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Dr. Rai explains drive-through mass testing, Remdesivir and plasma donations

(WBAY)
Published: May. 1, 2020 at 9:13 AM CDT
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Drive-through COVID-19 testing continues May 1 at the Resch Center in Green Bay. It's for employees at JBS, American Foods Group, Saputo and Hansen Foods. It is not open to the general public.

Prevea Health President and CEO Dr. Ashok Rai joined us Friday on Action 2 News This Morning to talk about that testing process, the drug Remdesivir, and the Red Cross and plasma donations.

TESTING AT THE RESCH

"The county put up, in partnership with the state, a specific community testing site to handle some of these outbreaks we've had in employer settings. This isn't a testing site that's really meant for where a health care provider will send you to after you've gone through an online screen. These are people both symptomatic and asymptomatic, that the companies that are worrisome, are sending their employees to. They've worked with the county, the state, and the National Guard to get the testing. People line up, they drive through the bowl of the Resch, they never leave their car. Everybody is very safe. The people doing the testing are wearing personal protective equipment. They do the paper work. They get tested and they leave. Their results are followed up with them," says Dr. Rai.

"This one specifically was stood up by the county and the state to really deal with the outbreaks we've been having.

"I think that probably the most important thing there is, you've got a couple of the local health systems working together. Ourselves and Aurora were there yesterday. Everybody's going to rotate through there. Great help from the National Guard coming in to help the county, and help us in health care help those manufacturers get back to work by testing their people."

NATIONAL GUARD RESPONSE

"There's different people with different qualifications. These are people that are meant to help with testing, so they're testing. The Guard just works side by side with local health care providers to give us staffing that we wouldn't regularly have to do all of that. So it's great to see the state and the governor mobilize that to help us out. I don't know what the other Guard units are doing. They each have different specialities. The ones I've met so far really specialize in testing and they definitely know what they're doing," says Dr. Rai.

REMDESIVIR

has been effective against the virus, according to the nation's top infectious disease expert Dr. Anthony Fauci.

"We've enrolled in clinical trials to get it here in Brown County as soon as possible. It's important to remember what Remdesivir is used for. It's really used for that really sick patient, once again. That ICU patient, the one that's been in the hospital for weeks, and try to shorten that stay up. What they did is they took two sets of patients who both had COVID-19, what we call a randomized control trial, some got Remdesivir, some did not. What they did when they compared the two patient populations, they found that those who were getting Remdesivir were getting better faster. Less people were dying with it. A slightly small descrease in the death rate. But really what they saw more significantly was the shortening of the disease. Not by a lot, by a few days, but enough to say the drug was making a difference. Stop the trial. Let's use it, number one, and let's look at different ways to study it," says Dr. Rai.

"I think what Dr. [Anthony] Fauci was talking about how important it is, a couple of things. We now know the mechanism of action of this drug. It's not the type of drug you're going to get like, 'I just got tested positive for COVID, give me Remdesivir.' It comes through an IV, and once again, it's for that really sick. But now different classes of drugs, or different drugs in this same class, can start to be researched and developed. So it's a significant development. Just like we learn something every week about the coronavirus, now we're learning better treatments," says Dr. Rai.

RED CROSS PLASMA DONATIONS

"So what you really talk about antibodies and the Red Cross, what they're doing is they are trying to get people who are good convalescent plasma donors. And that's somebody who has recovered from COVID-19, spent 28 days recovered, over the age of 17, and in pretty good health. Now what the Red Cross can do with that donated plasma, test it for the antibodies, make sure they're there and then make sure they're getting to the right patient. This is a national project so we've had a patient where we had to go to Florida to get the right plasma for that patient depending on their blood type. It's a very unique situation. I think it's been used over six-or-seven times to my knowledge by us locally here. And the patients seem to be doing very well with it. But you have to remember that these are the sickest patients. And it's just really reducing their hospital stay, getting them out of the ICU. We've even had a person go home so far," says Dr. Rai.

to learn more about the Red Cross COVID-19 Plasma program.

REOPENING

"I am concerned. People even talk about county by county in Wisconsin. And there's a lot more travel within a state, so that's very worrisome. But even across borders and international borders, I think there's no difference as long as we're doing what we should be doing--the physical distancing, the masking, the washing the hands--some of that will be reduced. But you are going to have what we call those hot pockets. And if we're not adequately testing in one area, and isolating, and letting people go into one area where there is good testing and isolation, you kind of ruin the efforts where there's good testing. The state of Wisconsin has invested a ton right now for the next few weeks to get adequate testing and make sure we're adequately isolating and tracing. And then if you have an influx of people in there, it kind of dilutes all of those efforts," says Dr. Rai.

"It can change overnight, is my point. There was

If you go down to Paris, Texas, for example. A town that wanted to reopen and started to. Didn't really have any cases. And then one case in a nursing home led to 65 infected people and that kept growing. You have to remember how contagious this virus is. It takes one single breakout--one manufacturer, one assisted living, one nursing home--to completely balloon up our numbers like we've seen in Brown County. So even if your county has none, doesn't mean that coronavirus is not there. It just means we haven't ramped up testing enough in that area. But it can get there. And once it does, it can balloon very quickly," says Dr. Rai.

WHO SHOULD GET TESTED

"Right now anybody with a COVID-19 symptom should go online, should call their physician's office, and get a test. For us, it's prevea.com/virtualcare. That's free. Going to a testing site, that's free, to get tested. And you should definitely get tested if you have symptoms," says Dr. Rai.

RESPONSE IN BROWN COUNTY

"I think what's happening different in Brown County than what's not happening in the country is that we had a governor get us testing kits and be able to mass test. That's a big difference when talking about reopening a manufacturer that has a breakout, is knowing exactly what's going on, finding people who are positive, and getting them out of the work place," says Dr. Rai.

"That's what's effectively being done here in Brown County. Now, it's still going to be nervous going back in there and it's not going to be perfect. But these plants have also had time to improve their safety. To screen people effectively so you're not going to get in with a symptom. You're going to wear masks. Different things are going to happen. They're going to open up slower and safer than maybe other areas in the country."

STORES REQUIRE MASKING

"To reduce the spread of the virus, obviously physical distancing is the number one thing. Washing your hands. We added masking to prevent that transmission from person to person. What Costco is doing, what the airlines are doing, is really what we need everybody to be doing, and that's universal masking. Over time--not overnight--but over time, that will reduce the transmission from person to person. And that is the goal, is to get less transmission so we can start getting back to a new normal. I commend them for what they're doing. I commend the airlines for what they're doing. And we hope that everybody starts to get the resources to be able to do that. What I mean by that is not a lot of employers have been able to mobilize the supply chain to get that many masks. Everybody's trying at the same time so that's hard for everybody. But over time, we'll start to see more masks available. And hopefully every single grocery store or store will start to do this, reduce the transmission, and then get out to a much better normal in the future," says Dr. Rai.

DEFERRED PROCEDURES START AGAIN

"A couple of things needed to happen to make today happen. We needed to have the ability to test people. We have that now in a broader sense. We needed to make sure the hospitals could handle any surge of patients and have the right amount of personal protective equipment. We have that. A lot of these procedures needed to happen. We just had to make sure they could happen in a safe enivornment. We've created that environment within the hospital for them--made sure they've been tested before they come in. These are things--people have been in pain, they've needed their cancer screening done--these are all things that needed to be done. And slowly and slowly, we'll start to ramp that up now," says Dr. Rai.

TESTING TURNAROUND

"We do have rapid testing available here, but it is really for a limited amount of people, because we have a limited amount of testing equipment for that. And that's really because the manufacturers are still ramping up and a lot of those tests went to other parts of the country. Slowly, that's ramping up here and we'll get a lot more rapid testing. But we do have it here today. And it's really for in the hospital, if somebody's about to have a baby. A laboring patient, as we call them, will get a rapid test. If we need to know right away with somebody coming in sick, we'll use that rapid test. So the majority of the testing we're talking about right now is a 48-hour turnaround, and that's through a commercial lab in Madison. We happen to be using Exact Sciences there, but we've used other ones like Quest, as well. And then we have the state lab that can turn that around in 24 hours for certain situations when we need to know that next day or that same day. It really depends on that clinical situation, and that will depend on how long that testing will take. I'd love to get everybody their results in an hour or two, or even 15 minutes, and as production of that ramps up we'll see a lot more of that. But the fact of the matter is we can test a lot more people, it just does take 48 hours to get that answer," says Dr. Rai.

PRISON TESTING

"So whether it's a corrections-type facility, a nursing home, assisted living, manufacturing, a meat packing plant, you really need evidence of a breakout. Because if we just tested everybody, and they're asymptomatic and everybody is negative, all it meant is they were negative for that hour or whatever they were tested that day. So really mass testing, such as a correctional facility, or one of the other places I talked about, you really have to have the definition of a breakout. [Wisconsin DHS] Secretary [Andrea] Palm tried to set that out for us this week. And it only takes a couple cases for us to go in there and use our clinical decision to test more people. But once again, we need to have evidence that there's a breakout for that to make sense right now," says Dr. Rai.

ADS FOR ANTIBODY TESTING

"It's a little frustrating seeing that out there, because number one, you have to understand that the antibody testing that's out in the main public right now is number one, not ones that have gone through the normal FDA channels. Those are coming. And these are ones that have what we call cross reactivity. So yes, it can maybe detect COVID-19, plus three or four other viruses, so it doesn't really give you a good answer. And all it's telling people is you may have been exposed to COVID-19. Even the ones that are super accurate. The only answer you're getting is you're exposed. We don't know about immunity yet. And we don't know how long, if it is immunity, how long that will last. Going out and getting an antibody test right now without a good clinical indication, and then getting one that hasn't gone through the regulatory processes, doesn't add any value," says Dr. Rai.

CDC

"The CDC has done a great job helping local health care leaders and public health understand the breakout more. Presenting us with what we call a heat map. You had five cases here, and then you had 20 cases, then you had 60 cases, now you have 500 cases. And what areas it was in. Identifying, was that due to a manufacturing situation? Was it due to a party here? They really can kind of narrow down where that happened, and that helps put together a broad testing strategy," says Dr. Rai.

ORIGIN OF VIRUS

"Although we call it a novel coronavirus, it does come from a certain family of viruses. It does not look to be--I don't know what the conspiracy theorists say--genetically engineered in any way, or created by somebody for a purpose. This is a natural evolution for a virus. And unfortunately evolution for us in history at this point. But it's not the first time in history we've seen a virus evolve and be this contagious and deadly. It's just such a rare event," says Dr. Rai.