Is it finally time to be tested for COVID-19?
The answer is yes… and no. Testing capability is just now getting close to the hype. We’ve been promised: “If you want a test, you can get a test” for a couple of months now, only to learn the reality was anything but that. There are now drive-through clinics in our area, and the local Urgent Care clinics can do testing as well. You may also want to check with your family doctor, who may be able to do the testing. If you have access to Google Maps, search for “COVID testing” and you will see the local facilities which offer testing. If you do decide to get tested, call the facility first. They may want to screen you first (mainly to see if you have any COVID-19 symptoms), and they may require that you make an appointment. The test itself is a nasal swab which is placed deep into your nostril. It is a little unpleasant but not really painful (and, yes, I’ve had it done to me, so I speak from experience).
So, now that you can get tested, should you be tested?
1.If you have Covid-19 symptoms (fever >100 degrees or chills, short of breath, cough, loss of sense of taste or smell, muscle or bodyaches, headache, sore throat, nausea, vomiting, diarrhea, congestion or runny nose), you should be tested. Definitely call ahead so the facility can take proper precautions. I will note that the underlined symptoms above are the major symptoms. If you have one or two of the minor symptoms such as you have allergies and have a runny nose, but no other symptoms, it is unlikely you have Covid.
2.If you have had close contact with someone who has tested positive, you should be tested. Close contact usually means less than 6 feet, for at least a few minutes. If you waved to them from across the parking lot, you’re safe.
3. If you are going to visit someone who is older, frail, or has a number of medical problems, you could get tested for reassurance, but you really should avoid close contact with that person instead.
4. If you are an essential worker who has a lot of interaction with people, you certainly can be tested, and probably should be tested. Certainly, if you fall in this category and you live with someone who is at high risk for Covid, testing should be done. In my office, we all got tested last week.
5.Finally, there are some who will be required to be tested: prior to surgery, prior to returning to work or reopening a business, or as proof you no longer have the virus after you were COVID-19 positive. Your doctor may be able to do these tests. Public Health usually tests the COVID positive people as part of their protocol.
In all the above cases, we are testing for the COVID virus, NOT antibodies. So, when/who should be tested for antibodies?
First, antibody testing is not useful if you are sick. If you want to know if you have COVID-19, you should get viral (nasal swab) testing. Antibody testing, (which involves a blood draw) will not show antibodies for at least 2 to 3 weeks after you’re infected.
Antibody testing is the “Wild West.” There are as many as 150 tests on the market, some making fantastic claims, with widely varying accuracy. You really have to dig to find out the data on the test, and to learn what test your lab/doctor is using. They should be using a test with high specificity, which means if you get a positive antibody test, it is more likely to be accurate.
The next problem is that we do not know if the antibodies that we are testing are neutralizing antibodies, which is what gives us immunity. Even if we do find neutralizing antibodies, no one knows how long the immunity will last (a few weeks? a few months? 1 year? 10 years? a lifetime?). We just don’t know yet.
The bottom line – it is probably not worth getting antibody testing at this point. Except for a few tests, the accuracy is suspect, and we are not sure if we’re getting the information we want and need. The current CDC recommendation is that even if you have a positive antibody test, you should still socially distance, wear a mask, and sanitize your hands. Sorry, we just aren’t there yet.
We are slowly beginning to open up once again in our region. This is very exciting but also could become scary very quickly. Remember, we still need to wear masks and socially distance. If we fail to do that, we will be going backwards into a second wave, and more people will die as a result. Please be part of the solution and remember that masks only work if they cover both your nose and mouth (an error I see frequently). Be safe and stay healthy.