An Independent examination of the Arizona COVID-19 antibody test

Arizona doctors explain novel coronavirus treatment

Posted 7/10/20

As of Friday, July 10 the state of Arizona remains ground zero due to continued reports of COVID-19 now widespread from corner to corner of the Grand Canyon State.

The Arizona Department of Health …

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An Independent examination of the Arizona COVID-19 antibody test

Arizona doctors explain novel coronavirus treatment

The above is one of the most common images of 2020: A photo illustration meant to help visualize COVID-19.
The above is one of the most common images of 2020: A photo illustration meant to help visualize COVID-19.
Graphic Courtesy of the CDC
Posted

As of Friday, July 10 the state of Arizona remains ground zero due to continued reports of COVID-19 now widespread from corner to corner of the Grand Canyon State.

The Arizona Department of Health Services, as of the close of reporting Thursday, July 9, has registered 116,892 cases of the novel coronavirus.

But as positive cases are spurred and more deaths confirmed the private and public health scientific communities are working along front-line medical professionals to develop treatments that could make a difference --- ultimately an effort to save lives.

In Arizona, there are 116,892 cases and 2,082 deaths of the novel coronavirus, which computes to a 1.81% death rate of confirmed cases in the state. In all, Arizona --- the 14th most populous state in the nation --- is one of nine states with over 100,000 cases.

Maricopa County shows a case rate of 1,702 cases per 100,000 residents, using 2019 Census Bureau estimates. The state average is 1,605.

Independent Newsmedia takes an in-depth look at the growing knowledge, confounding questions and hopeful enlightenment around the COVID-19 antibody test.

“Sonora Quest is the leader in COVID-19 diagnostic and antibody testing in Arizona, performing more than 70% of the testing in the state and serving the entire continuum of care,” said Dr. Brian Mochon, scientific medical director, infectious diseases division for Sonora Quest Laboratories.

“Sonora Quest has formed a number of strategic partnerships with local community organizations and our state agencies to provide testing to our most vulnerable and underserved populations. We are sharing the total number of COVID-19 tests that we have performed, along with the average result turnaround times and positivity rates with the Arizona Department of Health and all major Arizona media outlets on a daily basis.”

--- Dr. Brian Mochon

Since the beginning of the confirmed outbreak, a formal date of March 17, according to Sonora Quest officials, the laboratory behemoth has conducted more than 400,000 tests and more than 140,000 antibody serology tests in Arizona.

Those numbers, according to Dr. Mochon, are as of the first week of July.

“From March 17 through May 31, we received an average of 2,443 diagnostic test orders per day with an average positivity rate of 7.8%,” he said of the volume of testing growth. “In June, demand more than tripled to an average of more than 8,000 orders per day while the average positivity rate more than doubled to 17.5%.”

But what is the idea behind focused testing on the presence of COVID-19 antibodies being present in the human body?

“An antibody test tells us what proportion of the population has been infected,” Dr. Mochon explains.

“It won’t tell you who is infected, because the antibodies are generated after a week or two, after which time the virus should have been cleared from the system. But it tells you who has been infected and who is likely to be immune to the virus.”

The idea behind the testing at various definitions of human immune-system infection is to begin to add concrete approaches to care if spread persists and a vaccine cannot be developed.

Dr. Mochon says the devil is often found in the details when studying virus behavior.

“Molecular tests are used to directly detect the presence of the virus, rather than the presence of the body’s immune response, or antibodies,” he said of how antibody testing works. “By detecting viral Ribonucleic Acid or RNA, which will be present in the body before antibodies form, the molecular tests can tell whether someone has the virus very early on and whether they are infectious.”

But uncertainty permeates throughout the medical community’s understanding of how COVID-19 spreads and attacks the human body.

“While there is a lot of uncertainty with this new virus, it is also possible that, over time, broad use of the COVID-19 molecular tests and antibody serology tests, as well as clinical follow-up will provide the medical community with more information,” Dr. Mochon points out.

In the trenches with HonorHealth

As COVID-19 cases surged, Dr. John Neil, chief physician executive and network strategy officer at HonorHealth, knew it was time to enact best-laid plans.

“HonorHealth has been planning and preparing for a potential surge in COVID-19 patients since January,” he said of the steady-hand approach to a global emergency hitting home.

“Every day we monitor our bed capacity, equipment, supply and staffing levels to ensure we can safely treat any suspected COVID-19 patients, and all other patients who walk through our doors.”

HonorHealth, a Valley healthcare system serving 1.6 million people in the greater Phoenix area, has a total of 1,400 beds, officials say.

Dr. Neil confirms capacity is within normal bounds throughout the HonorHealth network here in the Valley of the Sun.

“The details of HonorHealth’s ICU, staffing and ventilator capacity are reported daily to the Arizona Department of Health Services. HonorHealth is not releasing specific data regarding hospital capacity since this information is very fluid and the numbers continually fluctuate,” he explained of data protocols. “The data reported by AZDHS is the most accurate and complete picture of healthcare capacity.”

But the current theme of uncertainty emerges at every level of the medical community as treatment options are limited, Dr. Neil agrees.

“While we’ve seen some success with treatments for certain patients, such as Remdesivir and ECMO therapy, we don’t have enough data at this time to comment on specific treatments for COVID-19 and whether or not they work on a broad population,” he said but explains everyday new approaches are being developed.

--- Dr. John Neil

“The HonorHealth Research Institute is currently conducting clinical trials for COVID-19.”

And, as far as COVID-19 antibody testing goes, there are no guarantees.

“On an individual basis, it is important to recognize that at this point in time it is not known with certainty if having a positive antibody test for COVID-19 means that the individual will not get recurrently infected in the future,” Dr. Neil pointed out.

“The other main type of COVID-19 testing that is currently being used is molecular testing using PCR technology. This is a type of diagnostic testing that is used to determine if someone is actively infected. The third type of testing that is being actively explored is called antigen testing. This is another diagnostic test that is used to determine if someone is actively infected. At this point the accuracy of antigen testing is still in question, so even if someone has a positive antigen test, they should be sent for a diagnostic PCR test to confirm whether they are actively infected.”

One community against COVID

Dr. Neil assures the Arizona community is in this together.

“Our entire clinical and support staff have been dedicated, flexible and focused on caring for our patients. They are working tirelessly to reduce the spread of COVID-19 and pull together to help heal those who have been hit hardest by the pandemic,” he said of front-line HonorHealth employees.

“They are all to be commended for their bravery.”

Abrazo Health CEO Brian Elisco says the health network he helms is holding strong in terms of capacity and ability to treat all patients.

“Abrazo hospitals continue to evaluate hospital capacity on a daily basis and are currently securing additional staff to manage the increase in COVID-19 patients,” he said.

“We are proactively resourcing our hospitals to continue to provide access to care consistent with the guidance from ADHS and during this challenging time. We continue to monitor our operations and adapt protocols to do what is best for patient care and ensure the safety of our patients, providers and staff.”

--- Brian Elisco

In tune with Dr. Neil at HonorHealth, Mr. Elisco commends front-line healthcare employees.

“Our staff has rallied to meet this challenge like true healthcare heroes, and we are so appreciative of the willingness to go the extra mile for patients every day,” he said. “We appreciate the support and donations we’ve received, and urge the community help slow the virus’ spread: wear a face mask, maintain social distance, and wash your hands.”

For Dr. Neil, his No. 1 concern remains the continued widespread of COVID-19 in Maricopa County.

“HonorHealth’s main concern is the increased community spread of COVID-19, and the impact that spread can have on our most important asset during this pandemic, our staff and physicians,” he said.

“Following guidelines, such as wearing a mask in public, maintaining social distancing, staying home unless absolutely essential, avoiding large gatherings of 10 or more and frequently washing your hands, are all aimed at keeping everyone safe. It is imperative everyone in the community follows this guidance, as it will help us protect our most precious resource, our staff and physicians, to ensure we have a full team available to treat all patients in need of services and care.”

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