Becker's Clinical Quality & Infection Control

10 INFECTION CONTROL There are limits to coronavirus antibody testing, AMA warns By Anuja Vaidya P hysicians and the general public should be cautious about the use of antibody testing for identifying previous COVID-19 infections, and they should especially be cautious of using the tests to determine if a person is immune to the coronavirus, the American Medical Association warned. Per a guidance released by the association May 14, while antibody tests may play a key role in identifying the overall prevalence of COVID-19 in the U.S. population, including among those who do not show symptoms, the testing has inherent limitations. The limitations include antibody tests on the market showing a significant num- ber of false positive results. These tests may also identify antibodies for other coronaviruses, such as those that cause the common cold. Also, a vast majority of more than 120 tests on the market have not been autho- rized by the FDA, and the association urges physicians to note the regulatory status of all available coronavirus antibody tests. Thus, the association recommends that "currently available antibody tests not be used as the sole basis of diagnosing COVID-19, and not be offered to indi- viduals as a method of determining immune status." The test should not be used to support decisions on returning to work or end- ing physical distancing, the association said. n Up to 25% of COVID-19 patients may not show symptoms, CDC director says By Anuja Vaidya A significant number of people who contract COVID-19 re- main asymptomatic, CDC Di- rector Robert Redfield, MD, said in a March 30 interview with radio station WABE, an NPR affiliate in Atlanta. Dr. Redfield said the agency has "pret- ty much confirmed" that up to 25 per- cent of COVID-19 patients could be asymptomatic. He also said that those who do begin showing symptoms appear to shed the virus significantly in their throats, potentially up to 48 hours before symptoms show. "This helps explain how rapidly this virus continues to spread across the country, because we have asymp- tomatic transmitters, and we have individuals who are transmitting 48 hours before they become symptom- atic," he said. Dr. Redfield also reiterated the impor- tance of social-distancing measures, saying, "This is not just a little recom- mendation on a piece of paper. This is a very powerful weapon." The CDC director said he expects the spread of COVID-19 to die down by early summer, but that a second wave will occur in late fall or early winter. In the intervening months, the U.S. needs to continue working on measures, such as early case defini- tion, isolation and contact- tracing, to prepare. "This virus is going to be with us," he said. "I'm hopeful that we'll get through this first wave and have some time to prepare for the second wave. I'm hopeful that the private sector in its ingenuity and working with the government, [National Institutes of Health] will develop a vaccine that ultimately will change the impact of this virus." n Beaumont Health develops technology to disinfect N95 masks By Mackenzie Garrity R oyal Oak, Mich.-based Beaumont Health bioengineers adapted technol- ogy to disinfect N95 masks and other personal protective equipment, according to MLive.com. "is is a major development which will help us contribute to protect our staff during this pandemic," said Carolyn Wilson, COO of Beaumont Health. "Our engineers stepped up, adapting technology to create this process. With the severe national short- age of masks, this will allow us to protect our staff, conserve resources and reduce medical waste." Using an ultraviolet light generator, the masks are cleaned while hanging from cables. e walls are covered in reflective foil for "safe and effective" sterilization. e process takes less than two hours to clean personal protective equipment. "We've adopted a two-step process based on work from the University of Nebraska and in collaboration with University of Michigan," said Sam Flanders, MD, Beau- mont's chief quality officer. "A powerful ultraviolet light exposes all surfaces of the mask for eight minutes. UV light has been proven to kill the COVID germ, along with other microorganisms. Next, the masks are heated to 150-160 degrees for one hour." Staff that are assigned N95 masks are asked to return their masks at the end of their shis. If the masks are visibly soiled, contaminated or wet, they are discarded. n

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