- The Current State of Testing and What Testing Looks Like in 2021 including At-Home Tests
- The Impact of Variants and COVID-19
- Addressing Health Disparities
- New CAP Survey Addresses Testing Supply Shortages
- The Effects of Delaying Medical Care during the Pandemic
PRESENTERS ADDRESSED VACCINES, VARIANTS AND HEALTH DISPARITIES
NORTHFIELD, Ill.—The College of American Pathologists (CAP) hosted on Thursday a virtual forum addressing the Rapidly Changing COVID-19 Testing Landscape, the fourth in a series of ongoing media briefings and the first in 2021.
“With Americans now getting the vaccine, testing remains a critical element as we navigate our new normal,” says CAP President Patrick Godbey, MD, FCAP, laboratory director, Southeastern Pathology Associates and Southeast Georgia Health System who introduced the program and was a panelist. “Today’s forum specifically addressed the role of at-home tests, new variants, the impact of deferred care due to COVID-19 and the health disparities we continue to see as the vaccine rolls out. This is a discussion we will continue to have to ensure efficient and effective turnaround of testing and fair, equitable care.”
View the full briefing program video recording.
The session was moderated by Kisha A. Mitchell Richards, MD, FCAP, Director of Pathology and Laboratory, Greenwich (Connecticut) Hospital
Other panelists included:
President, Board of Directors, College of American Pathologists Foundation; Chairman of Pathology and Medical Director of Laboratories, Advocate Illinois Masonic Medical Center; and
Kalisha Hill MD, MBA, FCAP, FASCP
Governor, College of American Pathologists; Regional Chief Medical Officer, Amita Health St. Joseph Medical Center and St. Mary's Hospital Kankakee; Medical Director, Pathology and Laboratory Services, Amita Health St. Mary's Hospital Kankakee (Illinois)
Drs. Godbey, August, Hill and Mitchell Richards are available for interview.
Dr. Godbey shed light on an online survey conducted by Ipsos.Digital on behalf of the CAP from Dec. 15 to 18, 2020. Two thousand U.S. adults participated:
- Approximately two-thirds of respondents “believe getting regular medical labs done is important to stay healthy” but falls to the bottom of the list of health maintenance.
- The proportion of those who have taken a COVID-19 test has increased (42 percent) since the CAP’s last online survey in August 2020 (24 percent).
- Despite constant news coverage and information, people feel less confident in their understanding of each test than they did in August 2020.
- An estimated 2 in 3 Americans would like more information about the accuracy of COVID-19 tests, and how they get validated.
The full briefing agenda included the following highlights:
Dr. Mitchell Richards acknowledged it was one year ago that the World Health Organization declared COVID-19 a pandemic. She and other panelists reflected on how their respective hospitals and laboratories stepped up to handle what no one could have envisioned and how far they have come. “Greenwich Hospital opened the first drive-through testing site in Connecticut at a time when people were unsure as to how they would get testing,” added Dr. Mitchell Richards. She also discussed collaborations with other hospitals and laboratories to ensure prompt turnaround and delivery of testing.
When asked about highs and lows of the year, Dr. Godbey acknowledged how laboratories “turned on a dime and did everything they could to meet the demands of COVID-19, a virus we had never seen before. Our labs met the challenge locally and I am so proud of our CAP members and how fast they all met this challenge.”
While all agreed pathologists truly stepped up to deliver tests accurately and as quickly as possible, they also agreed the largest challenge remained turnaround time often due to shortage of supplies; the enormous responsibility to ensure the safety and care of patients and staff; and the impact the virus has had on patients who delayed care and may have been reticent to return to a hospital.
The Current State of Testing and What Testing Looks Like in 2021 including At-Home Tests
Dr. Hill indicated that the polymerase chain reaction (PCR) test remains the gold standard test, and most sensitive test though acknowledged the convenience and cost-effectiveness that at-home tests provide.
All panelists agreed that understanding proper collection and storage is critical for accurate results. If the manufacturer directions are not followed properly, this can lead to false/positive outcomes.
Dr. Godbey expanded on the two different types of home tests: one where the collection is done at home and samples are sent to a lab; and the other where collection and performance are done at home. “The latter may rely on smartphones or computers which may create challenges, too,” he said.
The Impact of Variants and COVID-19
When asked about variants, Dr. Hill acknowledged their widespread implications and all panelists agreed variants are currently being accurately detected through PCR tests.
The CAP acknowledges that there is less available information on the effectiveness of detecting variants with antigen tests. Should there continue to be an increase in variants, tests to sequence and identify new SARS-CoV-2 variants in specimens collected from patients with COVID-19 would likely increase as well. As the virus continues to change, testing may also continue to evolve.
Addressing Health Disparities
Panelists acknowledged the existence of health care disparities throughout the United States after a year of the pandemic. According to the CDC, black and Hispanic Americans have been about three times as likely to be hospitalized from COVID-19 compared to white Americans; and it has killed Black, Hispanic and Native Americans at much higher rates.
“The CAP is against racial injustice and applauds the creation of the Biden Administration’s COVID-19 Health Equity Task Force to examine these disparities. It is working on several fronts including developing recommendations to ensure the right data is collected for contact tracing programs in communities of color and underserved populations,” added Dr. Godbey. “We will understand much more the challenges of disparity and have a more active role in meeting these challenges.”
Dr. Godbey also addressed the continued importance of overall diagnostic testing and ensuring that the laboratories serving diverse communities are equipped to test and track new variants; and, that the shortage of testing supplies continues to be a challenge.
New CAP Survey Addresses Testing Supply Shortages
The CAP unveiled today the results of a survey among board-certified pathologists nationwide that showed 45 percent of laboratories testing for COVID-19 have difficulties obtaining testing reagents and test kits they need within the last three months. While this represents an improvement since last summer, shortages still represent a substantial burden on those laboratories diagnosing coronavirus disease and require national attention to mitigate.
Respondents reported continuing difficulties acquiring pipette tips (30 percent); nearly 20 percent reported difficulties securing SARS-CoV-2 instruments (19 percent); flocked nasal swabs (18 percent) and viral transport media/universal transport media (17 percent).
Dr. Godbey applauded the Biden administration’s recent actions to utilize the Defense Production Act and other investments to strengthen supply lines for testing, as well as a legislative push to get laboratories the resources they need.
In January, the CAP sent a letter to President Biden and Vice President Harris outlining several initiatives with recommendations specific to testing and supply shortages; public health guidelines from federal agencies; addressing health care disparities; reimbursement
for COVID-19 tests; clinical laboratory regulatory issues; state and local issues; global health initiatives among others.
The Effects of Delaying Medical Care during the Pandemic
All panelists discussed the long-term implications of deferring medical care due to COVID-19 and the risk this presents to vulnerable patients who are not getting the immediate medical services needed. Surgeries have been cancelled or delayed; hospitals have closed and patients have had a fear to reschedule appointments despite the advice of their doctors. As a result, cancers and other diseases were detected and treated later. This deferment of care has led to increased disease severity for some patients, therefore requiring more advanced treatment, and an increased cost of care. In others cases, lives were lost.
The CAP Foundation’s See, Test & Treat Program
To address these challenges, Dr. August discussed the CAP Foundation’s See, Test & Treat (ST&T) program, providing no cost cervical and breast cancer screenings along with ongoing care to those who are un- or under-insured in some of the country’s most at-risk communities. She reinforced the importance of these screenings, which are available to thousands of women regardless of financial, language, cultural, or transportation barriers.
Started in 2001 by the late pathologist, Dr. Gene Herbek, the program was adopted by the Foundation in 2011. Since then, the Foundation has funded more than 100 ST&T programs, and screened over 6,500 women for cervical and breast cancer. Despite the pandemic, the program was able to serve more than 400 women in 2020. The ST&T program will celebrate its 10th anniversary under Foundation leadership this August.
“We had 16 programs in 2019; 10 last year and 14 hospitals already identified this year to provide assistance,” said Dr. August. She spotlighted several case histories of women who received same day results, immediate treatment, fiscal direction, ongoing medical consultation and a treatment roadmap ahead. As a result, one woman who was diagnosed with cervical cancer and received exceptional care has shared the program with others who may not have received the benefits the ST&T program offers.
Dr. August added that is it vital for pathologists and others to also be culturally sensitive to patients and their individual needs to ensure best care.
When asked what vaccine is most effective for African Americans and is there any vaccine that is more effective, Dr. Mitchell Richards responded that “the vaccine that is most effective is the one you can get.” She particularly encouraged vulnerable populations—Black, Hispanic, Native Americans, and Latinx communities—to be vaccinated.
“Today’s forum provides us with the opportunity to discuss these challenges as we reopen the country and recognize the continued vital role of testing, working closely with the new administration and ensuring the quality and efficacy of care we provide our patients,” concluded Dr. Godbey. “We look forward to continuing this dialogue and encourage everyone to get the vaccine while also continuing to wear masks, wash hands and practice physical distancing.”
About the College of American Pathologists (CAP)
As the world’s largest organization of board-certified pathologists with almost 18,000 members and as the leading provider of laboratory accreditation and proficiency testing programs, the CAP serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. Ninety-eight percent of the top 1,000 laboratories in the U.S. are CAP accredited. Pathologists oversee and provide laboratory testing and diagnose viruses, chronic diseases, cancers and other health conditions. For more information, visit yourpathologist.org to watch pathologists at work and see the stories of the patients who trust them with their care. Visit cap.org.
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