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COVID-19 Breathalyzer 1,000 Tests Per Hour


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The technology enhanced medical capabilities are demonstrably responding to this virus and capabilities to protocol.  Very interesting and impressive.

 

https://www.seatrade-cruise.com/environmental-health/multi-unit-covid-19-breathalyzer-system-can-screen-1000-cruisers-hour

 

Multi-unit COVID-19 breathalyzer system can screen 1,000 cruisers in an hour

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It certainly is interesting. It’s quicker, and less invasive that’s for sure. However, at this point does anyone really want to cruise or get on a ship where there is any form of Covid testing at all or at least after one during first embarkation? Tests that will have positives and false negatives leading to quarantines and a canceled cruise for all aboard. 100% vaccine for all and no testing and no results is really the only way to make it through a weeks long cruise at this point in my opinion. 

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4 hours ago, chengkp75 said:

Each unit is leased at $400k, and you need 8-9 units to get the 1000/hr rate, so that is an investment of $3.2-3.6 million per terminal.

 

A bargain vs posting a 150M loss every month

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5 hours ago, chengkp75 said:

Each unit is leased at $400k, and you need 8-9 units to get the 1000/hr rate, so that is an investment of $3.2-3.6 million per terminal.

I don't think  that you can run more than one person a minute through a unit. Remember that some people are just going to be slow. That means it will take 15 - 18 units to get 1000/hr. It is really cost prohibitive for big lines. For the luxury lines it would be great where they run fewer than 500 people through the system.

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4 minutes ago, zqvol said:

I don't think  that you can run more than one person a minute through a unit. Remember that some people are just going to be slow. That means it will take 15 - 18 units to get 1000/hr. It is really cost prohibitive for big lines. For the luxury lines it would be great where they run fewer than 500 people through the system.

Apparently, the "unit" that analyses the sample can do 100 per hour, but you can use more than one "breathalyzer" unit to collect samples.  It is not like a typical breathalyzer, in that the collection and analyzing functions are different units. 

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12 hours ago, tallnthensome said:

It certainly is interesting. It’s quicker, and less invasive that’s for sure. However, at this point does anyone really want to cruise or get on a ship where there is any form of Covid testing at all or at least after one during first embarkation? Tests that will have positives and false negatives leading to quarantines and a canceled cruise for all aboard. 100% vaccine for all and no testing and no results is really the only way to make it through a weeks long cruise at this point in my opinion. 

The first thing I thought of was what if a family is traveling- gets one false negative and it costs them thousands of dollars (perhaps the cruise is refunded, but other costs).

Now maybe if they used this in conjunction with something it could work.

But I thought about something else- someone goes to a terminal, leaves their bags with the porter- they are placed on the ship. Person enters terminal is tested- bags are gone.

 

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I'm not authorized to view the linked article, but the problem with rapid tests is the sensitivity. If you are positive and strongly positive, those tests work great. But in the majority of people you don't need a rapid test to tell you that you're positive - you'll have symptoms by that point and will know. The rapid tests are specific - meaning if you're positive, it's not a cross reactivity with influenza, RSV, or one of the other Corona viruses. However, they are not sensitive - meaning they do a poor job of picking up the viral antigen when it's present in low amounts (early stages of infection, asymptomatic, etc - exactly the type of people we need to be testing before they go onto a petri dish of a cruise ship).

 

That's why PCR is the gold standard. I won't bore you with the science, but that's literally what I do for a living. A different article that I was able to view stated this (this was from August, so they may have improved since then):

 

" In the test set, the device showed 76% accuracy in distinguishing COVID-19 cases from controls and 95% accuracy in discriminating COVID-19 cases from lung infections. The sensor could also distinguish, with 88% accuracy, between sick and recovered COVID-19 patients. Although the test needs to be validated in more patients, it could be useful for screening large populations to determine which individuals need further testing, the researchers say."

 

Think about that in terms of the actual numbers. For every 100 people tested, only 76 of them will have an accurate correct result. For every 1000 people, add an extra zero to that. So to keep it semi-simple, on a ship with 1000 passengers and crew, there will be 240 people who were told they were negative - who are actually positive floating around, sharing public spaces, spreading germs for the other 760 people to catch. Until they can prove accuracy to >= 95%, suck it up buttercup and get the nasopharyngeal swab. Or stay home.

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5 minutes ago, Sailing12Away said:

I'm not authorized to view the linked article, but the problem with rapid tests is the sensitivity. If you are positive and strongly positive, those tests work great. But in the majority of people you don't need a rapid test to tell you that you're positive - you'll have symptoms by that point and will know. The rapid tests are specific - meaning if you're positive, it's not a cross reactivity with influenza, RSV, or one of the other Corona viruses. However, they are not sensitive - meaning they do a poor job of picking up the viral antigen when it's present in low amounts (early stages of infection, asymptomatic, etc - exactly the type of people we need to be testing before they go onto a petri dish of a cruise ship).

 

That's why PCR is the gold standard. I won't bore you with the science, but that's literally what I do for a living. A different article that I was able to view stated this (this was from August, so they may have improved since then):

 

" In the test set, the device showed 76% accuracy in distinguishing COVID-19 cases from controls and 95% accuracy in discriminating COVID-19 cases from lung infections. The sensor could also distinguish, with 88% accuracy, between sick and recovered COVID-19 patients. Although the test needs to be validated in more patients, it could be useful for screening large populations to determine which individuals need further testing, the researchers say."

 

Think about that in terms of the actual numbers. For every 100 people tested, only 76 of them will have an accurate correct result. For every 1000 people, add an extra zero to that. So to keep it semi-simple, on a ship with 1000 passengers and crew, there will be 240 people who were told they were negative - who are actually positive floating around, sharing public spaces, spreading germs for the other 760 people to catch. Until they can prove accuracy to >= 95%, suck it up buttercup and get the nasopharyngeal swab. Or stay home.

One word - Asymptomatic

 

The problem with a PCR test is the time between test and embarkation. Take the state of Hawaii that require a negative PCR test within 72 hours of departure. They had agreements with large testing facilities like Quest and CVS. Both have pulled out because they can not meet the 72 hour requirements. The Costco mail in test is consistently not making the 72 hours.  So,,, Hawaii (like future cruise lines) are considering making the test requirement 4 or 5 days.
 

Even at 72 hours, you are testing at the instant that you are taking the test. 3 days later you could be spreading the virus to your new friends on the ship. Which makes the gold standard kinda tarnished. 
 

Testing at embarkation allows you to weed out those who are shedding at the port. 

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7 minutes ago, BirdTravels said:

Even at 72 hours, you are testing at the instant that you are taking the test. 3 days later you could be spreading the virus to your new friends on the ship. Which makes the gold standard kinda tarnished. 
 

Testing at embarkation allows you to weed out those who are shedding at the port. 

Just to keep to the facts - the PCR test itself only takes 1 hour to run. The problem we have nationwide is a lack of laboratory professionals to run the tests, and a nationwide shortage of testing kits and supplies. Hence the backlog of not getting your results until 3+ days later.

 

In NY we have an executive order that was put into place back in March that allows non-licensed lab staff to perform Covid testing. Double edge sword if you ask the lab professional side of me, as we now have extra people we can employ to help with the workload, but by taking people without the proper education, background or training - is that really helping to ensure accurate test results are going out? That's a discussion best saved over cocktails once we're all sailing again one day.

 

At my lab alone we have 3 different methods for doing testing, with a 4th on it's way soon. Two are the rapid PCR tests and take ~1 hour from the time we get the swab, a 3rd PCR test is longer and takes ~4 hours to run, and the newest method is the rapid test which we'll be putting in our ER's. I'm not a fan, but I don't run the hospital so I was overruled on that decision. Again, another convo for another day over drinks...

 

On average we run ~100 tests per day, with the capacity to run nearly 500 tests per day. We simply don't have enough bodies to sit here and run the tests, so we have to send a bunch out to our sister hospital in NYC - or, we don't get the needed testing kits. All kits are being distributed by the feds, with priority given to hot zones. Since NY has thankfully been doing great compared to other states, we get practically nothing each week at distribution time. We ask for 1000 kits, they give us 325. We ask for 500, they give us 72. We have zero control over how many kits we get, which makes it impossible to plan for staffing or logistics of where the samples get routed. It's quite a nightmare, and I'm sure other labs are going through the same thing.

 

Long rant over (sorry), but the technology is there to get results in 24 hours, we just don't have a good centralized testing center with enough staff to handle the workload and a reliable distribution of testing supplies to keep up with the demands. But I'll take a delayed yet accurate negative test result over a fast inaccurate one any day. 

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2 hours ago, Sailing12Away said:

Just to keep to the facts - the PCR test itself only takes 1 hour to run. The problem we have nationwide is a lack of laboratory professionals to run the tests, and a nationwide shortage of testing kits and supplies. Hence the backlog of not getting your results until 3+ days later.

 

In NY we have an executive order that was put into place back in March that allows non-licensed lab staff to perform Covid testing. Double edge sword if you ask the lab professional side of me, as we now have extra people we can employ to help with the workload, but by taking people without the proper education, background or training - is that really helping to ensure accurate test results are going out? That's a discussion best saved over cocktails once we're all sailing again one day.

 

At my lab alone we have 3 different methods for doing testing, with a 4th on it's way soon. Two are the rapid PCR tests and take ~1 hour from the time we get the swab, a 3rd PCR test is longer and takes ~4 hours to run, and the newest method is the rapid test which we'll be putting in our ER's. I'm not a fan, but I don't run the hospital so I was overruled on that decision. Again, another convo for another day over drinks...

 

On average we run ~100 tests per day, with the capacity to run nearly 500 tests per day. We simply don't have enough bodies to sit here and run the tests, so we have to send a bunch out to our sister hospital in NYC - or, we don't get the needed testing kits. All kits are being distributed by the feds, with priority given to hot zones. Since NY has thankfully been doing great compared to other states, we get practically nothing each week at distribution time. We ask for 1000 kits, they give us 325. We ask for 500, they give us 72. We have zero control over how many kits we get, which makes it impossible to plan for staffing or logistics of where the samples get routed. It's quite a nightmare, and I'm sure other labs are going through the same thing.

 

Long rant over (sorry), but the technology is there to get results in 24 hours, we just don't have a good centralized testing center with enough staff to handle the workload and a reliable distribution of testing supplies to keep up with the demands. But I'll take a delayed yet accurate negative test result over a fast inaccurate one any day. 

So, the PCR test won’t support a 72 hour turn around let alone day of cruise. How long it takes to process a sample and how long it takes to get results are totally different. How long it takes to process a sample is totally irrelevant. That is the fact. 

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On 12/6/2020 at 1:59 PM, BirdTravels said:

So, the PCR test won’t support a 72 hour turn around let alone day of cruise. How long it takes to process a sample and how long it takes to get results are totally different. How long it takes to process a sample is totally irrelevant. That is the fact. 

It's not irrelevant. It all depends on where the samples are sent, and what type of onsite support the testing center has. We're averaging a 72 minute turn around time for rapid PCR tests from the time we get the sample. Meaning that once we have the swab in our hands, the doctors have results in their hands in ~72 minutes. Giant factory labs like LabCorp, Quest, etc are the ones averaging the 3 day wait. 

 

There's a lot of politics and bureaucracy involved, but if the port authority of NY set up a contract with a lab to test cruise passengers, it could be done in <24 hours. Money talks, and outpatient testing (non hospital patients) is where the money is at.

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