandemic?

GP: Although there have been a number of FDA clearances, which are excellent steps forward, there are still supply constraints on the number of these tests that are available. As companies that produce testing materials increase their production, we will be able to test more and more people. More testing is needed to confirm infection and to perform contact tracing to help prevent further spread. Effective contact tracing and containment cannot occur until we have more widespread testing. 

Q: How is the rush of testing affecting hospital laboratories?

GP: Our medical laboratory scientists have been working around the clock. These are unsung heroes, behind the scenes, who I have seen early in the pandemic work to the point of exhaustion. We are testing 24/7. We are currently running four different platforms and validating a fifth. The hospital laboratory is a busy place. 

Q: What steps are needed with testing to rein in the pandemic further?

GP: First: We must decrease transmission with social distancing and enhanced case-detection through more widespread testing with isolation and contact tracing. Second: a vaccine. There is no reason to think that after the first wave of this virus passes that it will go away. In all likelihood there will be a resurgence next winter, so the development of a vaccine as well as effective therapeutic strategies are of critical importance.




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