{"id":13735,"date":"2021-03-09T12:46:21","date_gmt":"2021-03-09T20:46:21","guid":{"rendered":"https:\/\/www.functionalps.com\/blog\/?p=13735"},"modified":"2021-03-11T15:07:51","modified_gmt":"2021-03-11T23:07:51","slug":"kdhe-quietly-reduced-cycle-threshold-on-covid-tests","status":"publish","type":"post","link":"https:\/\/www.functionalps.com\/blog\/2021\/03\/09\/kdhe-quietly-reduced-cycle-threshold-on-covid-tests\/","title":{"rendered":"KDHE quietly reduced cycle threshold on COVID tests"},"content":{"rendered":"\n

by Patrick Richardson<\/strong><\/p>\n\n\n\n

Earlier this month \u2014 and without fanfare \u2014 the Kansas Department of Health and Environment\u2019s Health and Environmental Laboratories\u00a0reduced<\/strong><\/a>\u00a0the cycle threshold for its real-time COVID-19 test from 42 to 35 cycles.\u00a0 (The screengrab below shows KDHE mistakenly dated the change January 2020, but the\u00a0link address is dated 2021<\/strong><\/a>\u00a0and KDHE wasn\u2019t running COVID tests a year ago.)<\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

This comes after months of warnings by health professionals \u2014 including Dr. Anthony Fauci and the World Health Organization \u2014 that high cycle thresholds in the most commonly used tests were producing false positives.<\/p>\n\n\n\n

The cycle threshold is \u2014 roughly<\/strong> <\/a>\u2014 the number of times a bit of genetic matter must be copied by the testing equipment to determine how infectious a given individual is. The higher the cycle threshold needed to identify COVID, the less viral load a person has; some virologists say results above 35 cycles are \u201cfalse positives\u201d because they are only detecting dead nucleotides and are not contagious.<\/p>\n\n\n\n

In October of 2020, KHEL said their most commonly-used test \u201chas a Ct cutoff of 42 and is the most sensitive assay [test] currently available.\u201d<\/p>\n\n\n\n

On January 7, the Ct cutoff was\u00a0changed to 35<\/a>,\u00a0and the last half of that sentence omitted.<\/p>\n\n\n\n

The Sentinel<\/em> reached out to KDHE spokeswoman Kristi Zears, to ask if private laboratories being used by local governments like Wyandotte County<\/strong><\/a> had also reduced their cycle threshold, but received no response.<\/p>\n\n\n\n

Fauci has stated that the cycle threshold should be 34 or below.<\/p>\n\n\n\n

\u201cIf you get a cycle threshold of 35 or more, the chances of it being replication-competent are minuscule,\u201d Fauci said at roughly the four-minute mark of this video<\/a><\/strong>. \u2018Replication competent\u2019 means particles capable of infecting cells and replicating to produce additional infectious particles.<\/p>\n\n\n\n

Meanwhile, rising case-counts have been continually used by Governor Laura Kelly to justify continued restrictions, largely ineffective mask mandates<\/a><\/strong>, and lockdowns<\/a><\/strong>.<\/p>\n\n\n\n

The problem is, the WHO has now warned <\/a><\/strong>against over-sensitive tests, and recently issued guidance that \u201ccareful interpretation of weak positive results is needed (1). The cycle threshold (Ct) needed to detect virus is inversely proportional to the patient\u2019s viral load. Where test results do not correspond with the clinical presentation, a new specimen should be taken and retested using the same or different NAT technology.\u201d<\/p>\n\n\n\n

Downward trend in Kansas<\/h3>\n\n\n\n

While there is no proof that the lowered Ct has led to a sudden reduction in \u201ccases\u201d \u2014 and thanks to KDHE\u2019s silence it is unclear if private labs have followed suit \u2014 it is notable that, while case-counts have actually been dropping since Thanksgiving, there has been a noticeable drop in average daily positive results since Jan. 7, from 2,752 on the 7th to 1,795 between the 19th and 20th of January.<\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

KDHE doesn\u2019t publish daily case updates; the daily numbers in the chart above represent the daily average between reporting points.<\/p>\n\n\n\n

Proper cycle threshold<\/h3>\n\n\n\n

As national outlet PJ Media points out<\/a><\/strong>, the so-called \u201ccase\u201d numbers should more accurately be called positive tests, and as PJ\u2019s Stacey Lennox writes, \u201cThe New York Times<\/em> and several experts admitted in late August that up to 90% of positive PCR tests were not indicative of the active illness<\/a><\/strong> that could be transmitted to others.\u201d<\/p>\n\n\n\n

As the Sentinel<\/em> previously reported<\/a><\/strong>, Dr. Michael Mina, an assistant professor of epidemiology at both Harvard Medical School and the Harvard T.H. Chan School of Public Health, told Harvard Magazine<\/a><\/strong> that reporting people positive on tests with a high cycle threshold are \u201cfalse positives.\u201d<\/p>\n\n\n\n

\u201cTests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk,\u201d Mina said. \u201cAkin to finding a hair in a room long after a person has left.\u201d<\/p>\n\n\n\n

One maker of the COVID PCR test, Bioningentech, offers guidance<\/a><\/strong> quite similar to those in a New York Times<\/em> article<\/a><\/strong>, which points to oversensitive tests nationwide.  Cycle thresholds between 12 and 36 are considered positive; results between 36 and 40 cycles are considered marginally positive, and anything over 40 cycles is considered negative.<\/p>\n\n\n\n

\u201cAny test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. \u201cI\u2019m shocked that people would think that 40 could represent a positive,\u201d she said.<\/p>\n\n\n\n

\u201cA more reasonable cutoff would be 30 to 35, she added.<\/p>\n\n\n\n

Dr. Mina said he would set the figure at 30, or even less.<\/p>\n\n\n\n

\u201cThose changes would mean the amount of genetic material in a patient\u2019s sample would have to be 100-fold to 1,000-fold that of the current standard for the test to return a positive result \u2014 at least, one worth acting on.\u201d<\/p>\n\n\n\n

Source<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

by Patrick Richardson Earlier this month \u2014 and without fanfare \u2014 the Kansas Department of Health and Environment\u2019s Health and Environmental Laboratories\u00a0reduced\u00a0the cycle threshold for its real-time COVID-19 test from 42 to 35 cycles.\u00a0 (The screengrab below shows KDHE mistakenly dated the change January 2020, but the\u00a0link address is dated 2021\u00a0and KDHE wasn\u2019t running COVID […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[2340,2339,2337,2336,2338,2335,2341,2342],"class_list":["post-13735","post","type-post","status-publish","format-standard","hentry","category-general","tag-casedemic","tag-cases","tag-change","tag-cycle-threshold","tag-false-positives","tag-pcr","tag-test","tag-testing"],"_links":{"self":[{"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/posts\/13735","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/comments?post=13735"}],"version-history":[{"count":1,"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/posts\/13735\/revisions"}],"predecessor-version":[{"id":13736,"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/posts\/13735\/revisions\/13736"}],"wp:attachment":[{"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/media?parent=13735"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/categories?post=13735"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.functionalps.com\/blog\/wp-json\/wp\/v2\/tags?post=13735"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}