As many people yearn to return to some form of normalcy, states are beginning to consider what the reopening of nonessential businesses should look like. In his daily press briefing Gov. Andrew Cuomo (D-N.Y.) said a crucial first step for reopening is widespread COVID-19 testing — which New York State currently lacks.
On that same day, Dr. Augustine M.K. Choi, Weill Cornell Dean, announced a new initiative to begin antibody testing employees of Weill Cornell.
Current testing efforts across the state are focused on detecting those with the SARS-CoV-2 virus, but in order to begin reopening businesses people must be tested for previous exposure to the virus.
The current diagnostic used to test patients suspected of having COVID-19 at WCM is a real time reverse transcription polymerase chain reaction, an effective and relatively fast method to detect genetic material. It can be used to detect the RNA present in the SARS-CoV-2 virus.
“PCR is the gold standard because it’s such a highly sensitive and specific test and can deliver reliable and accurate diagnosis in as fast as 2-5 hours. Compared to other available platforms it’s much faster and more accurate,” said Dr. Melissa Cushing, pathology, in Choi’s update.
However, as institutions begin to test for people who were exposed to the virus and recovered, another method is required — antibody testing. Instead of testing for the genetic material of the virus itself, antibody tests search for the antibodies that the body creates in response to COVID-19. These antibodies are formed between three and 15 days after experiencing symptoms, according to Cushing.
As of April 17, testing was made available for New York Presbyterian staff that tested positive for COVID-19 or had a COVID-19-like illness and returned to work.
WCM plans to make more testing available to its staff, as it works to increase its testing capabilities. Cushing predicted that this public testing is “at least several weeks away.” Experiencing the brunt of statewide shortages of certain materials, WCM also requires access to reagents and more high output platforms to increase its testing capabilities.
“We need to really scale up with the amount of reagents we have with our current tests. Then we are really looking to some of the commercial labs to provide the large, high frequency platforms that we already use in our labs so that the process can be much more automated,” Cushing said. “That is our goal — to be testing as many people that need to be tested in our city.”
In order to address the testing insufficiencies on a statewide level, the governor issued an executive order on April 17 that directs all public and private labs capable of conducting virology testing to coordinate with the State Department of Health to prioritize coronavirus testing.
“The testing and tracing is the guideposts through this. As we are working our way through the next several months the testing, which is informing us as to who can go back to work helping us isolate people, it’s about testing,” Cuomo said in his daily briefing on April 17. “Testing is a totally new challenge. Nobody has done this and what we need to do on testing.
According to Cuomo, the lack of infrastructure to facilitate widespread testing mirrors the earlier lack of coordination between hospitals, which the Surge and Flex initiative addressed — the initiative coordinated the distribution of scarce medical supplies between public and private hospitals across the state.
Besides the lack of infrastructure, another impasse to wide scale testing is the availability of the materials — specifically chemical reagents — necessary to run the tests.
NEW: I’m issuing an Executive Order directing all public and private labs in NY to coordinate with the State Department of Health to ensure prioritizing diagnostic testing for public health and restarting the economy.
— Andrew Cuomo (@NYGovCuomo) April 17, 2020
Currently, this order will not affect the labs on Cornell’s Ithaca campus.
“Cornell University is not offering any human testing for COVID-19 on campus at this point. We will always follow all state/federal government regulations as appropriate,” John Carberry, a University spokesperson, wrote in a statement to The Sun.
Cornell is affiliated with two of the 301 laboratories and hospitals capable of performing viral testing — the Allyn B Ley Clinical Laboratory housed in Cornell Health and the Hospital for Special Surgery Dept of Pathology and Laboratory Medicine in New York City.
Initially, 28 laboratories with clinical laboratory permits from the state health department and experience in molecular-based virology could conduct testing. However, this system is unable to meet the demand for the widespread testing needed to reopen New York State.
“We don’t have a testing system that can do this volume, or that can be ramped up to do this volume. We don’t have a public health testing system, it’s de minimis if you look at what our government department of health have,” Cuomo said.
The state has begun its efforts to perform antibody tests on 3,000 individuals to better understand what percentage of the population is currently immune to the virus. The plan is being supported financially by former New York City mayor Michael Bloomberg, who pledged more than $10 million to create a test and trace program.