COVID-19 testing continues to be a rapidly-changing challenge. There are two types of testing that you need to know about: testing to see if you are currently infected with COVID-19 and testing to see if you have been infected.
Testing to see if you currently are infected with COVID-19:
This is the nose swab test. We are able to send samples now with turnaround times of 1-2 days, so it might be useful at this point. The accuracy of the test is good, especially for positive results. If you’re positive, you can be quite sure you actually have COVID-19. If it’s negative, there’s still some chance (10-15%) that you are infected and the test just didn’t detect it. That’s why if you’re using the test to determine whether to go back to work, you need two negative tests separated by at least a day.
Often, though, there’s not much the test adds to decision making: you self-isolate for 10 days. There’s not an outpatient treatment option for COVID-19 right now, so it doesn’t make a decision to start medication. And it’s fairly expensive. Currently the test costs $85 and it’s not certain whether insurance will pay for it. One option is to register for testnebraska.com which is the statewide system being used to organize mass testing.
Testing to see if you already have been infected with COVID-19:
These are antibody tests from a blood draw. This type of testing has been a Wild West affair until just recently. The clinic got many solicitations to buy in-clinic test kits from companies I’d never heard of. Fortunately the FDA put a stop to that. We send these tests out to a national reference lab (ARUP). That’s important because this is a lab that runs the tests in carefully controlled laboratory conditions with highly trained laboratory technicians. These types of laboratories have great experience running these types of tests and I trust the results. These tests have accuracies in the 90-95 percent range. The real question, though, is what do you do with the result? The presence of antibodies indicates you had the infection previously, but we don’t know enough about the immune response to the virus to know if you are immune to the virus for a little while, a long time, or not at all. And we won’t know that information for months yet. We can collect the blood and send the test for $50 for members.
Founded in 1984, ARUP Laboratories is a leading national reference laboratory and a nonprofit enterprise of the University of Utah and its Department of Pathology. ARUP offers more than 3,000 tests and test combinations, ranging from routine screening tests to esoteric molecular and genetic assays. ARUP serves clients across the United States, including many of the nation’s top university teaching hospitals and children’s hospitals, as well as multihospital groups, major commercial laboratories, group purchasing organizations, military and other government facilities, and major clinics. In addition, ARUP is a worldwide leader in innovative laboratory research and development, led by the efforts of the ARUP Institute for Clinical and Experimental Pathology®. ARUP is ISO 15189 CAP accredited.
The bottom line is that testing for COVID-19 is a tricky business. I’m still a firm believer that you only do the test if it changes your plan, and right now for the vast majority of people, either type of testing for COVID-19 just doesn’t do that. I do hope people will sign up for testnebraska.com. If you are a member and you are interested in testing, please give us a call to make sure it’s the right decision for you.