MLB, With Cue Health, Is Wrapping Up a Mostly Covid-Free Post-Season – SportTechie

Throughout most of the postseason and all of the World Series, Major League Baseball has avoided any significant interruption due to COVID-19, with only two players sidelined due to protocols and no games postponed. Helping the league stay on top of exposures and infections before they become outbreaks has been a new testing partner: Cue Health

Cue Health’s testing kit, which has received FDA emergency use authorization, is a digital cartridge in which the user inserts a lower nasal swab. That sample is analyzed with lab-grade sensitivity and reported in about 20 minutes to both the test taker’s smartphone or tablet and, crucially, to the league office’s surveillance system. This portable, user-friendly option can be administered with oversight from medical personnel at home, in the hotel room, the ballpark or wherever the Atlanta Braves and Houston Astros players, staff and family members may need it.

MLB has been using Cue Health’s kit to complement its existing testing program out of an independent laboratory in Utah—and the partnership signals a breakthrough for point-of-care testing, especially in a geographically disparate sport. 

“To date, there’s literally never been a molecular test that’s available over the counter or even by prescription, so that’s really significant because I think it heralds a pretty big shift in the way people can access this type of information for the future,” Cue Health CEO Ayub Khattak says. 

Cue Health’s Covid test, through a digital cartridge, is administered with oversight from medical personnel at home, in the hotel room, the ballpark or wherever the Atlanta Braves and Houston Astros players, staff and family members may need it.

When testing for COVID-19 previously, most compared the gold standard lab-based PCR tests with the rapid, antigen variety. But Cue Health is creating another thorough alternative.

“We’re a third category, which is distinct from antigen and lab, in that it’s got the accuracy of the lab but the convenience and ease of use of antigen,” Khattak says. “But actually, we think it’s easier to use than antigen. And you have this connected nature, which there’ll be a lot of benefits for long term.”

Throughout the postseason, every unvaccinated big league player has undergone daily tests sent to the Utah lab. But any time an individual is showing symptoms—vaccinated or not—they are able to take a Cue test to enable either a rapid start to isolation and contact tracing or to quell those concerns. 

“Cue has proven to be an effective supplement to our COVID-19 testing program,” Jon Coyles, MLB VP for drug, health and safety programs, said in a statement.  “Cue’s elegant device and intuitive platform are very simple to use, and the flexibility provided by the approval for at-home use has proven to be a great fit for our industry. We appreciate Cue’s support during the most critical part of our 2021 season and look forward to expanding the integration of their testing devices in the future.” 

Anytime a Braves or Astros player was showing symptoms, vaccinated or not, they would take a Cue swab test and insert into the digital device, enabling a quick result and then, if positive, a rapid start to isolation and contact tracing.

MLB stayed in contact with Cue for about a year before procuring some of its tests late in the 2021 regular season. By that point, the league’s vaccination rate had reached almost 88% among Tier I personnel—players, coaches and key support staff—with 24 of the 30 clubs reaching the 85% threshold for relaxed COVID restrictions. So that allowed the league to focus more on acute concerns than serial surveillance. Every club received a few Cue devices, with greater emphasis on their use this postseason among the Astros and Braves franchises, as well as MLB’s central office. 

The Astros and Braves are both highly vaccinated teams—though the Braves’ Jorge Soler (who hit the game-winning home run for Atlanta in Game 4 Saturday night) did test positive during the National League Division Series, while Houston catcher Jason Castro was placed on the COVID-19 list before Saturday’s game for a reported positive test that the team would not confirm. Most importantly, the 2021 MLB season has gone much more smoothly than in 2020, which had five times more COVID-related postponements despite playing barely a third the number of games.

Cue Health also has evolved into the NBA’s primary testing partner this season, which mainly includes regular tests of unvaccinated players or vaccinated players who show symptoms. (It’s a small group: Less than 4% of NBA players are unvaccinated.) This grew from a limited deployment during the NBA Bubble. The league mainly relied on lab testing but, in a few cases, began distributing Cue tests. That experience went well, and the relationship grew. In addition to sports leagues, Google and the Mayo Clinic are two other enterprise clients.

A NASDAQ-listed company whose IPO was in September, Cue Health is the brainchild of Khattak and Clint Sever, who serves as chief product officer. The co-founders began working on the idea in early 2010 when both were recent university graduates. 

“Really, it was the early scenes around swine flu, seeing how it was this problem that there was no way to access this information easily—do I have the flu or not?” Khattak says. “And it seemed very strange that in this modern era where you can find out any information you want with just a few keystrokes, you couldn’t find out the thing that you really cared about, which is, ‘What’s going on with my health?’ ”

Astros catcher Jason Castro, shown here tagging out Dansby Swanson in Game 1, is the only player to reportedly test positive for Covid-19 during this World Series.

Cue Health’s portable testing unit had advanced to clinical trials for flu detection at the onset of the novel coronavirus pandemic. “When COVID hit, it was about a four-week process to go from not having heard of it to having a test for it because the architecture of the system is very modular,” Khattak says. Most of the cartridge remains the same except for what Cue calls “a chemistry pellet” that contains enzymes and primers to detect genetic material that may be present on the swab.

The process to FDA emergency use authorization—initially in June 2020 and expanded to include over-the-counter uses in March 2021—required rigorous testing on both their own behalf and by independent groups. The Mayo Clinic, for instance, found 97.8% agreement between Cue’s tests and lab-based PCR tests. The FDA reported more granular results from prospective studies, indicating 97.4% accord with positive tests and 99.1% for negative cases.

Khattak rattles off a wide variety of potential use cases for Cue’s testing kit in the future, including flu, RSV, fertility cycles, pregnancy tests, testosterone, certain STDs, cholesterol and more. Part of its compelling pitch is the digital reporting of results, enabling large companies, public health systems or even private physicians’ offices to keep tabs on employees, citizens or patients.

“The connected piece is really important for an organization,” Khattak says. “You want to be able to keep track of who’s been tested and who hasn’t— but also, more broadly, having the data connected with virtual care, which is coming for the Cue platform soon. The big paradigm shift that we see coming is connected lab quality diagnostics that you can do in your home or in the doctor’s office and connecting that result to a physician so that you can close the loop and have their expertise on figuring out what to do for your health.”

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