https://www.tiktok.com/@distilledscience/video/7639493361585458462
Why are we not doing daily testing to catch and quarantine potential cases before they become infectious? Let me show you the data. And I genuinely want someone to answer this for me because I've asked a lot of experts in the space and so far no one can. Right now, the biggest worry is what if it spreads from the people who are exposed and are now being monitored but not quarantined given the long incubation period? There are 32 people who disembarked in St. Helena. And then many more who were on a flight to Johannesburg on April 25th with the actively sick passenger who then sadly died the next day. In the US, 12 of these people are being monitored, but I haven't seen any mention of quarantine or testing. We have very limited data on this Andes virus and how it spreads. And everyone seems to be focusing on this study from the 2018 Argentina outbreak and whether or not it showed airborne spread, which I can cover in detail if you want. But there was another really important study published back in 2007. It looked at 76 households with confirmed Andes virus infections from 2001 until 2005, in Chile. Not an outbreak, just individual index cases likely from the usual rodent to human route. But the researchers wanted to see how it spreads within households. They looked at the 476 household contacts, monitoring them for symptoms, and taking weekly blood tests. They analyzed the blood for anti-hontovirus antibodies and performed PCR tests to test for any actual viral RNA. If you remember from COVID, PCR tests are able to test for very small amounts of viral genetic material. So they can be positive before symptoms show and for a while after they go away. comparing these 16 to the other 460, they found that the risk of household transmission was 17.6% among sex partners versus 1.2% among non-sex partners, which strongly suggests transmission via bodily fluids rather than airborne. But these dynamics seem very different from the 2018 outbreak, and it was a different anties virus strain. But here's the key part. They detected Andy's virus RNA, a median of 11 days before the cardiopulmonary phase in six household cases, and 5, 7, 14, and 15 days before the onset of early, symptoms in the additional four cases. If we're not willing to quarantine everyone who is potentially exposed, why not test them daily to get an advanced warning to be able to quarantine them before they're able to spread it, which could potentially happen before they're symptomatic. Right now, the WHO says that infectiousness peaks in the early phase of the illness and that pre-symptomatic transmission cannot be entirely ruled out, which is accurate because many viruses do have pre-symptomatic spread, because the viral load in the body increases steadily after exposure and can be pretty high before symptoms actually shove. This influenza human challenge trial shows viral shedding 24 to 48 hours before onset of symptoms. But the CDC says that typically people are only infectious while they have symptoms. But we don't have enough Andy's virus data yet to know for sure, and now is when it pays to have an abundance of caution. I get that testing isn't fun, but if I had been exposed, I would be lining up to give them my blood. I'd rather know. Why aren't we doing this? After filming, I just found out that the UK actually is. Better leadership?
Additional notes
Right now the UK policy reads as follows: START: PCR tests are being used to detect the virus, with results expected within 24 hours of each sample being taken. We are testing both blood samples and throat swabs. All passengers are being tested even if they have no symptoms, to allow us to detect cases before they become unwell. Catching this early means we can transfer anyone who needs it for specialist care as quickly as possible. If a passenger tests positive or begins to develop symptoms of the virus, they will be transferred from the facility at Arrowe Park Hospital to a specialist infectious diseases centre where they can receive appropriate care. After leaving Arrowe Park the passengers will isolate at home or if this is not possible in an alternative location. For the full duration of their monitoring period, UKHSA Health Protection Teams will carry out supportive daily checks by phone or text message to confirm that contacts have no symptoms, check their temperature, and make sure they are well. :END 👉 This seems like the RIGHT way to do things. I was able to find the CDC guidance document for what “monitoring” means, and it reads: ”A CLIA Andes virus–specific rRT-PCR assay is not currently available in the United States; once available, it could be used to test symptomatic patients. However, sensitivity may be reduced for specimens collected later in the course of illness, as viremia may be low or undetectable beyond approximately 7–10 days after symptom onset. Detailed guidance for laboratory testing of contacts will be provided separately.” Why are they not available? This seems like something that it would be very possible for the administration to procure… and administer. If someone has a good explanation for why I’m wrong on this, please let me know! I’m actively looking for good reasoning / data to explain things. #science #hantavirus #learnontiktok #tiktoklearningcampaign #creatorsearchinsights
References
- UK policy / UKHSA / Arrowe Park Hospital monitoring and PCR-testing context is quoted in the caption, but no direct source link was available in the workbook row.
- CDC Andes virus monitoring/laboratory guidance is quoted in the caption, but no direct source link was available in the workbook row.
- Chile 2001-2005 Andes virus household transmission study is discussed in the transcript; no direct source link, DOI, or PMID was available in this workbook row.
- 2018 Argentina Andes virus outbreak study is discussed in the transcript; no direct source link, DOI, or PMID was available in this workbook row.
- WHO infectiousness/pre-symptomatic-transmission statement is discussed in the transcript; no direct source link was available in the workbook row.
- Influenza human challenge trial is discussed in the transcript; no direct source link, DOI, or PMID was available in this workbook row.