The state of Nevada withdrew a directive that blocked nursing homes from using federally provided rapid coronavirus testing equipment late on Friday, in response to an order from the Trump administration.
Nevada told nursing homes on Oct. 2 to stop using the rapid-testing equipment, citing concerns about false-positive results. The back and forth highlights a debate over the proper use of the tests after reports of some false positives.
In a letter to state officials, Adm. Brett Giroir, the Department of Health and Human Services official who has overseen U.S. testing efforts, said the state’s action to ban use of the tests was “inconsistent with and preempted by federal law and, as such, must cease immediately or appropriate action will be taken against those involved.” The letter was dated Oct. 8 and made public Friday.
Adm. Giroir defended the performance of the federally supplied equipment on a call Friday with reporters, saying the false-positive rate was low and the issue could be managed by using proper procedures to confirm results. The state’s action wasn’t justified, he said. Adm. Giroir declined to say what enforcement action the federal government could take against Nevada, but said he expected the state to comply with the federal order.
“We are very disappointed by the letter received today from U.S. HHS Giroir, as our goal remains united in protecting those most vulnerable in our communities,” Ihsan Azzam, Nevada’s chief medical officer, said. “We too want more testing with rapid turnaround in Nevada, but the results of those tests must be accurate as they affect clinical care.”
“We are not saying the tests have no use, we are just saying pause for further review and additional training,” he added. The health department issued a new bulletin late on Friday, recommending that nursing facilities continue to perform follow-up laboratory-based molecular tests for both positive and negative results.
The federal government has been supplying equipment from
& Co. to around 14,000 nursing homes around the country, which can use the machines to fulfill a federal mandate to test staffers. They perform point-of-care antigen tests that don’t have to be sent to labs for processing. Antigen tests focus on virus proteins, while molecular tests look for the virus’s genetic material.
Any type of diagnostic or clinical test will produce some number of false positives, laboratory scientists say. Rapid antigen tests are cheap and can provide quick, repeatable results, but they also tend to be less accurate than the laboratory-based molecular tests. Antigen tests are more likely to produce false negatives, but they can also produce false-positive results, especially as a part of wider screening programs in communities where the prevalence of the disease is low.
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