There’s no question that rapid antigen (Ag) testing is limited right now due to high demand: stores are sold out, health departments are prioritizing based on need, and online orders are delayed. While this shows that the U.S. government did not adequately prepare for Omicron, it also shows that people are finally leveraging one of the most under-utilized tools of the pandemic.
What would you suggest for those of us who are "hypersymptomatic" due to underlying conditions, such as allergies or acid reflux? One reason I use rapid tests is to justify fibbing about the stuff I always have. It's really the only way I have to rationalize going into work. Otherwise I'm forced to make impossibly subjective assessments of whether my cough is or isn't "dry" or "worsening" or if my nose is runnier than "usual". If someone comes up with a cough-o-meter I'll be more than happy to give up taking rapid tests.
Thank you for advising thriftiness! I see Curative is all booked up in our area. My wife is running into situations where patients are waiting over an hour in the waiting room to get tested.
I can’t help but imagine some people are getting/spreading Omicron simply due to the testing situation.
I always try to avoid talking about positive predictive values and negative predictive values, but this does play into our rapid tests. A positive result is pretty reliable (good specificity), a negative test is m'eh! (poor sensitivity). My issue, and an infection control guy is if you are symptomatic, and test negative (even with PCR) you still are symptomatic and could be spreading another respiratory virus to susceptible people. I am watching the numerous outbreaks around me in LTC of RSV and Rhinovirus...and I am always thinking, "I bet they tested negative for COVID and went to work!". Thanks so much for all you and your team does!
Thank you so much for this information. The question I have for you regarding the saliva swabs is: Are we able to use the Binax now at home tests to swab our throats and will it give us an accurate result as opposed to swabbing our nose? I was told at our testing site that it would need a different reagent to read the saliva? Is that correct? The only reason I ask is because this method is trending online. When a family member swabbed their nose it was negative, when they swabbed their throat, positive. They went and got a PCR test done and it was negative so why would they get a positive reading with the saliva swab?
Your article last evening included a reference to a study that pooled 70 other studies that showed the effectiveness of masks. Could you post a link to that particular study? Thanks.
I did a quick search through your blogs, but didn't quite see what i was looking for. Did you mention or do a write up on the antigen tests and the flu. I overheard a friend say that the tests pick up on flu more so than covid, and I for the life of me can't find really anything to support that or negate that. Care to give some insight or direct me to some reading to explain that?
I am very confused and need guidance. I tested positive on PCR and home rapid Dec. 28. No-one I was in contact with the entire week before has tested positive. I had barely any symptoms for three days, never a fever. I have not had a symptom for ten days now, I feel great, but I am on Day 14 and I still test positive on rapid home test (tested positive on PCR on Day 10). Am I contagious? Can I see people? Should I keep testing? Help!
I hope that the question most people are asking is do I need to isolate?. The problem is if they want to see their grandmother who has COPD and they think that she will be OK if they pass the test. Real world test performance seems to be very important. The Cochrane review last year had the sensitivity for asymptomatic patients at an average 58%. That indicates they are more suitable for someone working in a nursing home where every outbreak is a large problem, so a 50% reduction is important.
So honored to be a paid subscriber! Is there a source for not testing until 60 days after a positive case? I know SHIELD Illinois says 90 days, but their test is Gold Standard. CDC says 90 also w/PCR but also says if no symptoms, w/o clarifying. Thank you!
Thank you so much for this clear explanation and for the helpful links. I especially appreciate your clear guidance about what we as individuals should do.
Can you or anybody translate this cdc bulletin? Our local school board has translated it as pcr tests are no longer a valid dx tool. I can’t imagine that is true?
Your third subhead should be "real worLd performance." Your Local Editor (Also, thanks for this--it is extremely useful and actionable information.
What would you suggest for those of us who are "hypersymptomatic" due to underlying conditions, such as allergies or acid reflux? One reason I use rapid tests is to justify fibbing about the stuff I always have. It's really the only way I have to rationalize going into work. Otherwise I'm forced to make impossibly subjective assessments of whether my cough is or isn't "dry" or "worsening" or if my nose is runnier than "usual". If someone comes up with a cough-o-meter I'll be more than happy to give up taking rapid tests.
Thank you for advising thriftiness! I see Curative is all booked up in our area. My wife is running into situations where patients are waiting over an hour in the waiting room to get tested.
I can’t help but imagine some people are getting/spreading Omicron simply due to the testing situation.
I always try to avoid talking about positive predictive values and negative predictive values, but this does play into our rapid tests. A positive result is pretty reliable (good specificity), a negative test is m'eh! (poor sensitivity). My issue, and an infection control guy is if you are symptomatic, and test negative (even with PCR) you still are symptomatic and could be spreading another respiratory virus to susceptible people. I am watching the numerous outbreaks around me in LTC of RSV and Rhinovirus...and I am always thinking, "I bet they tested negative for COVID and went to work!". Thanks so much for all you and your team does!
Thank you so much for this information. The question I have for you regarding the saliva swabs is: Are we able to use the Binax now at home tests to swab our throats and will it give us an accurate result as opposed to swabbing our nose? I was told at our testing site that it would need a different reagent to read the saliva? Is that correct? The only reason I ask is because this method is trending online. When a family member swabbed their nose it was negative, when they swabbed their throat, positive. They went and got a PCR test done and it was negative so why would they get a positive reading with the saliva swab?
I had to become a paid subscriber after reading such clear and helpful information.
What about this study ??
Study about inaccuracies in rapid tests:
https://www.statnews.com/2022/01/05/study-raises-doubts-about-rapid-covid-tests-reliability-in-early-days-after-infection/
Your article last evening included a reference to a study that pooled 70 other studies that showed the effectiveness of masks. Could you post a link to that particular study? Thanks.
Hi Dr. Jetelina,
I did a quick search through your blogs, but didn't quite see what i was looking for. Did you mention or do a write up on the antigen tests and the flu. I overheard a friend say that the tests pick up on flu more so than covid, and I for the life of me can't find really anything to support that or negate that. Care to give some insight or direct me to some reading to explain that?
Thank you for all that you're doing <3
Dr. Jetelina: I am in the same situation as SS below. But I have a different question. What is the antigen test picking up that the test is positive?
Thanks for all good science and translation.
I am very confused and need guidance. I tested positive on PCR and home rapid Dec. 28. No-one I was in contact with the entire week before has tested positive. I had barely any symptoms for three days, never a fever. I have not had a symptom for ten days now, I feel great, but I am on Day 14 and I still test positive on rapid home test (tested positive on PCR on Day 10). Am I contagious? Can I see people? Should I keep testing? Help!
Hi, what are your thoughts on the recent FDA tweets about not swabbing the throat as well as nostrils?
I hope that the question most people are asking is do I need to isolate?. The problem is if they want to see their grandmother who has COPD and they think that she will be OK if they pass the test. Real world test performance seems to be very important. The Cochrane review last year had the sensitivity for asymptomatic patients at an average 58%. That indicates they are more suitable for someone working in a nursing home where every outbreak is a large problem, so a 50% reduction is important.
So honored to be a paid subscriber! Is there a source for not testing until 60 days after a positive case? I know SHIELD Illinois says 90 days, but their test is Gold Standard. CDC says 90 also w/PCR but also says if no symptoms, w/o clarifying. Thank you!
Thank you so much for this clear explanation and for the helpful links. I especially appreciate your clear guidance about what we as individuals should do.
Good morning Dr Jetelina!
Can you or anybody translate this cdc bulletin? Our local school board has translated it as pcr tests are no longer a valid dx tool. I can’t imagine that is true?
https://www.cdc.gov/csels/dls/locs/2021/07-21-2021-lab-alert-Changes_CDC_RT-PCR_SARS-CoV-2_Testing_1.html
Thank you