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

That’s because the test was not designed nor approved to use in the throat.

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Yes cheeks have worked

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I understand that, but it seems as though the test is detecting Omicron in the throat/cheek but not finding it in the nostril. The test was approved pre-Delta & pre-Omicron.

It is beyond pathetic that the US did not ramp up production of rapid tests, including saliva, but I suppose that is off topic.

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The UK has always done nose and oropharynx.
When the CDC put out guidelines or advisories in the past, they always had data to back it up. Now with saying you can go back to work after 5 days of symptoms if those symptoms are resolving? Where’s the data to back this up? Now it appears symptoms are showing early in the disease course, with rapid antigen turning positive a few days later because as soon as the body recognizes the virus (when circulating antibodies are present), the immune system immediately starts responding. It takes a few days for the viral load to climb high enough to turn the tests positive. Then, after the 5 days, people can return to work but are still in the infectious period. Everything has shifted to the left in Michael Mina’s chart posted above. No recommendation for a negative test first? I’m starting to lose confidence in them.

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I agree. And today, after significant pressure, CDC updated their isolation guidelines, stating the best approach is to use an antigen test before ending isolation.

If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period.

https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html

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So vaxxed under 17 no quarantine if a close contact but 10 day masking requirement? Who is going to keep track of that?

I did a Binax test yesterday and had no issue with the swab length for throat (and nose).

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And……good luck with that whole finding a test thing.

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The original free NHS rapid tests required swabbing throat and then nose (those handed out through about September). More recent batches are mostly nose only (we were just there last week) and there doesn’t appear to be any suggestion that they will go back to the original method.

For obvious reasons swabbing the nose only is much more popular, as you don’t need a mirror and won’t gag. I’d guess the new swabs are cheaper too, as they are much smaller. No one seems to feel that the new test method is less accurate: I would have expected to see it in the British press if that was a concern.

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Ok thank you for the correction!

And there you have it - large hospital system (over 26,000 employees). Just got the word that no new surgeries (including cardiac caths, colonoscopies) can be posted for the next 2.5 weeks because of current and anticipated staff shortages. And those that are currently posted may be canceled. This excludes emergency surgeries (ones that have to be performed within 24 hours). Any patient testing positive (which includes the asymptomatic who are tested as part of routine pre-op work-up) will be canceled but emergent cases may proceed at the discretion of the physician. To free up beds, the hospital is offering to pay for patients to stay in nearby hotel rooms if deemed medically cleared by the physician. Any surgery that may require prolonged stay in an ICU bed or a lot of transfusions (nationwide blood shortage) is encouraged to be delayed.

San Diego County and its major hospitalization systems are in the worst shape yet. Twice they’ve suspended the ER ambulance diversion program. Previously we’ve never been anywhere close to capacity. It’s a relatively well vaccinated populace, although the latest statistic I saw is that only 28% are boosted.

Right. That would mean no unmasking at school. So no eating, no PE (masks are removed for PE in my school district)…it’s just not going to happen.

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Are ER patients who are not admitted, counted in hospitalization counts?

I don’t think so. I think hospitalization means admitted.

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Kudos to Mayo!

I should probably add that 700 workers is < 1% of their 73,000 workers and their statements are:

“While Mayo Clinic is saddened to lose valuable employees, we need to take all steps necessary to keep our patients, workforce, visitors and communities safe,” the clinic said.

and to those opposed:

In the statement, the clinic said that “based on science and data, it’s clear that vaccination keeps people out of the hospital and saves lives.”

“That’s true for everyone in our communities — and it’s especially true for the many patients with serious or complex diseases who seek care at Mayo Clinic each day,” it said.

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Update to my situation. After listening to coworker whine about wearing a mask all day and it was suffocating him, and he was fine… This morning I texted him the article below and said I found it very helpful determining what results could mean… Then he backtracked his original description of low grade fever, sore throat, coughing, shortness of breath (W) and that they almost took the baby to a high risk hospital out of town… Now he said they all felt great and just had runny noses and then said some ugly things about a certain country and their people.

Anyhow, he had to go back for a follow-up test. Guess who was positive? No I will not say a word when he comes back Monday.

But I did find this helpful. Apologies if it’s been posted before

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Of course, if rapid tests were readily available and inexpensive, people could test just before going to where they may expose others, and higher risk venues (e.g. eating or drinking in indoor restaurants and bars, indoor workplaces) could require rapid testing before entry, since rapid testing turns positive approximately when one is contagious.

Here is the basic summary of tests:

  • PCR
    • More sensitive, finds whether you are or were recently infected, although you could be in the pre- or post-contagious state. Best for diagnostic testing for making medical decisions.
    • Not convenient, and delay in reporting results makes them less useful for precautionary testing (just before going to where one may expose others).
  • Rapid antigen
    • Less sensitive, may not find all infections.
    • But tends to detect when one is contagious, so can be useful for precautionary testing if one has a large supply that can be used at will. (However, they are not inexpensive or available enough in the US for this to be the case for most people.)
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I have learned that a major hospital in a large city has told its staff that they can no longer do contact tracing notifications for Covid positive staff members. They will only notify immune suppressed patients who may have had contact. They have too many cases to keep up with.

Our plan for the tests was to take the day we were seeing my immunocompromised FIL. But his doc nixed the visit so we had them. So I see them as handy for a specific event on a specific day. And you can’t get PCR around here to save your life!

We washed our hands when we could, but kept hand sanitizer in the car for when we couldn’t.

NYT article says home tests 85% accurate. And that the tests are more sensitive with people with symptoms than without and are most sensitive during the first week of symptoms.

FDA testing:

The BinaxNOW test correctly gave a positive result 84.6% of the time compared to PCR. In the same study, the test correctly gave a negative result 98.5% of the time. https://www.fda.gov/media/141570/download

The Cue COVID-19 test correctly gave a positive result 92% of the time compared to PCR. In the same study, the test correctly gave a negative result 98% of the time.
https://www.fda.gov/media/138826/download