Next Steps for COVID Testing

Hawaii, we have made it through the first phase of the worst pandemic the planet has seen in modern history. We have done this because of you and your commitment to your family, friends, coworkers, neighbors, and our Hawaii ohana that makes this state so special.

The ability to test 3% of our population rapidly, repeatedly and identify COVID positive individuals was a goal we had in early March. Aggressively following this with isolating these COVID positive citizens and testing their families and close contacts following the lead of other successful countries saved hundreds if not thousands of lives in our state.

We now need to begin phase two of testing in preparation for three events including opening the Kamaaina Economy, reopening the state to tourism and unfortunately the possible return of COVID through reintroduction, clusters, mutations or the cold and flu season “2nd wave” late this year or early 2021.

As of 10 days ago Clinical Labs of Hawaii has been able to process serum antibody tests for COVID IgG. This is performed by having your blood drawn by a traditional method into a tube that is then sent to the lab. This is not a finger stick. This finger stick test as of Monday 5/4 have again been called into scrutiny by the FDA due to their inaccuracy. The serum blood tests now done in Hawaii by CLINICAL LABS is 99.5% accurate in finding these antibodies if present (sensitivity) and 100% accurate in determining if you have no antibodies present (specificity). They are run in multi-million-dollar CLIA certified labs in Hawaii. DIAGNOSTIC LAB of Hawaii (DLS) as of two days ago has the same capabilities and both can run 2000 tests per day or more with a 24 hour turn around.

So what is the importance of this test? It is how we identify if one’s body is making the cells to fight COVID and potentially provide a person immunity from becoming infected with this horrible respiratory virus. It also can provide a medical provider and patient with a diagnosis of prior exposure to COVID where an individual was either asymptomatic or never tested and diagnosed at the time of infection.

As a busy physician with other providers and an Urgent Care seeing patient through our Premier Medical Group Hawaii, we all were surprised at numerous individuals and entire families with coughing and prolonged illness often with fever and even wheezing during January, February and March. The US and countries around the world now accept that COVID was spreading undetected during this time. As the “Gateway to the Pacific”, Hawaii certainly was one of the first states to experience this spread.

So who were these individuals? We believe it was hospital and medical personnel, first responders like EMS, Fire and Police, airline and airport workers, and of course our entire tourism industry. Let’s not forget their families and ultimately the children naturally spreading it in school!

I believe it now time to begin diagnosing and identifying if you or your family is someone who has already been infected with this virus that has changed the world as we know it. This is not too much to ask the leadership in our state and the federal government. Currently the cash price by Clinical Labs is $43 and $40 at DLS. It will not bankrupt any institution.
Congratulations to Hawaii Pacific Health who announced last week it will test all of its employees. We began testing first responders and hospital workers in partnership with the county in Hilo, Waimea and North Kohala this week.

In a short period of time, we can have a broad enough sampling of our state. These blood tests will provide diagnoses for our hard-working people, many of whom who remain out of work. It will tell us how broad spread COVID is in Hawaii. If you or your family members were exposed enough to COVID that you may have immunity don’t you deserve to know?

Second, we will begin to follow and understand if these individuals have enough of these cells that they potentially remain immune to infection. For SARS and MERS the so degree of immunity lasted two to three years. I say potentially because we just don’t know what the future will bring. But we must start somewhere. And this is what civilized, advanced states and countries are doing across the US and the planet, being proactive and preventative and not waiting.

If you or your family have the IgG antibodies, we will recommend rechecking your blood at 1, 3, and 6 months to follow you as an individual.

Let us again be leaders in the United States. We just proved to the country and world what we can do as a unified people working together for the common cause of saving the lives of our loved ones and neighbors in this land we love. By being progressive and studying and identifying who is and was infected with COVID Hawaii and evaluating immunity, we are another step closer to safely resuming life as we know it.

Look for screening to be available throughout the state beginning this week. Also, contact your Primary Care Physician who should be able to send in an order for this valuable blood test.

Mahalo to everyone for your support,

Scott J Miscovich MD
President and Founder
Premier Medical Group Hawaii