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Health care executive Kevin King discusses his article, “How to stay safe from back-to-school illnesses.” Kevin explains why the return to classrooms often triggers a surge in respiratory illnesses (like the flu, COVID-19, and RSV) and how diagnostic tests are a critical tool for managing them. He highlights how rapid diagnostics are essential for getting the right treatment quickly, such as antivirals, and perhaps more importantly, for preventing the wrong treatment, which helps combat the growing threat of antibiotic resistance. Kevin also offers insight into how epidemiologists predict outbreaks by monitoring school absenteeism and data from the Southern Hemisphere, providing a fascinating look at community health surveillance. Discover how early and accurate testing serves as our frontline defense in protecting vulnerable populations and managing respiratory illnesses this school season.

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Transcript

Kevin Pho: Hi. Welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Kevin King. He is a health care executive. Today’s KevinMD article is “How to stay safe from back-to-school illnesses.” Kevin, welcome to the show.

Kevin King: Great to be here. Thank you for inviting me.

Kevin Pho: All right. Just briefly share your story and journey. Then we will talk about your KevinMD article.

Kevin King: Hi. Well, I grew up in Athens, Ohio, and that is where Ohio University is. I received a bachelor’s degree in zoology and microbiology there. But most importantly, I had the experience of working at a startup biotech company that had brought a diagnostic device to market. That sparked a lifelong interest in infectious diseases and diagnostic devices.

I then got a Ph.D. and did two postdoc research positions, and then made the transition into industry working in a contract research organization where I led a team of scientists that were developing diagnostics devices to detect infectious diseases, including respiratory products.

I then had the opportunity to return to Ohio and work for a company that was acquired by QuidelOrtho, and that is the company that I work at now. I am the Senior Director of Scientific Affairs globally for our respiratory point-of-care and cardiometabolic products. In that role, I develop educational opportunities and teach our customers about our products.

Kevin Pho: All right. Your KevinMD article is very relevant. At this time of year, a lot of our school-aged children are dealing with respiratory illnesses. Your article is “How to stay safe from back-to-school illnesses.” For those who do get a chance to read it, tell us what it is about.

Kevin King: Well, the article stemmed from my observation, both in my own household when our kids go back to school and from the literature, that this is a time—although it is not, as epidemiologists would say, the start of the winter respiratory season—it certainly ramps up the amount of respiratory illnesses like strep throat, influenza, RSV, and COVID-19 as students return to school.

I wanted to highlight in the article that prevention is not just about taking the common precautions that we are all aware of, like washing our hands, vaccines, and covering your nose and mouth, but also the importance of leveraging diagnostics. Testing early following symptom onset is important not just so patients get the proper treatment, but also to help prevent the spread of illnesses within your community.

The piece came together through a lens of diagnostics and surveillance with a goal to emphasize how rapid diagnostics and data can help us anticipate and respond more effectively to what is coming later in the respiratory season. For example, tracking increasing school absences, wastewater, and looking at Southern Hemisphere illness trends all can provide early signals of which viruses are likely circulating in your community. When this knowledge is shared—for instance, from local health departments—it provides insights that can allow clinicians, schools, and families to act earlier and together to help limit the community spread of these illnesses.

Kevin Pho: Now, I am sure a lot of families and pediatricians are familiar with these point-of-care testing modalities, specifically with, say, strep testing. Tell us some other common respiratory diseases that we have point-of-care diagnostic testing for.

Kevin King: Yes, certainly for strep, but also for influenza, respiratory syncytial virus (or RSV), and COVID-19, of course. We are all familiar with the rapid at-home tests. There are similar rapid and accurate tests available wherever you seek care.

Kevin Pho: In your article, you mentioned when it comes to these rapid diagnostics, it could be either antigen versus molecular-based. Can you tell us the distinction between the two?

Kevin King: Sure. The antigen products are typically more rapid, although molecular products are becoming as rapid as the antigen products. They are different in what they detect. Molecular products detect some DNA or RNA signature and then amplify that signal to be detected of the virus itself. Whereas the antigen products are testing a protein component that might be on the surface of the virus. In general, molecular tests are considered to be more accurate.

Kevin Pho: All right. Run us through a few scenarios. Let’s say for those parents who may be listening to you and their school-aged children are coming back home with some upper respiratory symptoms, give us some scenarios where these parents would consider some type of rapid diagnostic tests.

Kevin King: Well, certainly if you keep the at-home tests, that is a place to do those tests even at your home. There are combo tests now for both COVID-19 and flu, the most predominant ones as we head into the respiratory season. If your child has a fever, that is one of the key symptoms that you would want to test early for.

But the importance of testing early—and not just waiting to see what further symptoms develop or decide at a later point to go to an urgent care or your primary care physician—is in part because there are medicines for both of these. There are prescriptions that can help reduce symptoms and ultimately prevent the spread to more vulnerable communities.

Sometimes we don’t realize how vulnerable the folks that we interact with are—like aunts, uncles, grandparents, those types of folks that you come in contact with—and it is really important. This helps prevent the spread of the disease, but knowing that you have a virus is also important in terms of making sure that you are not prescribed an antibiotic that is not going to work for a virus. So getting that knowledge is really important also for antibiotic stewardship.

Kevin Pho: Now, which of these tests are available over the counter versus which tests are available only through your pediatrician’s or urgent care center office?

Kevin King: There are types of antigen and molecular products that are available over the counter. Some of the molecular products, though, are in a scenario in which you would have to do a collection at home and then send the sample in. But both antigen and molecular products are available at most urgent cares or primary care physicians, especially small physician’s office laboratories.

Kevin Pho: Specifically these tests for things like influenza and RSV?

Kevin King: Yes. And COVID-19.

Kevin Pho: And then how about available over the counter? Are they available over the counter? Obviously, we have the rapid COVID-19 test, but what about things like influenza and RSV?

Kevin King: Absolutely. Influenza and COVID-19 tests are available. Even combo tests are available, so one test tests for both. I am not aware whether there are RSV over-the-counter tests available, so that is probably something that you need to go to your doctor for.

Kevin Pho: You mentioned earlier about some of the epidemiological implications of rapid testing, and you mentioned in your article that monitoring school absenteeism rates can predict outbreaks. So talk more about that.

Kevin King: Yeah. I think when you start to see higher levels of absenteeism, or if your community is monitoring wastewater for the detection of any of these viruses and those start to go up, those are good indicators of what is coming or that something is building. That can help inform a clinician. If you are aware of that knowledge, that can help inform the clinician what kinds of tests would make sense to do in coordination with the symptoms that you are observing.

Kevin Pho: Now the government and regulatory authorities like the CDC already track things like ER visits and, like you said, wastewater diagnostic results. So tell us the missing piece or the additional puzzle piece that point-of-care diagnostic testing can add to all that data.

Kevin King: Yeah. And I would clarify that we are also in a time now because of the shutdown that not all of that data is available and being released from the CDC. Those are national data and may look at your state, but may not inform you about what is going on in your community. So continuing to perform diagnostic tests, and if your health care system or your laboratory information system can be used to track what the positivity rate of these tests are, that can help inform you what is going on much closer to where you are actually practicing.

Kevin Pho: Now, can you give us a real-world example of how point-of-care diagnostic testing can inform disease trends? Just give us a practical example of how that happened in the past.

Kevin King: Well, during the COVID-19 pandemic, wastewater in local communities was a factor when health care departments were assessing recommendations for mask-wearing or things like that—additional precautions to be taken when it appears that something is emerging.

Kevin Pho: And what do we have to look forward to? We have talked about things like COVID-19, RSV, influenza. So down the point-of-care diagnostic test pipeline, what do we have to look forward to?

Kevin King: I think it is probably more accurate and rapid molecular products that are able to be used closer to the point of care. Those products may be able to test for more than one respiratory product at a time—so multiplexed. Those are available now in certain laboratories, but moving closer to the point of care and being able to be utilized in urgent cares or even retail outlets. If you see clinics in those retail outlets, even in those environments, the more accurate testing can be moved closer to the patient there.

Kevin Pho: And how about in terms of costs? Again, talking with some of the parents who may be listening to this, what can they expect for costs if they were to purchase an over-the-counter point-of-care diagnostic test from, say, a drugstore?

Kevin King: Well, unfortunately, I am not familiar with the exact cost of those, only what I see when I go. I don’t know what they are in other locations, but I have seen some over-the-counter products, even those that test for both COVID-19 and flu, to test for about $25.

Kevin Pho: And in terms of different types of brands, is there anything that parents should look out for in drugstores, or do they all work in similar ways?

Kevin King: Well, I think they all work in similar ways. It is more when you get to those tests that are conducted in either your physician’s office or in urgent care where choices can be made to utilize either more accurate tests or more rapid tests depending on what the needed workflow in that environment is.

Kevin Pho: We are talking to Kevin King, health care executive. Today’s KevinMD article is “How to stay safe from back-to-school illnesses.” Kevin, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Kevin King: Yeah, certainly. I think one of the key take-home messages that I would say is that it is possible to minimize the spread of respiratory illnesses during the back-to-school season. But it is about more than managing the symptoms of the individual patients; it is about staying ahead of them. So by combining rapid diagnostics and data, illness outbreaks can be identified, and then impacts on communities can be diminished through timely diagnosis, accurate treatment, and all of that to prevent the spread and ballooning into larger seasonal outbreaks, especially with a goal in mind to help protect those vulnerable communities as well.

Kevin Pho: Kevin, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Kevin King: Thank you for having me.