Covidome™ School Endowment Plan

The Covidome™ premise is the same as any school endowment: Provide capital and equipment so a school or district has the luxury of easily and rapidly committing to vital resources without wasting time considering the tradeoffs. An endowment that supports testing staff and gear can reduce the marginal cost of a test by 90% and reduce reporting delays by a week or more.

Nobel laureate economist Paul Romer:

“Just because something is unfamiliar doesn’t mean it’s impossible.”

Inspiration

• German biotech firm Centogene AG is testing all students and staff at Carolinum high school in Neustreltiz, Germany, and their families, twice each week.
• It’s difficult to reproduce the German service in the U.S. because the government chooses not to provide enough testing resources for an adequate turnaround time.
• Rapid reporting is the crucial metric for COVID19 testing.
• The only predictable way to duplicate the German program in the U.S. is for a school or district to quickly acquire its own point-of-care testing lab, equipment, and staff.
• That sounds absurd until you weigh the costs of the alternative and remember when a school nurse was a far-fetched idea.

Pilot Project Phases

California Phase 1, San Jose:

• Hammer Montessori & Galarza Elementary, SJUSD.org
  Testing and issuance of “digital health certificates” by MedCreds.com.
  Hammer and Galarza have about 700 students and 45 staff.
  Assume 3 additional household members and 2 tests per week =
  1500 tests per week.
• Funded by donations to the Hammer Montessori School Foundation.

California Phase 2: Willow Glenn & Campbell, SJUSD.org Area 3.

California Phase 3: Los Altos USD

Testing issues & phasing

1️⃣ Abbott Lab’s 5 minute ID Now: Rapid, inexpensive, but false negatives.
If Positive: Isolate, treat & trace.
If Negative: next-day followup: Cepheid Xpert Xpress.midrange speed & cost.
Run-time: 45−50 minutes; hands on time: 2−3 min.

2️⃣ Sunnyvale-based Cepheid Xpert Xpress: midrange speed & cost.
Run-time: 45−50 minutes; hands on time: 2−3 min.

3️⃣ if justified, full RT-PCR test, like Roche cobas 4800 or equivalent.
However, 3 separate Netherlands labs report: Cepheid Xpert Xpress as accurate as Roche 4800 (Elsevier, July 2020):

Xpert Xpress SARS-CoV-2 point of care test showed equal performance compared to routine in-house testing with a limit of detection (LOD) of 8.26 copies/mL. Other seasonal respiratory viruses were not detected. In clinical samples Xpert Xpress SARS-CoV-2 reaches an agreement of 100% compared to all in-house RT-PCRs.

California Pilot Timeline

1️⃣ Acquire test equipment
2️⃣ Hire trained staff
3️⃣ Acquire 1 or more facilities.

The New Normal

Obsolete advice: Test, Trace, Isolate, Treat. But it leaves out the important details, since rapid results are vital, and only proof of results matters.

Ask any teenager: The most important part of a DMV is the embossing machine that spits out your license. Today.

Real advice: Test, Re-test? Certify, Trace, Isolate, Treat, Re-test, Certify. MedCreds.com certifies your test results: