GardenWeasel: King Something: Yes, how dare the Centers for Disease Control make any sort of centralized effort to control diseases.

It's not that the centralization it's the not-invented-here-ism that seems to permeate the culture due to cross pollination with the FDA, pharmaceutical, and medical labs industries

wademh: baron von doodle: GardenWeasel: King Something: Yes, how dare the Centers for Disease Control make any sort of centralized effort to control diseases.

It's not that the centralization it's the not-invented-here-ism that seems to permeate the culture due to cross pollination with the FDA, pharmaceutical, and medical labs industries

That, combined with them wanting a testing panel for multiple pathogens. If you just care about the total amount of data, a panel is better. However, the only data we needed from that test was Covid-19 infection rate.

I will argue that a panel of respiratory diseases would make some sense. A person shows flu-like symptoms, or other respiratory disease symptoms, and you give them a test. Is it influenza A, influenza B?

Here's the list for one Respiratory Panel: Adenovirus, Coronavirus 229E, Coronavirus HKU1, Coronavirus NL63, Coronavirus OC43, Human metapneumovirus, Human rhinovirus/enterovirus, Influenza A, subtypes 2009H1N1, H1, H3, Influenza B, Parainfluenza virus types 1, 2, 3 and 4, Respiratory Syncytial Virus, Chlamydophila pneumoniae, and Mycoplasma pneumoniae.

Pursuing inclusion in a panel is a laudable goal.

Delaying the availability of a Covid-19 test, needed to detect the arrival of a risky new pathogen in order to do it all in an elegant manner is not a good idea.

The good thing about putting it in a panel is that you can quickly get the panel to be widely used. Otherwise, you have to get people to add your surveillance test for otherwise routine ER visits. Compliance would be spotty. Even if the CDC pays for part of it, the ER is going to do their billing magic to make some people pay some extra cost related to specimen processing. (USA USA USA USA)

So the attempt to build a panel wasn't a bad idea. The failure to properly QC their own test, and respond to the reality of their own test --- that was the failure.

piledhigheranddeeper: wademh: Monroe's review cited the favorable conclusion about sensitivity reached by Trioplex's designer, Munoz, and described the available data for comparing the two tests as "inconclusive and contradictory." His review also said, "It was reasonable to not share this information with external public health laboratories, as it did not provide any meaningful information for laboratories to act upon."

Monroe is an idiot. To take the data of the test designer over that of labs that put the test into practical use is a colossal mistake. Even if Munoz wasn't cooking the results in his favor, how the test works in his hands isn't what matters, it's how it work out in the real world. There were multiple independent lines of evidence for reduced sensitivity. As scientists, they were obligated to share that information. As government officials in charge of a public health issue, they have a separate but similarly compelling duty to inform.

It's criminal negligence on Monroe's part. I've worked in diagnostic testing. I recognize the failures. He deserves a pillorying.

I don't understand the need to multiplex everything.  I think that the upper management people treat nucleic acid amplification as a magic tool that always works correctly.  They don't realize how sensitive each reaction is to small changes in temperature, template concentration, etc., and that what works in your PCR machine may not work in the PCR machine next door.  It is frustrating to keep hearing about testing failures when there are thousands of postdocs and benchtop techs in the US that could troubleshoot a single PCR reaction.