Top Doctor Warns RI's Strategy Is Insufficient - "You Better Believe We Are Losing"
GoLocalProv News Team
Top Doctor Warns RI's Strategy Is Insufficient - "You Better Believe We Are Losing"
“We are not playing our A-game at all -- we're at the point of sending the Scituate high school junior varsity to play the LA Lakers and you better believe we are losing,” said Fine in an interview on GoLocal LIVE Friday.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTFine said the virus will continue to spread unless the state changes its strategy.
“Well, I think we're going to see more disease and more disappointing/ I don't think we're bringing our A-game. We are kind of sleepwalking through this pandemic," said Fine.
“If we don't up our game, if we don't really sort of fix and focus -- not on testing, but on how to prevent disease transmission and on how to prevent preventable deaths -- we're going to have a very, very hard and sad summer indeed and then potentially a disastrous fall," said Fine.
“We got to get more serious. We've got to develop some backbone and we've got to know what we can accomplish -- not get dissuaded or distracted by our own propaganda -- and actually focus on what has been proven to work here and around the world. We can do this but we've got to get the A-game going. We can't keep sleepwalking,” said Fine.
Fine says the tests being used are inferior and fail to stem the spread of the disease.
As GoLocal reported on Friday, the majority of Rhode Island’s coronavirus tests have been conducted by CVS at the Twin River facility using a testing machine produced by Abbott, but the equipment being used may be seriously flawed, according to a new study.
A study by lab officials at NYU Langone Health released last week found the Abbott test device missed 48% of 31 positive cases when using dry swabs.
The study finds, "Regardless of the method of collection and sample type, Abbot ID NOW COVID-19 missed a third of the samples detected positive by Cepheid Xpert Xpress when using NP [nasal passage] swabs in VTM [Viral transport medium] and over 48% when using dry nasal swabs."
On Friday, Raimondo's press office said, "The Governor is not asking CVS to replace the tests."
The Rhode Island Department of Health told GoLocal, "Every person who gets a negative test result at Twin River is notified that a negative test result does not completely rule out being infected with COVID-19. The FDA is doing an analysis to look into potential issues with the Abbott ID NOW test."
CVS also defended the use of the Abbott test. "The percentage of positive tests at these sites has actually been higher than state averages," said Michael DeAngelis, Senior Director, Corporate Communications at CVS. He did not respond to questions about the data.
False Testing
Fine had warned about the lack of effectiveness of the testing.
"I've been sensing this was going to happen because this was a test that was released after testing in the laboratory but never in real life -- the implication is that we've got testing that isn't going to get us where we want to go. Testing will be helpful if we got a positive but it's totally not helpful if we've got a negative. A negative test you know could just as well mean that you have the disease or it could mean that you don't have the disease and we can't tell the difference," said Fine.
Fine warns that the tests that are implemented in Rhode Island and other states are ineffective.
"We're not going to know about a significant number [of cases] and the problem isn't even just this test -- the best test we have is about 30% false negatives and that best test often is taking five to seven or ten days in turnaround time, so that gives us basically two weeks of time that disease can be spread before we even knew that the person was positive. So the good one is still lousy and late and the [other] one that's not so good and lousier and instant," said Fine.
Fine Warns Disease Will Spread Up the Economic Ladder
Fine warns that the disease which is hitting Providence, Pawtucket, Central Falls, and North Providence the hardest is likely to spread, not geographically, but by economic class.
“I actually don't think it will move geographically -- I think it will move to adjacent social classes. So that you know now, [it's] the poorest people who are getting sick. As we open up the next group of people who go to work are one step up the economic ladder,” said Fine.
Fine Said Trust Doctors
“Well I think we ought to go with two or three different options. The first option is a clinical evaluation by a trained clinician. If somebody has cough, fever and loss of taste and smell there is a very high likelihood they have the disease and ought to go into isolation the moment they developed those symptoms and have those symptoms reviewed by a competent clinician,” said Fine.
“The second is positive tests,” said Fine. "The third is a constellation of minor symptoms in the setting of an outbreak -- there's a notion called pretest probability that when there's lots of disease around minor symptoms are more likely to be significant."
Fine says if Rhode Island depending on testing to trigger intervention then it will have a failed strategy.
"If we're using the test to trigger contact tracing, if we're using the test to trigger isolation, if we're using the test to tell people when to quarantine -- we're probably missing a significant number of people who have the disease and are testing negative," said Fine. "We have been from the beginning lacking what I call a 'gold standard test,' a test that tells us for sure if somebody has the disease with few false negatives we don't have that."