Soon I started to feel a tingle in my throat and my husband started coughing. We had to lock ourselves in during the week running from home, delivering groceries and isolating ourselves from each other. I wasn’t sick anymore, but he was, with a rainy cough, congestion and a little fever. Either we did several immediate tests and also used nucleic acid amplification tests, which are more sensitive.
None of us have tested positive. But we wondered if we “still had COVID” in some sense, and that’s a difficult question to investigate on our own.
Fortunately, in my job, I can communicate with clinical experts, and who better to leverage infectious disease wisdom than Benjamin Pinsky, M. D. , Ph. D. , professor of pathology and medicine at Stanford Medical School who works in clinical practice, researches and designs infectious disease diagnostics and tests?
Pinsky, medical director of the clinical virology laboratory at Stanford Health Care and Stanford Medicine Children’s Health, answered any and all questions that crossed my brain quarantine. The main conclusion? Take a deep breath, research, be fair and considerate about your situation, and do as productive as possible for yourself and others.
“It’s vital that other people take inventory of their own dangers and their non-public duty to others with the data they have at the time,” Pinsky said. “But it’s hard to make those kinds of decisions with imperfect data, which is the challenge. “
The following questions and answers have been modified for clarity and consistency.
How reliable are immediate COVID-19 tests, and can other people use the darkness of the positive line to assess how contagious they are?
A developing evidence framework in the literature indicates a modest sensitivity of immediate controls, even in symptomatic individuals. Many other people who will test negative with the immediate antigen test, but are infected.
The nucleic acid amplification tests [used in this article] are much more delicate. But for this type, the internal nostrils are rubbed, which are less delicate than those that penetrate deeper into the nasal cavity.
Another thing to keep in mind is the frequency of control. The viral load increases, peaks, and then begins to decrease. You can check the overall functionality through serial sampling.
The darkness of the line and the time it becomes positive can be correlated with the amount of virus in this sample. But there is so much variability in how other people do the verification that immediate checks are only used as a yes or no answer.
What is the strict definition of “having” COVID-19?If someone finds themselves in the scenario I was in, with a probable COVID-19 infection but no positive result, what does they do?
Strictly defining what it means to “have” COVID-19 is difficult. Technically, the definition of infection is the ability to stumble upon the virus in a clinical sample.
It can actually become inflamed and go unnoticed by the medical system. There are other people who are inflamed and who do not test positive in any of our controls. Other people may never have a high enough viral load. That said, we would encounter most of those infections if other people were checked at the right time.
You can also find out after the fact if, and I love that term, “immunocurious. “You or your spouse may have an antibody test. But even that depends on the right time.
If you’re sick, you don’t want to have the diagnosis to isolate yourself. But if you can’t self-isolate and you have even mild symptoms, you have a molecular test. Preferably, it takes the maximum sensitivity, with the farthest swab, done. Through a professional: I suspect your spouse would probably have tested positive with this type of test.
If you later test negative with the most delicate tests, you most likely don’t have SARS-CoV-2. However, if you still have symptoms and can isolate yourself, you do.
The main goal is to be less likely to transmit. It becomes complicated and requires a lot of non-public accountability. Determine if you’re more likely to interact with other elderly, immunocompromised, or unvaccinated people—all of those kinds of things.
Increasingly, it turns out that other people are running while showing symptoms of illness, but they are convinced that it is not COVID-19 because they have been tested.
This is a bit concerning because most people check with immediate antigen checks and their functionality is not ideal. On the other hand, if you have negative antigen, it means that you probably do not have many viruses, so it is not at most probably to transmit; that is, if your pattern was taken at the right time. Unless you monitor continuously, you don’t know if your viral load is expanding or decreasing. So I don’t really accept that argument for making public or individual decisions as true.
Another not unusual refrain is, “Well, there are still other illnesses,” referring to colds and flu. But is anyone more likely to have one than COVID-19?
This is accurate, in the strictest sense, unless in the last two years there has been very little flow of other respiratory viruses. COVID-19 is also likely to be more transmissible, at least in today’s world.
The first year of the pandemic, with masking and social distancing rules, we had very few cases of influenza in the samples we analyzed in the Clinical Virology Laboratory. Separately, for one study, we tested 15,000 negative samples for COVID-19 and discovered one case of breathing syncytial virus, or RSV, a common cold virus. That’s right.
We have noticed that other respiratory viruses return as we “reopen. “But at Stanford Health Care, in adults, the flow of respiratory viruses is still low. In pediatrics, we get a lot of cases of respiratory viruses that are not COVID-19, basically rhinovirus. and RSV. As we enter respiratory virus season, we will be largely tracking a buildup of non-COVID-19 viruses, especially influenza.
Part of his paintings deals with some of those unknowns about the prestige of infection. What exciting examples can you share?
We are still conducting diagnostic tests for SARS-CoV-2. We seek to use the host’s reaction to the virus to diagnose SARS-CoV-2 and other respiratory viral infections, particularly through the search for metabolites generated by a framework. in reaction to infection. The concept would be to identify all the small metabolites in a swab employing a strategy called mass spectrometry, which would give a chemical signature that would indicate whether a user is infected.
We hope to move the procedure to more portable, less expensive and less difficult-to-use mass spectrometers, similar to those used in airport security lines to test swabs for chemical lines of explosives. The result would be one to two minutes.
We have also developed a verification that is primarily used to verify whether hospitalized patients still have a virus that replicates when they meet the criteria for discharge from isolation. The SARS coronavirus is an RNA virus “strand more”, which means that the mobile hosts a “negative strand” of RNA replication. If a check only detects this negative chain, we can identify the maximum number of patients likely to replicate.
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