More, please

For physicians on the front lines, the need for additional COVID-19 testing is stark reality, not a political talking point

Anthony Vecchione//April 20, 2020//

More, please

For physicians on the front lines, the need for additional COVID-19 testing is stark reality, not a political talking point

Anthony Vecchione//April 20, 2020//

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Dr. Alexander Salerno, a primary care doctor in Essex County, has seen a spike in both symptomatic and asymptomatic patients who need to be tested for COVID-19 but he doesn’t have enough test kits. And for the tests he is able to run, patients face waiting periods of up to two weeks before they can get results.

Among Salerno’s patients are first responders from Orange, East Orange and Belleville who are quarantined under the presumption they may be positive. “There is a big disconnect when they talk about testing at the press conferences in Washington and what’s really happening,” Salerno said.

He added that New Jersey ranks high not only in the number of COVID-19 cases, but also in mortality. The bottom line: “We are not getting the amount of testing that we should be.”

Dr. Alexander Salerno

Salerno said beginning in March his practice had 50 kits a week; in April he was getting 50 kits a day but it still wasn’t enough. The physician, who has offices in Orange, East Orange and Newark, said he is testing patients in triage tents at two locations.

He emphasized that it is important to get testing under control however it is difficult right now for a multitude of reasons.

“Initially the gold standard for testing was to do a nasal pharyngeal swab, get a specimen, put it into a sterile test tube send it to the lab – they would extract using certain reagents the RNA particles … and they would run the test. But because we were the third or fourth major continent in the world to be hit with coronavirus, the cotton-tip swabs and nasal brushes were experiencing a major shortage when we got hit with this at the end of February and early March.”

Salerno said that while health care practitioners had the test tubes and the reagents, they didn’t have the brush and cotton tip swab to get the specimen from the nasal cavity. “We weren’t able to jump out of the gate, properly test, accurately isolate and distinguish sick from non-sick, and as a result the virus spread rapidly.”

Now said Salerno, things are a little bit better thanks to a Rutgers University laboratory.

“Because of our affiliation with them we have been able to get more test kits and were able to do a study for FDA purposes of saliva and sputum collection as opposed to nasal swab collection as another form or media to be able to identify the COVID-19 virus.”

Abbott rapid tests

In March, Abbott Labs was given an Emergency Use Authorization by the U.S. Food & Drug Administration for a rapid point-of-care test for the detection of COVID-19. On April 10, Gov. Phil Murphy announced the acquisition of 15 point-of-care ID NOW testing instruments from the federal government to expand access to COVID-19 testing here. The portable, rapid testing machines were intended to be distributed to health care systems throughout the state.

“It has been hard to get the Abbott test kit,” Salerno said. “I got emails from the northeast regional representative from Abbott Labs informing me that the point-of-care test kits are very limited.”

Triage tent outside Dr. Salerno’s office in East Orange. - ALEXANDER SALERNO
Triage tent outside Dr. Salerno’s office in East Orange.

An Abbott spokesperson told NJBIZ that the company has been in close coordination with U.S. federal and state authorities – as well as its customers in urgent care clinics, hospital emergency departments, and physicians’ offices – to ensure ID NOW instruments and tests are sent to outbreak hotspots.

The spokesperson said that it began distributing its rapid point-of-care COVID-19 tests for the ID NOW system on March 31.

“And in that first shipment we sent more than 190,000 rapid tests to customers in 21 states,” the spokesperson said.

Through April 11, Abbott said that it shipped 566,000 of its rapid ID NOW tests to all 50 states, Washington, D.C., Puerto Rico and the Pacific Islands.

The spokesperson said that it is currently manufacturing 50,000 tests per day and they plan to increase ID NOW manufacturing capacity to two million tests a month by June and are working to expand beyond that.

“We’ve sent the tests to existing customers, in addition to an initial order from HHS/CDC for 30,000 tests and 1,200 instruments for the state public health labs. And we will be supplying more tests to the government and our customers in the coming weeks and months.”

Going forward, Salerno said he would like to see more testing.

We are not getting the amount of testing that we should be.
– Dr. Alexander Salerno

“I would like to properly test first responders. That’s the other problem first responders are being quarantined for 14 days and everyone in their unit is being quarantined. So you are losing first responders because we are waiting for test results.”

He said that he would like to see drive-thru testing for the first responders for every county and every town.”You have to test everyone. There are too many silent carriers.”