Talking to the NBA’s COVID-19 test provider

Dr. Jon Cohen is the executive chairman of BioReference Laboratories

BY HENRY ABBOTT

Florida is in rough shape—one local health official said the level of coronavirus is like Wuhan at its peak. So there is pressure on the NBA to get its Orlando bubble just right. From the beginning, the set up has raised some safety concerns from epidemiologists and scientists. The rate of infection in the local area is high and Disney workers come and go from the bubble, many without being tested. 

But the one thing nobody has questioned is that the NBA is doing testing right. According to the commissioner, they are testing every player every day. 

New Jersey-based BioReference Laboratories is doing that work. A press release from BioReference says they are providing “testing oversight for the National Basketball Association’s players and referees, as well as team and league staff participating in the NBA’s season restart in Orlando. Under the agreement with the NBA, BioReference will provide COVID-19 testing, which includes PCR diagnostics, rapid diagnostics and antibody testing.”

Dr. Jon Cohen, the executive chairman of BioReference Laboratories, says he is a fan of all sports, including the NBA. I asked him how they first reached the NBA, and he said “we know a bunch of people in the sports world, and we have interacted with them in the past.” We spoke by phone on Tuesday, our talk has been lightly edited for length and clarity:

How does this happen? Does the NBA just call you up and say they want 200,000 tests?
It was six weeks probably, back and forth. How we would do it. What we were looking for, how they viewed the bubble. How we could accommodate. I’m always honest, I think, and I’ll tell you these guys are really really really serious. Really serious. Really deep in the science. They spoke to a lot of experts. They put a lot of time into this.

Can you give me an example of how you could tell that?
You could see it from the questions about the testing, the science of the questions, the type of platforms they were going to use. What sort of frequency, what does the test actually mean. It was really really really not casual conversation. What do the values mean, what does the positive mean, what are the values?

Let’s say I am a player in the bubble, or the family of one, and I’m worried. What would you say to me?
I would say that they have put in place an extensive protocol to provide the safest possible environment they can, under the circumstances.

Is it a model for other businesses to follow?
We do a lot of testing for a lot of different entities. Hospitals, urgent care, nursing homes, the general public at Rite Aid, CVS. We serve eight to ten different verticals. Lots of businesses. Each one of these are custom designed to offer testing to meet the needs of the client.

So not a lot of NBA bubbles to set up.
No. 

We scheduled this call a few days ago, but today I see The New York Times says “most states are failing at coronavirus testing” right across the front. 
The numbers say we are doing about 700,000 tests a day. The models I’ve seen suggest about two million tests a day. We’re still short on what the country needs.

What is the choke point?
Oh god. It’s a complicated answer. You need more supply chain, more analyzers, more resources devoted to it. More evolving technology to do more. Multiple multiple questions.

How fast is the NBA getting test results?
I purposely don’t get into turnaround time. Make arrangements for all sorts of different people for all sorts of different needs. ICUs need a certain time. Pre-op in hospitals needs a certain time. Everyone has different needs. 

If I go get a test at CVS, what happens to that sample? Does it go to you?
All that stuff, depends on where you go, who does the test, what lab they use, certain pharmacies, certain drive throughs, you don’t have a good way to know.

Which part of it do you do?
We can either provide a turnkey operation—do all the swabbing and bring the test back and do testing—or in different circumstances we will do the swabbing or other parts of the process.

So the NBA signed up for the whole turnkey operation?
Yes.

Why did they pick you? Did they say?
I can’t say what I would normally say. [Laughs.] Not on the record. You’d have to ask them. I believe that in general we have a reputation of being real partners with people and not being a vendor. We have a reputation of customizing to the needs of the client. Doing essentially everything we can to make it work. And number two, I’ve probably said this 20 times in the last four days: We also live up to our commitments. 

Do you have staff in the bubble?
Oh yeah.

Like a full lab?
No, not a lab, but they do all the swabbing at multiple sites. 

Have you seen research on the science of testing’s role in preventing the spread?
In general, the more testing you do, the more knowledgeable you are about who’s positive. That gives you the ability to isolate and treat, and contact trace. This is how New York did a great job, they tested and isolated and shut it down. New Jersey had the same success. They did the lockdown and a lot of testing. We did the testing in 15 of New Jersey’s 21 counties.

The NBA is sensitive to the idea that they are jumping in line for tests.
First off, we have devoted more resources to Florida, including for hospitals, urgent care, et cetera. We also have more platforms in Florida. So we have increased resources down there. Number two, we have several different types of clients. Hospitals, ICUs, frontline healthcare workers, nursing homes, there are all of those that always get priority. 

After that, everyone has their own needs. Banks, retail, all different types of needs. Some need results quicker than others. We accommodate what people need. The sample gets picked up and brought to the lab. A lot of turnaround time is determined by logistics, like how close you are to the lab.

We have a capacity to test sixty to seventy thousand a day, PCR, across the nation, on a daily basis, increasing every single month. The amount of testing that we’re doing for the NBA is de minimis compared to capacity. The impact is negligible.

Also, since you’re writing a story, I don’t think people have talked enough about the fact that we’re supporting the thousands of people who work for the NBA and have jobs. On all sorts of different levels. It’s about all these thousands of people who have jobs, their families, bringing home a paycheck. That’s important. It’s an industry.

Is there a scenario where NBA tests could be delayed as you deal with tests for frontline workers and the like?
I haven’t not delivered on any of our hospitals or urgent cares. I can’t tell you what everyone else is doing. Also a question about the general public. They’re getting their testing done too. 

These are difficult questions. Who should get tested? Are schools more important than nursing homes? Are hospital workers more important than nursing homes? How do you want to choose? Do you want to be the guy deciding?

It’s hard. I am not pretending I have the answers.
Yeah. So, me neither. People come to me, they ask if we can do it, we make a judgment.

We’re providing huge amounts of testing for the public.

Schools have been in the news a lot lately, and how they might reopen. What is the right role for testing?
Trying to figure that out now, we’re talking to a lot of them. It’s the same situation I described before. They say this is what we want to do, and then we make a decision if we can provide that.

What does PCR mean?
Polymerase chain reaction. It’s the technology of evaluating if there is live virus. 

It’s the best kind of test, I understand?
It’s more accurate. 95-plus percent accurate.

What does that mean?
It means if you’re tested positive, there’s a 95 percent chance you’re positive. 

Same for negative? 
It’s a little different for negative, but it’s close for negative.

What else? What I have not asked that you want to tell me?
I think there’s … I can’t measure it, I think you’re in the middle of this thing. You live and breathe sports. I would ask you. There’s a psychosocial component to this. A part of our culture. So in addition to the jobs that occur because the NBA is up and running, there’s some desire to have sports back again so they can watch them. I don’t know how you value that. But it’s important to people. It’s important to this country. 

Not more important than other things. It’s important.

Yes. I think we all want to watch LeBron! But not if getting LeBron on the court keeps resources from our local hospital.
No one wants that.

Thank you for your time, and I hope tests continue to trend in the right direction from the bubble.
So far so good.


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