26 Mar Why a Tiny Colorado County Can Offer COVID-19 Tests to Every Resident
This story titled “Why a Tiny Colorado County Can Offer COVID-19 Tests to Every Resident” by Sarah Zhang for The Atlantic was published on March 23, just prior to the release of the information about the COVID-19 testing protocols published here on March 25.
Telluride, image courtesy of Ryna Bonneau for Visit Telluride
San Miguel County in Colorado has, in ordinary times, fewer than three full-time employees in its public-health department. It has no hospital. Its total population is only 8,000. And yet last week, the county became the first in the United States to announce that it would be offering all its residents a new kind of test for COVID-19.
The tests are being donated by United Biomedical, a multinational biotech company whose executives, a married couple, happen to live part of the year in Telluride, the resort town that is also San Miguel’s county seat.
“It’s a small community,” Mei Mei Hu of United Biomedical told me on the phone from Colorado this weekend. “Very small,” her husband, Lou Reese, added. “Whether it’s just getting a donut or walking by on the street or on the ski hill with the ski patrol,” he said, “we know and have met or interacted with almost every member of the medical or emergency community here throughout the course of our lives.”
Hu and Reese—along with Hu’s mother, Chang Yi Wang, who is United Biomedical’s chairwoman—are the founders of the company’s new COVID-19–focused subsidiary, c19. United Biomedical has facilities in New York, China, and Taiwan, and it develops animal vaccines as well as diagnostic kits for human diseases. So when the novel coronavirus first appeared in China, the company started working on testing, and when cases started showing up closer to home, Hu and Reese thought of their community in Telluride. They floated the idea of testing the county to an old family friend, who also happens to be the area’s chief paramedic. Like they said, it’s a small community.
At that point, San Miguel County was, like everywhere else in the United States, having trouble getting tests for every patient who needed one. This particularly worried Sharon Grundy, the county medical officer, because Telluride had so many visitors coming and going. “We’re a high-risk area because we are a resort community,” she told me. (A group of skiers visiting another Colorado resort town, Vail, ended up seeding a coronavirus outbreak in Mexico.) The county was able to test some people through the state health department and a commercial lab, and got its first positive result on Friday. But when I spoke with Grundy on Friday, she also said the whole county had only two swabs left. “It’s not just us,” she hastened to add. “It’s the whole country.”
Without testing, San Miguel County’s health workers would be unable to track the virus’s spread. They would be, to use the words of the World Health Organization’s director-general, fighting “a fire blindfolded.” So United Biomedical’s offer to donate the kits came as a relief. “This gave us some hope,” Grundy said.
United Biomedical’s COVID-19 test is different from those typically being run on nasal swabs collected around the country. Those tests use a technique called RT-PCR to look for the virus’s genetic material in a patient’s nose and throat, but United Biomedical’s test requires a blood draw. It uses a different technique, called ELISA, to look for antibodies, the proteins the immune system makes to neutralize the virus. Antibody tests, also known as serological tests, don’t always pick up early viral infections, but they can tell if someone has ever had a particular virus—maybe even if they were asymptomatic.
For this reason, scientists all over the world have been pushing antibody tests as a way to study the true scope of the coronavirus pandemic. If serological testing can find asymptomatic carriers of COVID-19, it can also clarify the disease’s transmission and fatality rate. Testing a whole population—say, a whole county—would give epidemiologists a snapshot of everything going on in one place. “Any sort of population-based study is really interesting,” says Caitlin Rivers, an epidemiologist at Johns Hopkins University. And while it’s unclear how long immunity to COVID-19 lasts, she says, it could allow people who are immune to go back to their normal lives.
Hu said that United Biomedical started working on an antibody test back in January, as the outbreak got serious in China…
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