Research

PROS AND CONS OF THE DIFFERENT DIAGNOSTIC METHODS

Figure 1: Comparison of Molecular, Antigen, and Antibody Tests. This table compares the time to results, accuracy, significance of results, and limitations of these three types of COVID-19 diagnostic tests. Molecular tests include RT-PCR and LAMP tests. This table can be used to determine which type of test is the best option based on accuracy, rapidity, and types of results.

What we did wrong - things to do for future pandemics

It is arguable that COVID hit the United States worse than any other countries. There are many things that went wrong that could have been easily prevented. Here are some improvements we can use in the future:

Self-isolation - We can slow down the spread of the virus if those who are infected isolate in their homes.
Wearing masks - Masks are person protective equiptment that shield us from spreading germs to others (containing coughs and sneezes). Ultimately, we can significantly decrease the spread of the virus if it is mandatory to wear a mask.
Social distancing - By distancing yourself from others, it will reduce the likelihood of transmitting the virus.
Stocking up on masks allow for the reduction of individuals crowding in stores to buy them when the virus rate increases.
Reduce social events to less then ten individuals in order to avoid contact with too many people.

Provided are things that went wrong with diagnostics that relate to testing and treatment.

CDC developed an RT-PCR diagnostic that had issues with the primers causing them to be recalled. Ultimately this resulted with slower diagnostic response.
The Limitation of testing supplies which slowed down diagnostic results
The government was slow in allowing private labs to work and test on the virus, which essentially harmed our ability to react appropriately and contain the virus.
RT-PCR tests were the "gold standard", but the turnaround time was still slow. Test results would not be received until a couple days after the sample was taken, which led to inadequate effort to quarantine and essentially increased the spread of the virus.

Additional Methods for Testing

Wastewater Testing

Wastewater testing could also be used as an early-warning sign to see if the virus returns. Additionally, it could be used as a way to see in which dorm hall does COVID-19 reside. According to microbiologist Carol Wilusz, analyzing wastewater samples is "a lot cheaper than doing individual clinical tests" (2) because instead of issuing many individual tests you can narrow it down to which dorm hall COVID may be in.

Pool testing

Pool testing has been a strategy used to expand the testing for SARS-CoV-2 nucleic acid diagnostic/screen testing capacity. This type of testing involves combining sample tests for SARS-CoV-2 from numerous individuals and evaluating the results. Ultimately, if all tests are negative from the pool testing, then all of the samples would be considered negative. In this aspect it makes the testing process more efficient by evaluating multiple tests at the same time. On the other hand, if the pool comes back positive, each individual who have to be retested again. This strategy is done in institutions with large amounts of people, such as Universities.

CRISPR Testing

CRISPR or clustered regularly interspaced short palindromic repeats is a novel diagnostic tool that has seen much use and favor in recent years. CRISPR is used both find and edit nucleic acids and in COVID-19's case RNA which makes this method of diagnostic very useful and effective. An recent paper brought up a interesting use of CRISPR based model connected to your smartphone which would help make it form of testing that works with the assured model of testing (Fozouni et al,. 2020).

Proposed Potential Future Research

This is a new field so there potentially we could design aptamers to detect viral particles (ex. the spike protein on SARS-CoV-2). It would also be beneficial to improve and simplify the viral RNA extraction and purification steps (see original sample preparation on page COVID-19). Another area of future research is to optimize the use of isothermal amplification and CRISPR-based methods as alternatives to the standard PCR style tests.

References

(1) - Interim Guidance for Use of Pooling Procedures in SARS-CoV-2 Diagnostic, Screening, and Surveillance Testing [WWW Document], n.d. [WWW Document]. URL https://www.cdc.gov/coronavirus/2019-ncov/lab/pooling-procedures.html (accessed 12.9.20).

(2) - Nadworny, E., 2020. Colleges Turn To Wastewater Testing In An Effort To Flush Out The Coronavirus [WWW Document]. URL https://www.npr.org/2020/10/26/925831847/colleges-turn-to-wastewater-testing-in-an-effort-to-flush-out-the-coronavirus (accessed 12.8.20).

(3) - Fozouni, P et al., Amplification-free detection of SARSCoV-2 with CRISPR-Cas13a and mobile phone microscopy, Cell (2021), doi: https://doi.org/10.1016/ j.cell.2020.12.001

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