COVID-19 has become a regular fixture in the respiratory virus season. The public is familiar with the ebb and flow of COVID-19 outbreaks, often triggered by new variants. But the landscape continues to evolve, including when it comes to testing. With mobile test units and drive-thru sites all but gone, at-home rapid tests are now the predominant method to diagnose respiratory illness symptoms.
Dr. Traci Marquis-Eydman is program director for the Rural Family Medicine Residency Program at Quinnipiac University and a primary care physician at Hartford HealthCare. She joined Connecticut Public’s Morning Edition.
With new variants, are rapid tests still effective?
“It's complicated,” Marquis-Eydman said.
The rapid tests are helpful in telling if somebody is positive for COVID-19, she said.
“What they're less helpful for, is in telling you if you're negative,” she said. “People shouldn't use them as a fail-safe mechanism to say, ‘I'm safe’, or ‘I'm clear.’ They're really meant to capture the positive more than to rule out the negative.”
Are we using these rapid tests correctly?
Experts have said tests aren’t meant to be used to make sure everybody in a family is negative on the day they pile into the car and visit grandma. Marquis-Eydman agrees the rapid tests are much better at detecting positives and people who have symptoms, as our bodies get better at fighting the virus.
“Many have been vaccinated. And even with these newer strains, we still have some antibodies circulating that protect us,” she said. “But when you test for COVID, with a rapid test, really what you're seeing is: ‘Do I have some of these proteins from the virus in my nose?’ So if we don't get a good swab, or you were exposed very recently, and don't yet have those proteins in your nose, you may test negative and think that you're OK.”
At that point, you could be carrying something around that could infect somebody else; you just haven't developed the symptoms yet, Marquis-Eydman said.
“The issue is that the prevalence of the virus and many forms is so out there, either so many people that have been exposed or have had the virus or have it and may not even realize they have it, they think it's a sniffle,” she said. “And they don't realize it's a milder version [of COVID-19].”
What to do if you show symptoms?
Assume that you have a virus that could be transmitted to others, Marquis-Eydman said.
“There are many viruses out there that can get our more vulnerable people sick,” she said. “RSV, influenza, even the common cold can affect some people more severely.”
If you have symptoms, it's best to stay at home, or wear a mask, she said.
“But again, if you test negative, it doesn't mean you don't have it,” she said. “It just means that you're testing negative.”
What to do if the U.S. Centers for Disease Control and Prevention loosens quarantine guidelines?
A couple of states have already loosened isolation times, but a recent article in the Washington Post said the CDC may soon drop its five-day isolation guidance for people with COVID. If the guidelines are approved, quarantine would no longer be recommended if someone didn’t have a fever for more than 24 hours.
If isolation guidance does change, Marquis-Eydman said she would tell patients who have tested positive to monitor symptoms.
“ I will still encourage patients to quote unquote ‘do the right thing,’” she said.
She notes that COVID infections, as well as flu cases, continue to cause a significant number of hospitalizations. And she encourages people to consider getting vaccinated. “I'm hopeful that because the virus is so prevalent that many people have protection circulating within them,” she said. “If you have a disease or a condition that puts you at higher risk, or you're in a situation where you have a loved one at home who's at higher risk than you may want to be a bit more careful.”
If you want to test or you have a job that requires it, when is the appropriate time for a follow-up test? And how many times should you test after being positive?
Marquis-Eydman said the current guidance is unclear. But if the CDC relaxes quarantine guidelines, and if employers stop requiring people to have a negative test to come back to work, it may limit the need for follow-up COVID-19 tests.
“Frankly, if you already know that you're positive, early in the course of the illness, and we know it takes approximately five to seven days to be less likely to be spreading the virus to others, why do we retest?” she said.
Repeat testing may be more necessary for those who work in health care, or who are around people who are vulnerable or high-risk, Marquis-Eydman said.
