Inside Medicine. What Are You Seeing? [COVID-19 medical news]

@Maryland Joe thanks again- got my two kits!

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I almost feel guilty that I cancelled a PCR drive through test today at UCSD. I had made the appointment about two weeks ago (after they cancelled my 12/24 appointment; it was the first available) because we had gone to an indoor unmasked party with fully vaxed and boosted attendees, and an outdoor meal with a group of same protection friends. But in the meantime, I was able to get a test at Walgreens on December 27 which came in negative.

Since that test, I have quickly run through two small groceries (everyone masked) and one dinner out on an almost empty patio (all staff masked). I figured the chance of me encountering a viral load since my negative test was infinitesimal. And hopefully someone who needed the test took my place.

But of course Iā€™m second guessing myself!

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Why would you need to get a test today? If you have no symptoms and donā€™t need it for a specific reason itā€™s best to let someone that really needs it take that test slot.

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Thatā€™s why I did cancel my appointment, but everyone is trying so hard to get tested! I rationally know there is no need to double check to see if Iā€™m asymptomatic. I need a test for paranoia, I guess.

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I think you did the right thing. I wasnā€™t trying to be critical of you in particular.

I do believe more need to be less paranoid so that tests are more available for those that really need one.

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@homerdog try.

For those using the CUE systemā€¦

"Cue users who receive a positive test result for COVID-19 will be able to opt-in to SARS-CoV-2 variant sequencing. After consenting to participate in this study, users will receive a same-day sample collection kit with a prepaid return shipper via Cueā€™s last-mile delivery partners. The Cue Health App will guide users through a simple, lower nasal swab self-collection to obtain their sample for sequencing. Returned samples will arrive at Helix for immediate processing, and results from Helix will be shared with the individual through the Cue Health App within ten days. This fully integrated and connected workflow will help expedite sequencing information turnaround time, while providing those tested with insight about their role in pandemic response and containment.

'Helix and Cue Health Collaborate to Provide Individuals with Access to their COVID-19 Variant Sequencing Information

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Preprint studying antibodies from small numbers of people finds that antibodies from prior infection (convalescent) or various vaccines have much reduced neutralization against Omicron. Neutralization reduction was least but still substantial in those who had both prior infection and Pfizer vaccine (prior infection with other vaccines not checked). Vaccines were just primary series (not boosted) and included Moderna, Pfizer, AstraZeneca, J&J, Sputnik V, and Sinopharm BBIBP.

Thoughts on this situation.

Last Friday (NYE), co-workerā€™s family (co-worker, W, infant, middle schooler) all come down very sick with sore throat, congestion, coughing. Couldnā€™t find any PCR tests, but found 4 home tests. W is immediately bright line positive, co-worker, middle schooler are negative. Weekend was rough, but Monday is feeling better. Co-worker goes to clinic and tests negative - I assume itā€™s a rapid because Iā€™ve never heard of a PCR test coming back faster than 2 days here.

Co-worker had covid last year and 1 shot - to which he reacted terribly, so he skipped the second. he was contemplating getting it, but I donā€™t know if he did. W was not vaccinated due to Dukeā€™s recommendation while (super high risk) pregnant, and was concerned that her type I diabetes wouldnā€™t do well with it. But, she was looking to get her first shot the beginning of Dec. Iā€™m not sure if she ever went. Unsure about the middle schooler.

Do you think it was covid or not? He is currently sitting in my office about 12 feet from me with no barriers between us, and will likely be here all day. He is masked, for now. He hates wearing them, so Iā€™m not sure how long that will last. Workplace does not require it. I have my air purifier going and my paper mask on. Joyā€¦

Yes, I would assume he had it.

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Edited because of timeline. Iā€™d agree he had it. At this point he should be quarantined.

Isnā€™t the advice to assume the person has it? So, since he only got one dose of the vaccine, this would apply:

ā€œFor people who are unvaccinated or are more than six months out from their second mRNA dose (or more than 2 months after the J&J vaccine) and not yet boosted, CDC now recommends quarantine for 5 days followed by strict mask use for an additional 5 days .ā€

He shouldnā€™t have come back yesterday or today, but he would technically be correct to come back tomorrow (as he is ā€œimprovingā€). However, note the ā€œstrict maskā€ directive. There is the weak spot.

Iā€™d try to work from home. Can you do that?

P.S. Any school system that is allowing the weakened CDC guidelines re isolation and quarantine will be violating the ā€œstrict mask usageā€ guideline immediately, unless they will be denying those students food, drink and PE (masks allowed to come off during PE where I am; probably other places, too).

And these are the school districts WITH mask mandates. Where they are not allowed (no-mask mandate), there can never be any adherence to the CDC guidelines. Then again, many places have always considered the CDC guidelines to be on an ala-carte basis ā€“ follow the ones that you want to and ignore the rest, all under the guise of not being ā€œfeasibleā€ or ā€œpracticable.ā€

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Nvm

Heā€™s sitting he maintaining over and over that W is a false negative and heā€™s fine. But, now heā€™s saying they got sick on the 29th, so thatā€™s better with the new guidelines. They couldnā€™t find the home test until the 31st. Anyhow, our workplace doesnā€™t follow CDC guidelines very well. They donā€™t even want us testing unless we have symptoms even if youā€™ve been in close contact with people. And masks are only if youā€™re within 6 feet of someone for more than 15 minutes - and thatā€™s not even enforced as Iā€™ve been in meetings with the big wigs (and the ones you would complain to), and they are all happily violating protocol.

And no, I canā€™t work from home. Iā€™ve asked and been denied. The person who would approve it still maintains that his secretary who hasnā€™t been able to work full days for 4 months isnā€™t that way because of covid. The heart and lung problems arenā€™t from covid. She got better (after 3 days) and then got pneumonia. the pneumonia isnā€™t related to covidā€¦

Iā€™m not THAT upset because Iā€™m sure Iā€™m exposed plenty everywhere. But, itā€™s still highly irritating that I have to be here without a choice.

If W had a positive test then I would say yes, everyone had Covid. Rapid antigen testing has a 0.1% chance of being wrong, so trust that positive test in the W. Knowing how infectious omicron is, the other close contacts would be positive as well. The other tests may have been negative due to inadequate sampling or timing. They may still be in the infectious period but a negative test in the clinic is somewhat reassuring that they may not be infectious. Donā€™t know if the clinic test was PCR or rapid. If PCR, youā€™re good. If rapid, I would feel better if it was OP and nasal and not just the nasal area that was swabbed.
Hereā€™s a chart showing why you trust the rapid positive:

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You mean false positive, right?

" W is immediately bright line positive,"

My area doesnā€™t follow CDC protocol very well, either. They know better, they think.

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oops. yes. I meant false positive. The health clinic agreeing with him doesnā€™t help. But omicron has definitely arrived. Our 7 day average of daily case per 100K slowly increased from the 20s in early November to the 40s when we got back last Wednesday. In one week itā€™s jumped to over 150.

Looks like they all had it, although if your coworker previously had COVID-19 and one dose of vaccine, he may have had a strong enough immune response to produce symptoms before rapid testing shows virus (note recent posts by @TexasTiger2 on the subject) and vanquish the virus quickly enough that an infrequent testing interval missed the detectable period.

It would still be better if he could rapid test every day before coming to work in person, although if tests are scarce, that may be hard to do. For your own protection, wear the best mask you can ā€“ typically a well fitting genuine N95, KF94, KN95. If you only have surgical masks, use the mask hacks to close the gaps on the sides as much as possible.

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I donā€™t think itā€™s as clear cut as others believe. Our family has had an unpleasant cold going round all Christmas, with the same symptoms as Omicron. But we have been testing repeatedly on PCRs and rapid tests (7-8 times each in 3 weeks) as we traveled to the UK and visited relatives. Everyone tested negative, except one cousin who picked up COVID elsewhere (fortunately that was after we saw him). But no one else in the family appears to have caught it from him.

So I could imagine a situation where the family all got a cold and one member also caught COVID elsewhere at about the same time. If the one positive case isolated then others may not catch it. OTOH if the family didnā€™t isolate from each other then I would worry that the rest of them may test positive up to 5 days later (as happened to SIL when her kids got it last fall).

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Itā€™s hard to remember bad thingies - other than the Covidians - are still out to get us.

We did our first get away since March 2020. A day after returning I was suddenly slammed with chills, a headache, an elevated heart rate and a mild temperature. But of course - it must be covid. A rapid test = negative. twelve hours later I take a NAAT test also negative. Hmmmā€¦Then another 12 hours laterā€¦oh waitā€¦this is familiarā€¦yup. UTI.

A family of 5 - all have cold symptoms. Only one ever tested positive for COVID.

There also is a bit of hemming and hawing and gulping going on by the PTB in regards to ā€˜trusting the testsā€™. Although that particular messaging rings like the ā€˜donā€™t wear masksā€™ tune which was based on availability rather than science.

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