R.I. Department of Health Blocks Release of Potentially Reassuring Covid-19 Testing Cycle Threshold (Ct) Data, While Promoting “Positive Test” Hysteria

Thursday, 11/5/20, I was interviewed by the local Rhode Island #MikeswithMics team of Mike Stenhouse and Mike Collins about Governor Raimondo’s new covid-19 “edicts”, especially extending the quarantine period from 14 to 24-days for those who “test positive”. My interview segment of just under 20-minutes is embedded below.

For weeks, Raimondo has been urging mass asymptomatic covid-19 testing claiming,

“We know that a strategic asymptomatic testing plan is one of our strongest lines of defense against the spread of COVID-19.”

Is this indeed a tenable, evidence-based strategy to “limit” covid-19 spread? Simply put, no.

During a January 28, 2020 Health and Human Services presser, Dr. Anthony Fauci emphasized, “in all the history of respiratory-borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks.” Here are his remarks in full:

“Historically people need to realize that even if there is some asymptomatic transmission [of covid-19], in all the history of respiratory-borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks. The driver of outbreaks is always a symptomatic person. Even if there’s a rare asymptomatic person that might transmit, an epidemic is not driven by asymptomatic carriers”

A study of covid-19 transmission in South Korea supports Fauci’s generic view, based on previous respiratory virus outbreaks. Among 97 confirmed covid-19 case-patients in this study (published by the Centers For Disease Control and Prevention [CDC] journal, MMWR), 4 (4.1%) remained asymptomatic during the 14-days of monitoring. None of the 4 household member contacts of these asymp­tomatic case-patients, exhibited covid-19 symptoms nor tested positive after 14 days of quarantine. In contrast, 34 of 210 household members who had contact with symptomatic case-patients, contracted covid-19 translating to a secondary attack rate of 16.2% (34/210). {Note: During the interview I mentioned these two references pertaining to asymptomatic transmission (pre-symptomatic found but not asymptomatic) and testing (high false positive rate when testing asymptomatic contacts of those with covid-19), but felt the Korean study, above, and data cited below, were more rigorous.}

Governor Raimondo’s dubious strategy of focusing on “asymptomatic testing” is rendered even more questionable by the inherent limitations of the gold-standard method of determining covid-19 “asymptomatic cases” by reverse transcriptase polymerase chain reaction (rtPCR) testing. The rtPCR test method amplifies genetic sequences (i.e., nucleic acids from the virus’ core RNA [ribonucleic acid]) obtained in samples, typically, from nasopharyngeal swabs, or saliva. This amplification of viral nucleic acid sequences is measured in Cts, a proxy for the total amount of live virus present, or “viral load.” An rtPCR covid-19 assay system developed at the Harvard University/ Massachusetts Institute of Technology Broad Institute, currently determining covid-19 “positivity” at 108 northeastern universities (including R.I.’s major colleges) described this exponential relationship:

“…the Ct values correlated strongly with the logarithm of (covid-19) RNA concentration (R-squared > 0.99; indicating a very strong correlation), with the observed range from Ct =12 cycles to Ct = 38 cycles corresponding to viral loads ranging from ~1.9 billion copies/mL to (a mere!) 8 copies/mL, respectively (i.e., an ~250 million-fold difference!).”

Ct values from upper respiratory samples (nasopharyngeal and saliva specimens), symptom onset in relation to test date (STT), and the ability to culture live virus, are strongly correlated. Lower Cts, meaning less  amplification is required, and shorter STTs, indicate a patient’s infectious potential is greater. Additional validating clinical data suggest lower Cts—and hence larger viral loads—are associated with higher covid-19 mortality when patients are hospitalized for symptomatic covid-19 pneumonia, and/or other manifestations of being heavily infected by the virus.

Conversely, there is no tenable evidence asymptomatic persons with “positive” covid-19 rtPCR tests at Cts >30—particularly, K-12, or college age students—are at risk for serious covid-19 infections themselves, nor that they pose a serious risk of infectious spread to others. For example, an analysis evaluating the infectiousness of patients hospitalized with covid-19 reported that only viral loads > 10 million copies/mL, equivalent to Cts ≤ 25, were associated with isolation of infectious virus from the respiratory tract. Moreover, a systematic review of studies comparing the ability to culture live virus with the results of rtPCR testing, concluded:

“Infectivity declines after day 8 even among cases with ongoing high viral loads. A very small proportion of people re-testing positive after hospital discharge or with high Cts are likely to be infectious…A cut-off RT-PCR Ct > 30 was associated with non-infectious samples”

Finally, Dr. Fauci, during a 7/16/20 interview with the podcast, “This Week In Virology”, observed, regarding covid-19 rtPCR testing Cts:

“If you get a Ct of >=35, the chances of it being replication competent (i.e., infectious) are miniscule…you almost never can culture virus from a 37 threshold cycle. If somebody does come in with 37,38, even 36, you gotta say it’s just dead nucleotides. Period.”

Screening of asymptomatic R.I. residents demands transparent sharing of the “positive” Ct data recorded for all rtPCR tests conducted in the state, and compiled by the Department of Health (DOH), which as of 11/6/20, stood at 36,380 so-called “positive cases.” Gauged by the uncooperative response to a straightforward Freedom Of Information Act request for Ct data in the state’s possession—levying some $3K in upfront fees to gather this public information already paid for by taxpayer dollars—the R.I. DOH has chosen not to be transparent about these potentially clarifying, and reassuring data.  (see pdf of correspondence, below).

RI reply to FOIA 10.28.20_redacted SD

Rhode Islander’s are entitled to know the Ct values for any of their individual “positive tests,” and having the statewide trends for these “positive test” data, i.e., weekly updates at the R.I. DOH website (“Rhode Island Covid-19 Response Data”) made public, in a bar graph display: percentage of Cts ≤ 20; 21-25; 26-30; 31-35; and >35.

As of 11/4/20, 77% of the state’s covid-19 deaths (938/1223) continue to accumulate from nursing homes and elder assisted living facilities, with 59% occurring in those ≥ 80 years old, including 27% among those 90+ years old, while no Rhode Islander <30 years old has died from covid-19.

“Positive test” hysteria absent transparent release of the accompanying Ct data, and simultaneous acknowledgment of the unchanging covid-19 mortality demography, i.e., heavily skewed toward those at or above life expectancy in the state (=79.9 years), is ghoulishly dishonest.

Hope springs eternal Rhode Islanders will demand such transparency of their governmental and bureaucratic overlords.

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