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How The Gatekeepers Of 500 Million Tons Of Cargo Power Through The Pandemic

Any cargo ship that enters the Mississippi River—one of the busiest waterways in the United States—first has to stop three to five miles offshore in the Gulf of Mexico. A radio call goes out to a base camp, perched on a strip of land where the river meets the gulf. A small boat leaves to meet the ship, and a person scrambles up the rope ladder hung over the side and takes control.

These expert navigators are known as “bar pilots,” so called for their ability to weave between sandbars. It’s a specialized skill—right now, there are only 49 of them permitted to guide ships through the river entrance. But an entire economy is dependent on them. Would anything happen to the bar pilots, the entire flow of goods entering and exiting the Gulf could come to a standstill.

Licensed by the state of Louisiana, they are the only people allowed to steer the more than 11,000 ships through the Southwest Passage each year and on to five major ports, including New Orleans and Baton Rouge. These cargo ships and bulk carriers, which can be up to several football fields long, carry a combined 500 million tons of cargo. The trade value through the Port of New Orleans alone is more than $130 billion each year.

It’s a special role they’ve held for the past 150 years. The bar pilots are unique in that they eat, sleep and live together in close quarters, in two-week rotations, on two desolate pilot stations at the very southernmost tip of the boot of Louisiana, along with around 40 other crew members. “We are very communal,” says Captain Michael Miller, president of the Associated Branch Pilots. “All of our employees and all the pilots are living together.”

When the coronavirus pandemic hit in March, the bar pilots kept powering through. “We are considered essential,” says Miller. The pilots navigate cargo ships up and down the first 30 miles of the river, which are subject to shoals, or sandbars, that are constantly changing with the water currents, which is why the local expertise is required. Working with the U.S. Coast Guard and public health authorities, they developed the litany of protocols most of the world is now familiar with: personal protective equipment, disinfectant and distance.

A strict protocol was vital because each pilot on duty boards about 2 to 3 ships a day, interacting with the crews of the vessels they steer and then returning to the base. “Every time you penetrate that bubble from the outside, you risk just dragging Covid in with you,” says Miller. “And that’s our greatest fear.” An outbreak could not only incapacitate many of the pilots in one swoop, but it could clog up some of the busiest seaports in the Western hemisphere.

A key aspect of keeping the ships moving was a fast and reliable Covid-19 diagnostic test. For that they turned to Abbott Laboratories’ ID Now test, which gets results in under 13 minutes. The machine, which is about the size of a toaster, is portable and can be used by a trained medical professional in different environments.

The gold standard for test accuracy is what’s known as a polymerase chain reaction-based test, which is performed in a lab and requires a cycling of temperatures to amplify the viral RNA, which creates billions of copies, so as to identify the presence of the virus in a sample. The ID Now test, which received emergency use authorization from the FDA at the end of March, is able to amplify the RNA as a constant temperature at a much faster speed than PCR.

The ID Now isn’t new technology, having been around since 2014, and was already cleared for rapid identification of the flu, strep throat and respiratory virus. Abbot has shipped nearly 10 million Covid-19 tests to all 50 states. The ID Now accounted for $180 million of the company’s $615 million of coronavirus diagnostic-related sales in the second quarter of this year. Abbott, which offers a range of products from nutrition to medical devices, reported $31.9 billion in total sales in 2019. The company’s rapid diagnostics sales grew nearly 10% from the first to the second quarter and are expected to continue accelerating, as Abbott rolls out new products.

While it typically takes around a year to develop a new test, Abbott was able to get authorization from the FDA for the Covid-19 version of the ID Now in a matter of weeks, says Dr. Philip Ginsburg, a senior medical director of infectious disease at Abbott. “One of the reasons that we were able to do it so fast is because we already had an established, well-tried and tested platform,” says Ginsburg.

In May, the FDA identified potential accuracy concerns with the test, though subsequent interim results released by the company suggest a level of accuracy in line with PCR tests. The test shows 94.7% sensitivity, meaning it correctly identifies positive test results 94.7% of the time, and 98.6% specificity, which is the rate at which it identifies negative results. “Until there’s a vaccine or until there are drugs that we can use to treat, [Covid-19], testing is, and will remain, one of the highest priorities in helping to reduce the state of infection,” says Ginsburg.

For the bar pilots, having rapid, real-time results is key to keeping everyone safe. They contracted with a Louisiana-based urgent care chain called Premier Health to test all pilots and crew before they go for their two-week tours on the pilot stations.

Dr. Kevin DiBenedetto, CEO of Premier Health, says he has been using Abbott’s ID Now tests for years for flu, and has a high level of confidence in the results. The key, he says, and one possible reason for the previous accuracy concerns with the Covid-19 test, is that people weren’t doing the nasal swab procedure correctly. There are three levels of swabs related to how far up you go in the nose: just inside the entrance, the mid-level and way up in there, which some patients have said feels like it’s poking their brain. The ID Now requires a mid-turbinate swab, which DiBenedetto likens to the sensation of getting water in your nose. “It kind of burns, but it doesn’t really hurt,” he says.

While the test isn’t foolproof, it has so far succeeded in keeping the bar pilot operations up and running. Miller says only one pilot has tested positive since March, and some staff have had to quarantine. He recognizes the test is “not 100%, but it’s about as safe as we can get in this environment right now.”

And Miller is proud of his team’s pandemic record so far: “We never had to delay ships. We never had to shut down or slow down. We were able to keep fully functioning through this whole thing.”
Source: Forbes

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