Which COVID19 Test
Getting the Right COVID19 Test
Leading up to the Thanksgiving break there was a challenge getting tested. What unfolded for some people was getting a test that provided little useful information. Sadly, with the constantly changing landscape of COVID19 determining what test you should be getting and what the results mean can be difficult. This week Fred and I discuss different state experiences, the limited utility of antibody testing even when it is offered as a “Rapid” result.
- 🛑Rapid ⍯ (necessarily) Useful
- ❗️Testing ⍯ No need for other precautions
- ✅Buyer beware (and with some insurance you may be the buyer)
Join Dr Luis Saldana, Fred, and myself for our COVID Insights to Action Discussion webinar taking place Wednesday, November 25 at 4 pm ET
Our training modules are available to help businesses, education facilities and employers get their employees, staff, customers and students back to work and school safely in the context of COVID19
Transcript
Nick van Terheyden
Hi, this is Dr. Nick, I’m the incrementalist here with incremental insights for better business and a better health.
Fred Goldstein
And I’m Fred Goldstein, with accountable health here helping companies along with Nick and others reopened an operator in the COVID pandemic. Now, we just went through Thanksgiving, all kinds of testing issues all over the country. I’ve got some experiences. I know, you’ve heard of some things around testing. So what are you seeing Nick? What’s going on out?
Nick van Terheyden
Yeah, so I think the overriding message for everybody, and it doesn’t just relate to Thanksgiving is buyer beware, unfortunately, what happens is, in circumstances where there is a shortage, there is high demand, not only do you have elastic pricing, but you also get charlatans who are Hawking all sorts of things that essentially are fulfilling no or little to no value. And let me give you a specific example of that. So in the run up to Thanksgiving, I think what happened was, many people were going back to family in some form. And, you know, I recognize that all of the guidance was don’t get together, we saw the numbers, you know, big people, or large numbers of people flying and you know, no commentary on that. I think it’s it’s easy to issue edicts and say you shouldn’t do x and y, we have no idea what the details were. But if you were getting together, people were trying to do the right thing. And doing the right thing was potentially to get tested before you got together. Now, testing, as we’ve discussed in the past, doesn’t answer anything. But the question at the point in time that we test you we can determine with a reasonable degree of accuracy, whether you have the virus or not. But that demands you use the right test. And in one particular instance, and a group small clinic of some description, was offering rapid tests, they had a procession of people flowing in for this rapid test, and everybody was excited to be able to get it because it was low availability. And, you know, the earliest appointment that I saw locally for any kind of testing. Availability was Friday. So that was the Friday after Thanksgiving, which you know, is almost as useful as the test that these folks were offering, which turned out to be a blood test. And what does that tell you the instant that I tell you, it’s a blood test, Fred.
Fred Goldstein
I think that’s an antibody test there. But that’s
Nick van Terheyden
right. And what is an antibody? an antibody is something that the body makes, that fights the virus, so we can detect antibodies, and there are different sorts of them and different profiles. But we have very clearly stated, We have no idea what your antibody levels mean, and whether those are neutralizing antibodies, and is it sufficient. It’s really a research tool at best at this point in time until we have a better understanding. So getting a rapid test with a blood test is roughly speaking, useless. So for those of you that need to get tested, you need to understand what the test is and who’s providing it preferably so that you can assess what the accuracy level so we know that with the molecular tests There are different sensitivities and specificities, I would be asking that question to know, at least even if the facility doesn’t, and quite frankly, if they have a physician on staff, that would be a reasonable question to ask, which is what is the sensitivity and specificity of the test, who’s providing where is the test coming from. And if you’re getting an antigen test, there is a different set of figures. And you also have to take into context. So next time around for any additional testing and for a business, you need to be able to understand what it is you’re getting, and what the actual results mean. And I’m here to tell you, that’s not as simple as well, I got a test, I’m free of the virus.
Fred Goldstein
That’s just unbelievable. And it’s really sad to see this happened. I mean, obviously, testing is something we still haven’t solved around the country, and to have people stepping in and offering that. And for those who got it and don’t even understand as you do, what that ramifications are of getting that test is just really sad.
Nick van Terheyden
It’s not just sad. It’s it’s an I have to say, I’m a little bit outraged, because that was a group of people essentially doing this, for the benefits of making money. In my view, this was not a service, there were many people that were out there, many folks who put themselves out work through Thanksgiving, all of those things, and they do everybody else a disservice. Now, interestingly, in other places, even in states that really have done some questionable things in terms of decision making, there are actually good experiences. Right, right.
Fred Goldstein
Yeah, it’s rather unbelievable here. And you know, in Florida, obviously, we have the least number of rules associated with COVID, per our governor, you know, places you can’t shut them down, you can cut them to 50%. But you can’t, you know, and so you, they, you can’t penalize people for how they run their businesses, etc. And so testing has been an issue here. We actually had some folks come in during Thanksgiving, which was a new experience, they came in their RV, they’ve got nephew of mine, his girlfriend, and they stayed out front, we did everything outdoors, they never came into the house. But they’ve been extremely nervous as they travel around, and been very good about it. I mean, I watched their match play, and it was unbelievable outdoors all the time. You know, and except when we were eating dinner, it was all the time, I imagined that this thing, Fred would be a stressful circumstance, because that’s the guy Oh, my God, he’s looking at my mask wearing Oh, between me and you know, obviously my wife was in the field, it’s a it’s not the kind of place you want to come and say, Great fun time. It’s but we had a great time, we did things outdoors. But what was amazing is they came down. And on Saturday, it’s signed up to get tested at one of our local testing sites, it’s free, and it’s an antigen test. And if you schedule it, it took them a little while to get through the line. But there was a huge line, obviously pre thanksgiving for them I hadn’t scheduled. And then they did it again, before they left and went, Wow.
Nick van Terheyden
I but importantly, getting a test that entirely appropriate. You know, and understanding sensitivity and specificity, you know, important, but ultimately, they’re getting a result that has some meaning and decision, right?
Fred Goldstein
Yes. And they know that that still doesn’t mean they don’t have it, you know, at that point time, they’re going to go visit people. So they continue to practice safe habits as the people they’re visiting. And so what then happens is fascinating is, you know, they’ve been able to keep themselves traveling around and really limiting their exposure as they as they work from remotely. And what’s also interesting is another experience with a friend of mine who just, you know, signed up and drove through Mayo, and got a PCR test here in Jacksonville with results within 24 hours. And so there are ways to do this, for you to exceed hear that experience of somebody having to do that kind of stuff is just ridiculous. And especially as you talked about, it’s a money making endeavor. I don’t know what they were charging for that test. But But as you said, there was a huge line that is just incredible.
Nick van Terheyden
It’s just it’s really tragic. And it really bothers me because we need everybody pulling in the same direction. And they’re always the outliers. But we shouldn’t default to sort of tar everybody with the same brush. I mean, I think you know, for the most part you see people very well intention doing things. But you know, the message and lesson here for businesses, individuals is you need intelligent counsel and guidance through this crisis through the next aspects of this, how you going to manage and deal with vaccinations, all of those things that are central to the tenants that we offer. And if you’ve got questions, you can always join us on Wednesday at four pm when we hold a webinar with an open session to be able to sign up and just ask questions.
Fred Goldstein
Yeah, just a great point. So as everyone considers that, whether it’s testing or screening or contact tracing, there is so much to it that goes beyond just the basics of Oh, go get yourself tested. And I think that’s the important point you raised today. It’s something that everybody needs to consider. So, again, another fantastic week, Nick, this is Fred Goldstein with accountable health. Thanks so much for joining us.
Nick van Terheyden
I’m Dr. Nick. I’m the incrementalist here with incremental insights for better business, better health.
