Is testing always necessary?

[MEmama]

Somehow I’m a bit slow to understand the point of testing for every sniffle or fever. For people who are typically in public *and* would change their behavior if they tested positive, I understand. But let’s hypothetically say that one morning I wake up feeling lousy (I don’t, fwiw— this is purely a hypothetical). My life is such that I’m rarely in a public space, and it’s never truly necessary. DH works from home and doesn’t run errands or go anywhere. If I felt bad, the only possible change to my day is that I could simply order grocery delivery instead of go in person. I would stay home, assume it’s covid, and isolate for probably 2+ weeks cause I’m paranoid like that. In this situation— no kids going to school, no one in or out of my house, nowhere to need to be— is there a point to test? Which would not only use up a test but also require me to go in person, thereby potentially exposing multiple people vs just staying home?

Talk to me like I’m 5. I feel like I’m missing something. 

 

[Mrs Tiggywinkle]

3 minutes ago, MEmama said:

Somehow I’m a bit slow to understand the point of testing for every sniffle or fever. For people who are typically in public *and* would change their behavior if they tested positive, I understand. But let’s hypothetically say that one morning I wake up feeling lousy (I don’t, fwiw— this is purely a hypothetical). My life is such that I’m rarely in a public space, and it’s never truly necessary. DH works from home and doesn’t run errands or go anywhere. If I felt bad, the only possible change to my day is that I could simply order grocery delivery instead of go in person. I would stay home, assume it’s covid, and isolate for probably 2+ weeks cause I’m paranoid like that. In this situation— no kids going to school, no one in or out of my house, nowhere to need to be— is there a point to test? Which would not only use up a test but also require me to go in person, thereby potentially exposing multiple people vs just staying home?

Talk to me like I’m 5. I feel like I’m missing something. 

 

I don’t think there’s a reason if your whole family is at home all the time.  But I think that’s probably a very rare circumstance and most people should test.  Honestly, most people should just be able to stay home if they feel sick, because the flu is rampant this year too and also contagious and making people very sick.  But for most families, just staying home is impossible.

In your case I agree, there’s no reason to frequently test.

[Katy]

I ordered rapid tests from Walmart for that reason. DH does go into the office or factory a few times a month.

[thewellerman]

If you wanted to try MCAB, those are best used as early as possible, so testing could be worth it in that case. Though, I've read they aren't as effective with Omicron.

[sbgrace]

Your family situation is different than most. Most families someone or multiple someones are in public much more often.

But, beyond that, I would want to know if I had COVID. That information could become important later. Further, if I should need treatment later (say for long COVID), no proof of infection could make that more difficult I think. (My uncle got the monoclonial's early and I really think it probably saved his life. I don't think most of them help Omicron, but there is still a lot of Delta floating around right now.)

Edited December 29, 2021 by sbgrace

[Pam in CT]

For me, the reasons to test are:

• Ability to inform anyone we've been in contact with *in the past* few days that they've potentially been exposed
• Ability to dial back any contacts we've planned *in the future* few days
• Ability to plan for access to MCAB treatment if circumstances (age or other risk factors) warrant
• Ability to document having-had COVID in the event that symptoms associated with long COVID emerge in the future.

In your particular circumstances, it sounds like the first 3 of these are not much of an issue.  And the fourth is pretty low odds. So testing may well not get you, particularly, much.

Most households -- even the quite COVID-cautious -- necessarily have work/ medical/ caretaking / other unavoidable contacts that take them out more than it sounds like yours is.  And lots of households at this point are too weary to sustain high vigilance COVID caution.  Testing makes good sense in those circumstances.

[Pawz4me]

I'm pretty much right there with you, @MEmama(which isn't unusual--we seem to agree on a lot of things).

I think in a perfect world if we had plentiful testing ability it would be great if everyone with a sniffle or who wanted a test "just because" could go get one and get quick results. But we don't have those things.

And I think encouraging everyone who has even the tiniest symptom (or even worse, encouraging people to test "just in case") is in hindsight going to prove to be a very huge mistake. I suspect there are many, many people with obvious symptoms who are working in person, in public this very minute because they can't get tested easily, and even when they jump through all the hoops and spend hours of time getting tested, the results often don't come in for days because so many are getting tested "just in case."

In short, I think we need to start doing some sort of triage for testing so that those who have an immediate need can get tested relatively easily and get results back quickly.

[Farrar]

I have been trying to think of tests in a sort of backwards way. As in, they give me the freedom (as a vaxxed, boosted person) to take more risks on myself without transferring those risks to others. As in, they allow me to go do more things in public spaces without risking random people or friends the next time I go do something else in a public space. Not at all perfect, but there it is.

[marbel]

21 minutes ago, Pawz4me said:

I think in a perfect world if we had plentiful testing ability it would be great if everyone with a sniffle or who wanted a test "just because" could go get one and get quick results. But we don't have those things.

Right. One of my kids had a lot of trouble getting tested even though they knew they were exposed and had to know for their public-facing job. We finally found some at-home tests and then they were able to get a PCR test from our county. There was a lot of hassle involved. 

On the other hand, it would be nice to know if one has had it. We are all sick right now, with basically the same symptoms, but because of the dearth of test availability, we only know for sure about 2 of the 4 of us. (The 2 who work outside the house.) As others have said, it would be good to have in our medical records, though if Covid is going to become like the flu, in that we would likely have access to a vax every year for the new strain, it might not matter. I don't believe I have ever been asked by a doctor if I have had the flu. 

[Carrie12345]

1 hour ago, sbgrace said:

Your family situation is different than most. Most families someone or multiple someones are in public much more often.

 

This.
I have tested my kids for a few minor symptoms, primarily because we WERE successful with in-house isolation when dh was positive with the OG strain. So I’d be happy to protect my kids from me or the rest of us from one of them. 

Even in our semi-bubbled life, dh is around a handful of non-maskers and dd is around some coworkers and drive thru customers. It’s still important to know if they’ve been exposed, wherever it came from, to protect from it coming in or going out.

Most people I know are around a LOT of coworkers, other students, customers, extended family members, friends, etc.  I would like to think they’re testing whenever they have a reason to, but I also know there are financial and supply limitations, as well as the reality that they’re already around other people before they know they’re contagious.

Because I have much more control over my exposures (in or out), I do think it’s wise to test if symptoms are present or close exposure known.

[MEmama]

5 minutes ago, marbel said:

As others have said, it would be good to have in our medical records,

I tend to agree with this. DS had covid toes early on, and I've been vigilant in making sure all his doctors have it on record, just in case there’s more to learn or need to know in the future. Technically, he tested negative (he got a test after the window of opportunity) and we weren’t tested because we didn’t have respiratory symptoms (the common baseline at the time) but there’s zero doubt that's what it was. Because I had ever so slight symptoms (that I didn’t fully put together until a conversation here with others whose teens had covid toes at the same time), my doctor assumes I had it as well (also I was literally the only possible source to bring it into the family).

I do wonder, with testing as inconsistent as it is, if having a positive test on record will even matter in the long run, or if it will just be assumed. I’d rather err on the side of caution but my guess is it won’t make much difference for future long term treatment.
 

 

[Hilltopmom]

Also if long covid became an issue for someone, they might need proof of having covid initially for coverage or access to care, perhaps.

[kristin0713]

I don’t think anyone has enough access to tests right now to test for every sniffle. Up until last week, I had told my family that we were *not* testing for every sniffle but we would certainly stay home if sick and let people know to avoid us if anyone had any symptoms. Now with omicron, I would and will test for bad colds but of course that is if we can get a test or get tested. I’m not going to isolate for two weeks unless we actually have confirmed positive covid. But again, if we’re sick, we’re not going anywhere. Fortunately, I don’t work and my kids take online classes. DH works from home has a lot of flexibility with seeing colleagues so we are all able to avoid people if we’re sick. 

[Ting Tang]

At this point, I am just feeling defeated by the whole thing. 

My husband said go ahead and get the kids vaccinated if I want (I know he isn't happy about that), but truthfully, I feel like if we do that, we are going to be exposed to Covid.  My riskiest situation was when I got a booster at Walgreen's just over a week ago and a unmasked lady got in my face at the checkout wanting to use my $5 rewards coupon I was given for getting boosted! We have well checks scheduled, and I am going to ask if they can give children's vaccines there (I'm guessing no, though) before we go in.  I've put off well-checks the entire pandemic, but we have found important health concerns that way in the past. 

I think about the poor at risk, immunocompromised people and my children right now, but I don't think at this point it is realistic to test so much for most people. We spent $48 on two boxes of Binax and already used one (we felt find but did it before we celebrated Christmas with the others who were able to get tested, and I know, those are not even a guarantee).  I can't seem to find them anywhere, and appointments are hard to come by around here for the time being.

 

Edited December 29, 2021 by KrisTom

[Ting Tang]

13 minutes ago, Hilltopmom said:

Also if long covid became an issue for someone, they might need proof of having covid initially for coverage or access to care, perhaps.

Can a t-cell test provide some indication?  Maybe it's hard to distinguish between vax/prior infection. Maybe they just have to "assume" any long covid symptom is due to a prior infection at this point?  I'm just thinking out loud.

[Ali in OR]

Our employers require tests. Dh mostly works from home, but if he wants to go onsite he has to do a rapid test first (once per work week). He brings home a new rapid test for the next time whenever he is on site--his employer has been able to provide tests so far. My employer requires an official test if I have any symptoms. I did that for just a sore throat in the fall--lost 1 day of work (would be 2 or more with slower test turn-around times--mine took 8 hours). It's enough of a pain that I'm going to KN95 or N95 masks in January hoping to avoid all symptoms of anything! But I chose to follow the rules because one symptom is enough that it could be Covid and I would feel horrible if I spread that to someone else.

[Longtime Lurker]

1 hour ago, Pawz4me said:

I think in a perfect world if we had plentiful testing ability it would be great if everyone with a sniffle or who wanted a test "just because" could go get one and get quick results. But we don't have those things.

And I think encouraging everyone who has even the tiniest symptom (or even worse, encouraging people to test "just in case") is in hindsight going to prove to be a very huge mistake. I suspect there are many, many people with obvious symptoms who are working in person, in public this very minute because they can't get tested easily, and even when they jump through all the hoops and spend hours of time getting tested, the results often don't come in for days because so many are getting tested "just in case."

In short, I think we need to start doing some sort of triage for testing so that those who have an immediate need can get tested relatively easily and get results back quickly.

This exactly. I have been thinking this lately but you expressed it so much better.

[marbel]

The thing that is annoying me about at-home tests...

The local pharmacies or general merchandise stores like Target are showing nothing available for shipping or for pickup at store, but saying something like "visit store for availability." Well, OK, everyone in my family is sick, two with confirmed and two with suspected covid. No one can go driving around, wandering in and out of stores looking for tests.  I know that situation is not unique to my family. I would think the merchants would prefer people to get them via shipping or curbside pickup to avoid having exposed people in the stores. (I get that it's easier for them to control inventory if they are just selling in the store.) 

[Ting Tang]

20 minutes ago, marbel said:

The thing that is annoying me about at-home tests...

The local pharmacies or general merchandise stores like Target are showing nothing available for shipping or for pickup at store, but saying something like "visit store for availability." Well, OK, everyone in my family is sick, two with confirmed and two with suspected covid. No one can go driving around, wandering in and out of stores looking for tests.  I know that situation is not unique to my family. I would think the merchants would prefer people to get them via shipping or curbside pickup to avoid having exposed people in the stores. (I get that it's easier for them to control inventory if they are just selling in the store.) 

I was able to do a curbside at Walgreens, when we found a store with them in stock. Walmart has them for "pickup" as of today.  But I have seen this, too, with others!  I can't find a way to have Binax shipped to us. 

[busymama7]

3 hours ago, sbgrace said:

Your family situation is different than most. Most families someone or multiple someones are in public much more often.

But, beyond that, I would want to know if I had COVID. That information could become important later. Further, if I should need treatment later (say for long COVID), no proof of infection could make that more difficult I think. (My uncle got the monoclonial's early and I really think it probably saved his life. I don't think most of them help Omicron, but there is still a lot of Delta floating around right now.)

Yes exactly this. I commented on another thread about the long haulers being refused admittance to clinics for long haul because they don't have proof.  It's super sad because many are from the first wave when they couldn't get tested.  Others though just didn't think it important because they had a known exposure or they isolated anyways and that has come back to bite them.  

[marbel]

3 hours ago, sbgrace said:

Further, if I should need treatment later (say for long COVID), no proof of infection could make that more difficult I think.

OK, I am dense, not intentionally. 

If someone is having symptoms of illness, why would they need proof of having had Covid?  They are sick, experiencing symptoms. The symptoms must be investigated and the underlying causes treated.  If a person says "I think I had Covid" or, "I did a home test for Covid and it was positive" (which I don't think would be considered proof), but do not have proof, how could they be denied treatment?  I know people who ordered PCR tests which were mailed to them; they Fedex'd the sample back and got a positive result. But even that may not be considered proof, because there is no way to prove who the sample came from. The only way to prove would be via a test at a medical facility, right? 

I am missing something here, can someone clarify/fill me in?  

[busymama7]

11 minutes ago, marbel said:

OK, I am dense, not intentionally. 

If someone is having symptoms of illness, why would they need proof of having had Covid?  They are sick, experiencing symptoms. The symptoms must be investigated and the underlying causes treated.  If a person says "I think I had Covid" or, "I did a home test for Covid and it was positive" (which I don't think would be considered proof), but do not have proof, how could they be denied treatment?  I know people who ordered PCR tests which were mailed to them; they Fedex'd the sample back and got a positive result. But even that may not be considered proof, because there is no way to prove who the sample came from. The only way to prove would be via a test at a medical facility, right? 

I am missing something here, can someone clarify/fill me in?  

Because people with non clear, chronic type illnesses have such a fight to even get care.  Long covid is still not believed by many providers and even those with proof (me!) are being dismissed.   Also, the clinics who are dedicated to long covid and trying to figure it out will not accept patients without proof they had it. And by proof they mean a PCR test.  Maybe it shouldn't be that way but they truth is it is happening that way right now. 

 

[73349]

Testing here is done in a parking lot (handed a self-test kit--through the car window cracked open a couple of inches--by a person in full PPE); we don't expose anybody.

If you're willing to just do delivery anyway instead of going into a store, and you're boostered and in generally good health so unlikely to experience severe illness, you probably wouldn't need to test.

For us, it's the difference in going into the library masked vs. not at all, and a few other activities.

That said, I just got a negative ("not detected," technically) and don't trust it and will probably isolate through Tuesday (symptoms started last Friday), because either we have Covid or mysteriously picked up a wildly transmissible cold with the same symptoms as omicron (so quite possibly a coronavirus even if not the one we can be tested for). DS will be tested tomorrow.

[Jean in Newcastle]

I have not had a single Covid test all pandemic. I was quite sick for six weeks at the very start of the pandemic but testing was limited to people over 65 and I didn’t qualify. (I did have a negative antibody test later but then found out that I was probably past the window for it to be accurate. ). 

[Halftime Hope]

So there's quite a discussion on "medtwitter" regarding the usefulness of rapid antigen tests, often known as lateral flow tests. Quite a few including Binax (Abbott) are not picking up infections even when someone has been symptomatic for several days and has returned a positive PCR.  They may finally return a positive a few days later than the PCR when virus levels are high enough to finally show up, perhaps on day 5 of symptoms.  This calls into question the advisability of healthcare workers being asked to return to work while not fully recovered.  (HCWs justifiably feeling thrown under the bus.)

It's a bit of a conundrum...it may be that Omicron makes you feel crappy quite a bit earlier.  And theoretically, you can definitely be contagious, even though the LFT may not be properly calibrated to tell you that. 

On the other hand, waiting for a clear PCR after a SARS-COV2 illness is a mess, as the PCRs can pick up viral debris and return a "true" signal, but for the wrong thing--viral remnants. 

Sigh.  Science is messy and open to interpretation.

 

[Faith-manor]

5 hours ago, Hilltopmom said:

Also if long covid became an issue for someone, they might need proof of having covid initially for coverage or access to care, perhaps.

This. For me, I would want it in my medical records. And then the other issue is I want to be a part of the medical and scientific community having more information/data to work with so it is important to me that home test folks still follow up with PCR.

[Drama Llama]

In my area, they are requiring PCR testing with increasing frequency, in order to do various things.   Some of those things might be things you wouldn't want to do, but other things, like flying to the side of a sick relative, or getting semi-elective surgery are things you might not know you want to do until you want to do them. 

PCRs are waived for those within 90 days of recovery from a documented infection, and if you find yourself in a situation where you suddenly want one, it will be too late. 

[MEmama]

7 minutes ago, Baseballandhockey said:

In my area, they are requiring PCR testing with increasing frequency, in order to do various things.   Some of those things might be things you wouldn't want to do, but other things, like flying to the side of a sick relative, or getting semi-elective surgery are things you might not know you want to do until you want to do them. 

PCRs are waived for those within 90 days of recovery from a documented infection, and if you find yourself in a situation where you suddenly want one, it will be too late. 

If I had to fly or get surgery, I’d just get a PCR, which I think is more valid than proof of past infection anyway (not everyone develops antibodies, and the thought with omicron is that past infections don’t help with this strain anyway). Neither of those scenarios happen without advanced warning, enough time to get a test scheduled. 
 

[Drama Llama]

Just now, MEmama said:

If I had to fly or get surgery, I’d just get a PCR, which I think is more valid than proof of past infection anyway (not everyone develops antibodies, and the thought with omicron is that past infections don’t help with this strain anyway). Neither of those scenarios happen without advanced warning, enough time to get a test scheduled. 
 

But if you had the virus, and recovered, the PCR can stay positive for up to 90 days.  So, if you need to do something urgently, and get a positive result on that PCR, then it can delay the thing you want to do.  

[Matryoshka]

1 hour ago, Halftime Hope said:

So there's quite a discussion on "medtwitter" regarding the usefulness of rapid antigen tests, often known as lateral flow tests. Quite a few including Binax (Abbott) are not picking up infections even when someone has been symptomatic for several days and has returned a positive PCR.  They may finally return a positive a few days later than the PCR when virus levels are high enough to finally show up, perhaps on day 5 of symptoms.  This calls into question the advisability of healthcare workers being asked to return to work while not fully recovered.  (HCWs justifiably feeling thrown under the bus.)

I saw the FDA report coming out saying some rapid tests weren't performing well, but from what I can tell, Binax seems to be holding up okay.  I read something on here that called out a couple of other brands as being useless, and to make sure I hadn't missed anything I googled, and I can't find anything saying the Binax isn't holding up.  I did find this: 

https://www.nbcchicago.com/news/local/can-at-home-covid-tests-detect-the-omicron-variant-heres-what-the-fda-and-researchers/2716174/

According to the Food and Drug Administration, both the Abbott BinaxNOW and Quidel QuickVue antigen tests are able to detect the omicron variant "with similar performance as with other variants."

However, the FDA based its findings on preliminary studies that used heat-inactivated omicron samples, not live samples. Clinical evaluations using such samples remain ongoing.

Heat inactivation can potentially alter the virus's protein structure, which may lead to changes in test performance that can be mistaken for changes due to viral mutations.

Two other tests, Linea COVID-19 Assay Kit from Applied DNA Science and Revogene SARS-CoV-2 from Meridian Bioscience should not be used, according to the agency. The FDA stated research has found both are unable to detect the variant.

Abbot (Binax mfg) did also put out a press release yesterday (I'm guessing in response to the FDA report) saying at least from their tests (yes, consider the source, but still some data), Binax is holding up well: 
https://www.abbott.com/corpnewsroom/diagnostics-testing/an-update-on-omicron-and-test-effectiveness.html

Abbott has been intently monitoring the mutations of COVID-19 so we can ensure our tests can detect them. We've conducted lab analyses and tests on the Omicron variant from live virus, including from the first U.S. omicron case, and BinaxNOW detected the virus in all tests we performed at equivalent sensitivity as other variants. Additionally, our data from customer use has not shown any change in test performance.

Edited December 29, 2021 by Matryoshka

[scholastica]

I’d like to know if I had it in case they recommend a 4th shot. It is safest to wait at least 90 days after a Covid infection to get the vaccine.

[Lucy the Valiant]

1 hour ago, Matryoshka said:

I saw the FDA report coming out saying some rapid tests weren't performing well, but from what I can tell, Binax seems to be holding up okay.  I read something on here that called out a couple of other brands as being useless, and to make sure I hadn't missed anything I googled, and I can't find anything saying the Binax isn't holding up.  I did find this: 

https://www.nbcchicago.com/news/local/can-at-home-covid-tests-detect-the-omicron-variant-heres-what-the-fda-and-researchers/2716174/

According to the Food and Drug Administration, both the Abbott BinaxNOW and Quidel QuickVue antigen tests are able to detect the omicron variant "with similar performance as with other variants."

However, the FDA based its findings on preliminary studies that used heat-inactivated omicron samples, not live samples. Clinical evaluations using such samples remain ongoing.

Heat inactivation can potentially alter the virus's protein structure, which may lead to changes in test performance that can be mistaken for changes due to viral mutations.

Two other tests, Linea COVID-19 Assay Kit from Applied DNA Science and Revogene SARS-CoV-2 from Meridian Bioscience should not be used, according to the agency. The FDA stated research has found both are unable to detect the variant.

Abbot (Binax mfg) did also put out a press release yesterday (I'm guessing in response to the FDA report) saying at least from their tests (yes, consider the source, but still some data), Binax is holding up well: 
https://www.abbott.com/corpnewsroom/diagnostics-testing/an-update-on-omicron-and-test-effectiveness.html

Abbott has been intently monitoring the mutations of COVID-19 so we can ensure our tests can detect them. We've conducted lab analyses and tests on the Omicron variant from live virus, including from the first U.S. omicron case, and BinaxNOW detected the virus in all tests we performed at equivalent sensitivity as other variants. Additionally, our data from customer use has not shown any change in test performance.

 

[Lucy the Valiant]

Also, I think CDC is discontinuing PCR tests January 1? 

https://www.cdc.gov/csels/dls/locs/2021/07-21-2021-lab-alert-Changes_CDC_RT-PCR_SARS-CoV-2_Testing_1.html

[Lucy the Valiant]

57 minutes ago, scholastica said:

I’d like to know if I had it in case they recommend a 4th shot. It is safest to wait at least 90 days after a Covid infection to get the vaccine.

Some doctors recommend 90 days after antibodies diminish (and that has been many many months for some people; less for others  - need antibody test to find out).

[Drama Llama]

4 minutes ago, Lucy the Valiant said:

Also, I think CDC is discontinuing PCR tests January 1? 

https://www.cdc.gov/csels/dls/locs/2021/07-21-2021-lab-alert-Changes_CDC_RT-PCR_SARS-CoV-2_Testing_1.html

I am reading that as they are discontinuing the PCR test that is made by the CDC itself.  But there are many companies making PCR tests.

 

[prairiewindmomma]

Always? No. 

On a practical matter, it's dang hard to get testing right now. This week, the urgent cares are backed up for days and the community testing center has people waiting outside for hours in 20Fs weather. I watch the news and just think about how f-d we are as a state with regards to our health management right now.  No one is funding drive through testing in my counting right now, though I hear it may happen by the end of January with this next wave. 

I think it's probably best if you test.  I think someone people (those likely need to MCABs) should absolutely test.  But always? Eh, I live in a world more grey than that.

[Hilltopmom]

50 minutes ago, Lucy the Valiant said:

Some doctors recommend 90 days after antibodies diminish (and that has been many many months for some people; less for others  - need antibody test to find out).

Our dr and health dept both said to go  ahead  and get the shot once your off quarantine of you tested positive.. they are no longer recommending waiting 90 days

[Janeway]

I think some people are really in to the testing. They also get in to denial when the tests are negative. I know some people like this.

[BlsdMama]

11 hours ago, MEmama said:

Somehow I’m a bit slow to understand the point of testing for every sniffle or fever. For people who are typically in public *and* would change their behavior if they tested positive, I understand. But let’s hypothetically say that one morning I wake up feeling lousy (I don’t, fwiw— this is purely a hypothetical). My life is such that I’m rarely in a public space, and it’s never truly necessary. DH works from home and doesn’t run errands or go anywhere. If I felt bad, the only possible change to my day is that I could simply order grocery delivery instead of go in person. I would stay home, assume it’s covid, and isolate for probably 2+ weeks cause I’m paranoid like that. In this situation— no kids going to school, no one in or out of my house, nowhere to need to be— is there a point to test? Which would not only use up a test but also require me to go in person, thereby potentially exposing multiple people vs just staying home?

Talk to me like I’m 5. I feel like I’m missing something. 

 

I couldn’t fathom isolating for two weeks on the maybe. It would mean isolating seven of our at home kids from their activities, no college kids visits, no grandkids visits, no visiting grandparents. We’ve had about a half dozen or so times in which we’ve potentially had Covid due to cold symptoms.  Plus, beyond two weeks, we then extended our isolation for another two weeks beyond the last symptomatic person. Heck. No. It could be a month or more every time one of catches a bug. 
 

However, I will add this - took DD10 to Urgent Care today for an earache. Dr told us not to trust the two Binax tests we administered five days apart. He did a PCR. I swear we are the single most tested family in the US currently. And, no we haven’t had it - I did an antibody test a couple months ago. But I do not want to be the person to give it to someone who gets deadly sick. 

Edited December 30, 2021 by BlsdMama

[BlsdMama]

I’ll add though that I am floored by the unreliability. Someone who is asymptomatic? I wouldn’t bother. 36% sensitivity - 

 

https://www.cdc.gov/mmwr/volumes/70/wr/mm7003e3.htm

[Lucy the Valiant]

2 hours ago, Baseballandhockey said:

I am reading that as they are discontinuing the PCR test that is made by the CDC itself.  But there are many companies making PCR tests.

 

I did not realize the CDC itself manufactured the PCR (?); so the lab warning to find a new way to test that includes differentiating for influenza . . . have labs already done that? (I know at least some of the labs in my area do a flu swab at the same time as covid, but some do not.) I haven't heard much about this locally, but just came across it on CDC website looking for something else.

Does the current-in-use PCR test differentiate between SARS-Cov 2 and influenza? (I definitely thought it did?)

from the CDC link (bolding mine):

 

 

Level: Laboratory Alert

After December 31, 2021, CDC will withdraw the request to the U.S. Food and Drug Administration (FDA) for Emergency Use Authorization (EUA) of the CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel, the assay first introduced in February 2020 for detection of SARS-CoV-2 only. CDC is providing this advance notice for clinical laboratories to have adequate time to select and implement one of the many FDA-authorized alternatives.

Visit the FDA website for a list of authorized COVID-19 diagnostic methods. For a summary of the performance of FDA-authorized molecular methods with an FDA reference panel, visit this page.

In preparation for this change, CDC recommends clinical laboratories and testing sites that have been using the CDC 2019-nCoV RT-PCR assay select and begin their transition to another FDA-authorized COVID-19 test. CDC encourages laboratories to consider adoption of a multiplexed method that can facilitate detection and differentiation of SARS-CoV-2 and influenza viruses. Such assays can facilitate continued testing for both influenza and SARS-CoV-2 and can save both time and resources as we head into influenza season. Laboratories and testing sites should validate and verify their selected assay within their facility before beginning clinical testing.

 

 

 

 

Edited 5 minutes later: 

Okay, found this list of the top supplies of medical testing kits - so when the CDC withdraws the EUA request, these companies can still make PCR's and sell them? Or do the companies make them under the EUA granted by the CDC's request? I'm confused as to how that process works. What is the point of CDC withdrawing EUA request?

Edited December 30, 2021 by Lucy the Valiant

[Halftime Hope]

5 hours ago, Matryoshka said:

I saw the FDA report coming out saying some rapid tests weren't performing well, but from what I can tell, Binax seems to be holding up okay.  I read something on here that called out a couple of other brands as being useless, and to make sure I hadn't missed anything I googled, and I can't find anything saying the Binax isn't holding up.  I did find this: 

https://www.nbcchicago.com/news/local/can-at-home-covid-tests-detect-the-omicron-variant-heres-what-the-fda-and-researchers/2716174/

According to the Food and Drug Administration, both the Abbott BinaxNOW and Quidel QuickVue antigen tests are able to detect the omicron variant "with similar performance as with other variants."

However, the FDA based its findings on preliminary studies that used heat-inactivated omicron samples, not live samples. Clinical evaluations using such samples remain ongoing.

Heat inactivation can potentially alter the virus's protein structure, which may lead to changes in test performance that can be mistaken for changes due to viral mutations.

Two other tests, Linea COVID-19 Assay Kit from Applied DNA Science and Revogene SARS-CoV-2 from Meridian Bioscience should not be used, according to the agency. The FDA stated research has found both are unable to detect the variant.

Abbot (Binax mfg) did also put out a press release yesterday (I'm guessing in response to the FDA report) saying at least from their tests (yes, consider the source, but still some data), Binax is holding up well: 
https://www.abbott.com/corpnewsroom/diagnostics-testing/an-update-on-omicron-and-test-effectiveness.html

Abbott has been intently monitoring the mutations of COVID-19 so we can ensure our tests can detect them. We've conducted lab analyses and tests on the Omicron variant from live virus, including from the first U.S. omicron case, and BinaxNOW detected the virus in all tests we performed at equivalent sensitivity as other variants. Additionally, our data from customer use has not shown any change in test performance.

I've seen several posts from sick people who got positive PCRs , and showing photos of it taking another day or two for a rapid antigen test to finally return a positive test, and the photos were clearly Binax tests.  What Abbot is saying above, is that their tests do detect Omicron, but not when they do so.  So it seems that at least for some folks, there is lag time between when the PCRs came back positive and when the rapid antigen tests finally came back positive.  

That really shouldn't surprise us at all, because we know the PCRs are more sensitive. However, what we don't know is if the RATs are sensitive enough to tell when someone is contagious. 

[katilac]

I don't know anyone who tests without a reason. 

[MEmama]

16 hours ago, Baseballandhockey said:

But if you had the virus, and recovered, the PCR can stay positive for up to 90 days.  So, if you need to do something urgently, and get a positive result on that PCR, then it can delay the thing you want to do.  

This is a concern particularly relevant to my family with a college kid living overseas, making travel an occasional necessity.

I’m deeply concerned about the unreliability of testing—if we get covid but test negative for all the reasons that seems to regularly happen, we can mysteriously test positive 3 months later? How is this a workable system? 

[MEmama]

4 hours ago, katilac said:

I don't know anyone who tests without a reason. 

Sorry if I wasn’t clear, I didn’t mean for no reason. More like, since DH and I can and would isolate fully if we get sick, is it necessary to test—assuming, too, since we are fully vaxxed and boosted that it’s mild. We would isolate whether we had a cold or covid; the *being sick* would change our behavior, not a test result, if that makes sense.  

I do understand many families have entirely different circumstances that make testing essential. 

[Pam in CT]

re international travel when PCR positives can show up for months

33 minutes ago, MEmama said:

This is a concern particularly relevant to my family with a college kid living overseas, making travel an occasional necessity.

I’m deeply concerned about the unreliability of testing—if we get covid but test negative for all the reasons that seems to regularly happen, we can mysteriously test positive 3 months later? How is this a workable system? 

My eldest had a (PCR confirmed) asymptomatic breakthrough in early September, and was still showing up (PCR) positive through early December.  She was concerned about this as she had planned to travel to Asia this week (sigh).  Her physician wrote up a letter confirming that she had been exposed and positive in September and had multiple negative antigens since. Daughter submitted that in advance to Singapore Air and got a written clearance that she'd be able to board with a RAT negative.

(Then they called off the trip because Omicron, sigh.)  But I think that's how other airlines/nations are handling the issue already. It's not like it's only Americans who keep testing PCR-positive for months.  All the airlines requiring testing are facing the same problem; there has to be a solution.

[freesia]

1 minute ago, Pam in CT said:

re international travel when PCR positives can show up for months

My eldest had a (PCR confirmed) asymptomatic breakthrough in early September, and was still showing up (PCR) positive through early December.  She was concerned about this as she had planned to travel to Asia this week (sigh).  Her physician wrote up a letter confirming that she had been exposed and positive in September and had multiple negative antigens since. Daughter submitted that in advance to Singapore Air and got a written clearance that she'd be able to board with a RAT negative.

(Then they called off the trip because Omicron, sigh.)  But I think that's how other airlines/nations are handling the issue already. It's not like it's only Americans who keep testing PCR-positive for months.  All the airlines requiring testing are facing the same problem; there has to be a solution.

I know Canada will accept a negative PCR or a positive PCR that is more than 14 days and less than six months old. So, that’s how one country is handling it. 

[MEmama]

43 minutes ago, Pam in CT said:

re international travel when PCR positives can show up for months

My eldest had a (PCR confirmed) asymptomatic breakthrough in early September, and was still showing up (PCR) positive through early December.  She was concerned about this as she had planned to travel to Asia this week (sigh).  Her physician wrote up a letter confirming that she had been exposed and positive in September and had multiple negative antigens since. Daughter submitted that in advance to Singapore Air and got a written clearance that she'd be able to board with a RAT negative.

(Then they called off the trip because Omicron, sigh.)  But I think that's how other airlines/nations are handling the issue already. It's not like it's only Americans who keep testing PCR-positive for months.  All the airlines requiring testing are facing the same problem; there has to be a solution.

I’m glad to hear there are some ways of handling it in certain circumstances. But your daughter was fortunate that her asymptomatic case was caught, which then allowed for the chain of events that followed. Most asymptomatic cases won’t ever be tested for, so there would be no paper trail, as it were. And that’s deeply concerning— I could have Covid today and not have any idea, but then in the spring I might test positive for something I didn’t even know about months earlier and have a life plan completely derailed for no reason. Or DS might have to miss an entire semester because of a test result that has zero relevance (again, assuming he could be asymptomatic today but gets a positive test when he returns to Ireland). 

I was awake for hours in the middle of the night stressing about this scenario. In no way am I against testing, but if it isn’t reliable it seems like it’s causing an awful lot of headaches and needlessly—even dangerously, in the case of surgeries for example—derailing a lot of lives.

[MEmama]

49 minutes ago, freesia said:

I know Canada will accept a negative PCR or a positive PCR that is more than 14 days and less than six months old. So, that’s how one country is handling it. 

I think this is pretty standard protocol, but the issue is that if a case— even an asymptomatic case— isn’t initially caught or the tests are inaccurate, it all falls apart. The whole system relies on accuracy, and it seems that doesn’t exist. 

[freesia]

1 minute ago, MEmama said:

I think this is pretty standard protocol, but the issue is that if a case— even an asymptomatic case— isn’t initially caught or the tests are inaccurate, it all falls apart. The whole system relies on accuracy, and it seems that doesn’t exist. 

Yes, that’s true and definitely nerve wracking for those of us whose children go to school out of the country. Although, in dd’s case, she’d just need to wait 11 days (3 for the test 72 hours ahead plus 11 to get to 14.). When I went to university in Ireland the grade for the year was based on final exams in May. Has that changed?  I’m not arguing with you that the unreliability is a problem at all. I just don’t know what a different solution would be at the present time. But I am trying for myself to keep perspective. I’ve been way too stressed trying to will things to go my way. There’s not much I can do if dd has to wait a couple more weeks to go back. She will miss stage managing a play that’s only for January, but she can do classes online.