A wealthy, California beach town near Silicon Valley is to become one of the first communities in the world to test all its residents for both active COVID-19 and for the presence of antibodies revealing if they already had the disease.
Residents of Bolinas, a reclusive Bay Area town, who are older than four can available of free testing between Monday and Thursday.
The $400,000 study was privately backed by the town’s residents and will be administered by staffers at University of California San Francisco, who will use the results to track the spread of the outbreak around the state.
The town was identified by researchers as a uniquely situated community to teach the medical community about how the disease spreads.
The second location chosen for the study is Mission District, an inner city neighborhood with Latino roots in San Francisco, where testing will begin on Saturday.
A health care worker prepares a nasal swab diagnostic COVID-19 test on a person at a drive through in Bolinas Monday. The new project is a privately-funded guerrilla-style operation lead by Venture capitalist Jyri Engestrom and Cyrus Harmon, founder of the startup Olema Pharmaceuticals, partnered with UCSF scientists to test the whole town of 1,600 residents
A sign is seen upon entering Bolinas, a coastal enclave in Northern California, where all residents are being tested for the novel coronavirus and its antibodies this week
Bolinas has been identified as being uniquely situated to teach the medical community about how the disease spreads because it lies two miles from a highway with no through road
There have been no confirmed coronavirus cases so far in Bolinas but many residents are older than 60 and at higher risk from contracting COVID-19, the respiratory disease caused by the virus.
Telluride, Colorado, and Fisher Island, Florida, are two other wealthy towns providing free diagnostic tests for all their residents.
Bolinas is known as a coastal enclave that fought against becoming a tourist hotspot, even resorting to pranks and moving road signs in the days before GPS to avoid welcoming visitors.
The average home price in Bolinas has climbed to over $2.5 million, according to Curbed, and is also the part-time home of Academy Award-winning couple Joel Coen and Frances McDormand.
More than 300 residents – almost a fifth of the town’s population of 1,680 – was tested by Monday evening and most had pre-registered for a test by Friday, according to the Mercury News.
HOW DO ‘STRIP’ BLOOD TESTS FOR CORONAVIRUS WORK?
Simple blood tests for coronavirus, like Premier Biotech’s, work much like pregnancy tests.
After the sample of blood is collected, a technician injects it into the analysis device – which is about the size of an Apple TV or Roku remote – along with some buffer, and waits about 10 minutes.
The blood droplet and buffer soak into the absorbent strip of paper enclosed in the plastic collection device.
Blood naturally seeps along the strip, which is dyed at three points: one for each of two types of antibodies, and a third control line.
The strip is marked ‘IgM’ and ‘IgG’, for immunoglobulins M and G. Each of these are types of antibodies that the body produces in response to a late- or early-stage infection.
Along each strip, the antibodies themselves are printed in combination with gold, which react when the either the antigen – or pathogen, in this case, the virus that causes COVID-19 – or the antibody to fight are present.
Results are displayed in a similar fashion to those of an at-home pregnancy test.
One line – the top, control strip – means negative.
Two lines – the top control line and the bottom IgM line – in a spread-out configuration means the sample contains antibodies that the body starts making shortly after infection.
Two lines closer – control and IgG – together mean the person is positive for the later-stage antibodies.
Three lines mean the patient is positive for both types of antibodies.
Dr. Aenor Sawyer, an assistant professor at UCSF and a Bolinas resident, said the town is uniquely situated to teach the medical community about how the disease spreads because it lies two miles from a highway with no through road.
‘So we’re fairly isolated, rural, and (with) stable ecosystems right now for the last several weeks. So it will be very interesting to see the footprint of the virus in this arena,’ Sawyer said.
Volunteers direct the town’s residents to drive into four testing bays set up for nasal swabs and finger pricks.
The swabs are used to test for the coronavirus, while the finger prick is used to collect blood samples that will be tested for antibodies which can help show who has been infected and recovered.
‘Because diagnostic tests cannot detect the presence of the virus once it is cleared from the body (which can happen whether a person was asymptomatic or recovered on their own), both types of test are essential to understanding how widely the disease has already spread in these communities,’ a statement from UC San Francisco said.
‘In order for us to respond effectively,’ added Dr. Diane Havlir, head of UC San Francisco’s HIV/AIDS division, ‘we need more local community epidemiology like this study to get a sense of where we stand, and where active infection may still be occurring, so as public health officials begin to release constraints on movements we can avoid resurgence of the disease.’
Test results will be returned within 72 hours and those who are actively infected will receive immediate follow-up calls from UCSF experts.
Those who test negative are urged to continue to shelter in place as the virus may still spread further.
A second round of testing will follow in two weeks time if enough funding is secured, the Los Angeles Times reports.
The widespread free testing was spearheaded by two locals, venture capitalist Jyri Engestrom and pharmaceutical company executive Cyrus Harmo, and completely funded by private donations.
The community was inspired by the Italian town of Vo’, outside Venice, which gained control of coronavirus spread by two rounds of testing.
Town resident Dr. Aenor Sawyer of the University of California San Francisco Medical Center speaks to the media Monday about the free COVID-19 testing in Bolinas. She said the town is uniquely situated to teach the medical community about how the disease spreads
Signs of the free COVID-19 testing at a drive through at Mesa Park in the town of Bolinas on Monday. All 1,680 residents can avail of free testing through until Thursday
Volunteers check in drivers at a COVID-19 test at a drive through in Bolinas. The wealthy town is part of a privately funded drive to have all its residents tested in partnership with UCSF
‘It’s this question of, well, do you just sit around and wait for the federal government to do something or do you try to take action and help?’ said Engestrom, who is from Finland but a resident of the town, told Mercury News.
The town joins other isolated, wealthy communities of Telluride, Colorado, and Fisher Island, Florida, is using their own wealth to secure testing for their community.
Bolinas residents were quick to try and close down any spread in their community, hanging signs telling travelers to stay away once a shelter-in-place order was issued in California the weekend of March 21 and even turning back tourists trying to enter the town.
‘Why not Bolinas? It’s a terrific place. A community expressed the motivation and willpower to partner with the scientific community and policymakers to get this information,’ said Dr. Havlir said.
‘Wealthy people? Whatever. It’s a motivated community.’
Remote Bay Area town Bolinas where all 1,680 residents will be tested for active covid and antibodies to if they have already had the virus, one of the first communities in the world to offer such widespread community testing for free in partnership with UC San Francisco
The average home price in Bolinas is over $2.5 million and it is home to Oscar-winning couple Joel Coen and Frances McDormand. Pictured is a typical on piles house on the lake in the town.
Residents in Bolinas were quick to post signs telling tourists to stay away when the outbreak first hit. The whole twon is now to be tested even though there are no confirmed cases
The testing in Bolinas is the first of a two-part study in which UCSF researchers will examine the spread of the disease in both rural and urban areas.
Researchers have chosen the Mission District, a vibrant inner city neighborhood with Latino roots in San Francisco, for the second location. Testing will start there on Saturday.
‘There are two paired sites that are going on right now: One here in Bolinas, which is very rural and people are quite separated and it’s isolated. And another, less than an hour’s drive away, in the Mission District of San Francisco, where it’s very densely populated, people live very close to each other, and it’s very connected,’ said Dr. Bryan Greenhouse, an assistant professor at UCSF and one of the study’s researchers.
‘By sort of bookending the different types of communities that we’re evaluating within a short period of time, we hope to be able to extrapolate much more to different places throughout northern California.’
Effective testing is considered essential if shelter-in-place and shutdown orders are to be lifted.
‘All our public health decisions, including when it will be possible to relax regional and statewide shelter-in-place orders, are driven by rough assumptions about how this virus behaves based on very limited data,’ said Dr. Greenhouse.
‘Studying in detail how the virus has spread in these two distinctive communities will give us crucial data points that we can extrapolate to better predict how to control the virus in similar communities nationwide.’
Some residents in Bolinas expressed concerns about the testing and asked if their DNA would be shared on a database, which the organizers denied.
‘This study stands to benefit people at three levels – individuals who will get to learn their disease status, the community for the opportunity to isolate and eradicate the virus, and worldwide through improved ability to understand how this virus spreads,’ said Aenor Sawyer, MD, MS, a Bolinas resident and UCSF orthopedic surgeon who has served as project medical director and a liaison between Bolinas community members and university researchers.
‘This effort has been made possible by extraordinary volunteerism and partnership between the community, local agencies, public health officials, UCSF staff and students, and many others. We hope that this effort can provide a reproducible model for how other communities can build partnerships to provide rapid and comprehensive pop-up testing to their residents, as UCSF begins assisting with testing capability statewide.’
While there are no confirmed cases in Bolinas, cases of coronavirus jumped to 199 in Marin County on Monday. Ten people diagnosed with the virus in Marin have died, 140 have recovered and 33 have been hospitalized — including four in Marin hospitals Monday.
There were 33,866 confirmed cases and 1,229 deaths in Califorina as of Tuesday morning.
