Testing

I am curious to know what the general public think about getting tested. There is much discussion about needing additional testing, but is there enough "advertisement" about the importance of seeking testing, particularly when symptomatic? How many symptomatic people are NOT seeking testing? And if there is suspected spread by asymptomatic carriers, then why, when an individual with "obvious" covid symptoms presents for testing (they are usually with a family member who lives with the individual), why aren't we foregoing the test on the symptomatic person and testing the asymptomatic one living in the same household? That makes more sense in my opinion. The daily reported numbers are like smoke and mirrors to me.

Comments

  • Hi: This is AJ Plunkett, an editor for HCPro and DecisionHealth. We went to Ivan Gowe, an infection preventionist at Pardee Hospital in North Carolina, with your question. Here are his thoughts (lightly edited for clarity):

    Gowe: "I am noticing a lot of communication, advertising testing for symptomatic and exposed persons, though that varies by state. The following is a statement from the North Carolina Department of Health and Human Services website: “Anyone with symptoms of COVID-19 or who has been exposed to someone with COVID-19 should consider getting tested. NCDHHS issued updated guidance on who should be tested for COVID-19. The new guidance recommends that clinicians test any patient in whom COVID-19 is suspected.”

    An operational snag with testing is that there are many people who want testing when they do not meet criteria. They are curious, some are afraid, and many do not understand the way the existing tests work. Limited re-sources in addition to these human behavioral factors are forcing healthcare providers to be more tight-fisted about testing.

    [As for the symptomatic people who are not seeking testing] the guidance to stay home with mild illness may drive this. The only value of the test is to say, “Yes, you have COVID-19” since there is not treatment. If I have mild illness, I would not venture out to a doctor to get tested if there is nothing more that can be done about it. Flu testing makes sense because there is medicine I can get. Testing for COVID with mild illness does not make sense to me. That would be my reason to be in the number of people who are symptomatic but do not seek testing.

    [As for testing asymptomatic individuals in the same household], the symptoms of COVID-19 are so varied, providers want to be sure they are dealing with COVID so they are testing the symptomatic patient. I expect that if testing kits are readily available, the family should be tested as we do during flu season. Some of this might also be due to the varied availability of testing kits in various locations. Under ideal conditions, your idea is a reasonable one.

    While the data may seem like “smoke and mirrors,” all data can have value. The tests results “are not 100% accurate, but they are not worthless data. Inaccurate data are more helpful than absolutely no data. It is prudent to look at any data report and analyze it for its inaccuracies (which I think you have done), then use that data within its limitations.”

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