As we head into fall, could the United States be poised to experience a “twindemic” – a surge in both COVID-19 and influenza cases? Masking requirements have been lifted, and the Centers for Disease Control and Prevention (CDC) recently relaxed guidelines on isolation for both positive and exposed individuals [1]. In the Southern Hemisphere, which experiences the flu season first, Australia is seeing a spike in both flu and COVID-19 cases [2]. In fact, reported flu cases in Australia are higher than pre-pandemic rates. These numbers could be a harbinger of what’s to come in the U.S. Though flu cases were down at the height of the pandemic, a return to normalcy may mean higher influenza activity, in addition to increased COVID-19 cases.
At the 2022 AACC Annual Scientific Meeting, presenters from Thermo Fisher Scientific and Poplar Healthcare joined to discuss the need for ongoing bio-surveillance and the advantages of multiplex PCR to test for multiple infectious diseases. As health systems look beyond COVID-19, multiplex PCR can help rule out and diagnose other respiratory infections like the flu, which may present similar symptoms.
Watch their presentation here
The push for global bio-surveillance
“Surveillance is important because as the SARS-CoV-2 virus has evolved, many new variants have emerged,” said Dr. Manoj Gandhi, the Senior Medical Director of Genetic Testing Solutions at Thermo Fisher Scientific. According to Dr. Gandhi, as we transition into the endemic phase of COVID-19 surveillance is key for detecting new variants that could potentially evade the immune system as well as lessen the effectiveness of existing vaccines and diagnostics.
At the same time, influenza is a concern. With lower exposure the past few seasons, it remains to be seen if that will impact population immunity this year.
A case study on multiplex PCR performance
In the summer of 2020, Dr. Anami Patel, PhD, Chief Science Officer at Poplar Healthcare, and his team were preparing for the oncoming flu season, knowing the presence of COVID-19 would complicate things. With fall approaching, there were already concerns of a twindemic. “The obvious question was can we do multiplex tests for the flu and COVID-19 so we can support our patients?” said Dr. Patel.
Depending on the year, between 3% and 11% of the U.S. population suffers from a symptomatic flu infection, with many other cases asymptomatic [3]. In his presentation, Dr. Patel described how he approached testing recommendations for when COVID-19 and the flu are co-circulating. According to Dr. Patel, those hospitalized or in nursing homes should receive multiplex PCR to test for influenza A/B or COVID-19. Patients who are not hospitalized should be tested for COVID-19 and then influenza if multiplex PCR is not available.
Dr. Patel also compared clinical performance between the TaqPath multiplex PCR test* and two other multiplex workflow offerings. Testing positive COVID-19 samples, positive Flu A samples, positive Flu B samples, and triple negative samples, he found that there was 100% agreement across all three assays. Though Dr. Patel did not see co-infection in tested samples, he concluded that multiplex PCR testing is relevant during flu season with COVID-19 circulating in the background.
Storytelling with laboratory data
Closing out the discussion, Dr. Imran Mujawar, MBBS, MS, Sr. Staff Data Scientist at Thermo Fisher, joined to present on the benefits of lab analytics in serving global bio-surveillance. “Every clinical test has a patient at the end of it. This really ties back to having tests that provide a clear and accurate picture of what’s going on in that patient,” said Mujawar.
Providing an overview of Thermo Fisher’s Lab Analytics Beta Program, Mujawar described how analytics can help tell a more complete story of the labs testing efficiency, infectious disease spread, and emerging mutations or variants. Analytical dashboards like this can also help identify invalids so a lab team can determine solutions and save time and cost. The role of analytics in surveillance is clear, according to Mujawar: “The analytic question is what kind of mutations and variants are you seeing in your samples, and can you identify any new or emerging variants that can help you prepare for upcoming waves?”
As we prepare for a future with endemic COVID-19, investing in global bio-surveillance through multiplex PCR testing and laboratory analytics will be important.
To learn more about how lab analytics and multiplex PCR testing platforms can serve global bio-surveillance beyond COVID, watch the discussion from the 2022 AACC Annual Scientific Meeting on-demand.
To learn more about molecular testing for respiratory pathogens, please visit: https://www.thermofisher.com/respiratory
*For Emergency Use Authorization (EUA) Only. For prescription use only. For in vitro diagnostic use. Product availability varies by country.
Sources:
- CDC | Isolation and Precautions for People with COVID-19
- WebMD | Is Australia’s COVID, Flu ‘Twindemic’ A Warning for the U.S.?
Clinical Infectious Diseases | Seasonal Incidence of Symptomatic Influenza in the United States