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Old 03-22-2020, 11:20 AM
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Is there a reason for people who are already self-quarantining to be tested?


Yes, more information is better than less information, for the science and predictive aspects.

What I don't understand is the furor over not having enough test kits to test the vast majority of the population RIGHT NOW. What's the importance of testing people with mild to middling symptoms who are already basically in quarantine?

It's not like there is a magic cure that must be given within X days of symptoms appearing in order to greatly increase your chances of recovery, is there?

The impression I've gotten is that if you have basically an 'ordinary' case, with symptoms like low level fever, muscle aches, sneezing, congestion, and you get tested, then one of these two things happen:

The test comes back negative, and you have an ordinary cold or flu. The doctor tells you to stay home, avoid contact with other people, get lots of rest, drink fluids, eat sensibly, and wait for your body to heal itself.

The test comes back positive, so you have the corona virus. The doctor tells you to stay home, avoid contact with other people, get lots of rest, drink fluids, eat sensibly, and wait for your body to heal itself.

The only difference is that in the first case you may be a little less worried (and you shouldn't be too worried anyway, because all along they've said mild cases just pass in a week or two.) Stay home and the only people you can expose are those in your house and they'll no doubt already have been exposed to what you were carrying for days before the symptoms appeared.

(Well, I guess in the second case you can justifiably buy a "I beat the Corona Virus' t-shirt.)


Yes, there are people who should be tested, the people whose jobs force them into close contact with a lot of other people. And those unfortunates who get really bad cases and need to enter the hospital where the doctors will need to know what exactly they are testing for.

But what's the point of testing tens of thousands of ordinary people who are following the isolation rules and just have coughs and such no worse than any other flu?
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Old 03-22-2020, 11:43 AM
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In my opinion the reason South Korea managed to get control of the disease is because they are testing everyone. If everyone who has the illness knows they have it, and isolate until they are no longer contagious, the disease would likely disappear within a month.
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Old 03-22-2020, 11:45 AM
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I think it's more a panic response than anything else.
However, if you go and lock yourself in your house and promise to stay there for the length of time that it would take to go from getting infected to no longer being contagious, then I don't see any real reason to get tested. No more than needed to get tested for any other virus. This of course assumes you don't get sick to the point of hospitalization.

But people want to know for sure. I came down with a nasty cold on Monday. Had several of the COVID symptoms, but no fever. I did talk to a doctor who didn't seem concerned, however, if tests were available and cheap, I would have preferred the peace of mind. It would have been helpful to have definitive proof every time I coughed and people looked at me like I had the plague.

Something else to keep in mind. There's no reason why you couldn't test negative today and catch it tomorrow.
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Old 03-22-2020, 11:46 AM
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In my opinion the reason South Korea managed to get control of the disease is because they are testing everyone. If everyone who has the illness knows they have it, and isolate until they are no longer contagious, the disease would likely disappear within a month.
And along those lines, there would be a lot less restrictions since the people that tested negative (and should probably be retested every X days) could go on with their lives like they normally would.
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Old 03-22-2020, 12:00 PM
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South Korea, I think, tested 200,000 or so people out of a population of fifty million? The numbers may be slightly off, but that is still 0.4%. It’s impressive. It’s in a fairly homogenous and autocratic country. It’s more tests than others have done. But hardly everyone.

Singapore is a very small and autocratic country with a highly paid and competent government. They have also done better than most. But it may be hard to scale their successes.

It is still unknown how contagious people with mild symptoms really are. It may be that mild cases can spread the virus to 2-3 other people. These other people may have serious reactions to the virus, leading to death. If you have mild symptoms and are self-isolating, testing is less important. If you have coronavirus, but it seems like a cold or has no symptoms at all, and are going to work and not strictly isolating (since you don’t know you need to), you can put others at risk.

The first reason for testing is it would give us the data to make better decisions. The second is that if you knew you were isolating most of the positive cases than you could possibly relax distancing measures sooner and for people not exposed.

A lot of people with no or mild symptoms may not be “basically in quarantine”. But if testing is limited, you are right that quarantine for mild possibles and priority tests for severe cases is a better strategy.
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Old 03-22-2020, 12:03 PM
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The retesting point is relevant, and would also be necessary (but not necessarily beneficial) to strictly prove recovery. No one even knows if and when you could recatch coronavirus.
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Old 03-22-2020, 12:04 PM
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Duplicate due to server error.
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Old 03-22-2020, 12:37 PM
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IMHO only testing those meeting the current criteria (travelled to a community spread area, showing respiratory symptoms, having been close to someone already tested positive) is self limiting: we have no way of understanding if the virus manifests differently (though there are plenty of anecdotal stories of people who tested positive and had no symptoms, or unrelated symptoms to those that are typical.)

We don't know what we don't know, and as others have pointed out, without widespread testing, there's no way to estimate the denominator of known cases. These could lead to further spread by people who are "loosely" quarantining but break quarantine because they don't have the specific symptoms, but may nonetheless be carriers.

I am personally frustrated by the inability to get tested, as I am self-quarantine from my family within my own house. I returned from the UK recently and late last week developed a fever, diarrhea, and a persistent headache. I don't have any respiratory symptoms so don't qualify for testing, but I'm in a holding pattern wondering if symptoms will progress, whether I'll remain subclinical, or just don't have it. I have no way to know but Day 4 of being confined to one room/bathroom is starting to wear thin - I wish I had some more certainty. It seems more people are testing positive with non-respiratory symptoms....I just wish I knew.
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Old 03-22-2020, 12:51 PM
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Quote:
Originally Posted by Joey P View Post
And along those lines, there would be a lot less restrictions since the people that tested negative (and should probably be retested every X days) could go on with their lives like they normally would.
Do you realize how many test kits and lab capacity we would need to test everyone every week?

Last edited by CarnalK; 03-22-2020 at 12:52 PM.
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Old 03-22-2020, 01:23 PM
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What I see in my community is a lack of adequate capacity to test symptomatic people, and support for getting more test kits for this reason.
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Old 03-22-2020, 04:14 PM
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Originally Posted by susan View Post
What I see in my community is a lack of adequate capacity to test symptomatic people, and support for getting more test kits for this reason.
But the OP's point is that there is not really a need to test even symptomatic people right now. Sure, when production is ramped up and you can buy a Covid-19 test kit like you can an OTC drug test kit for your kid then lets collect the data. But when there are shortages, let's save them for people in the hospital who have serious illnesses so doctors can treat those people appropriately.

Otherwise, if you are just congested or have a fever, self quarantine and act like you do have the virus: plenty of rest, liquids, etc. Don't waste a test that is in short supply.
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Old 03-22-2020, 07:34 PM
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Maybe I should be clearer: What I see in my community is a lack of adequate capacity to test symptomatic people who have the symptoms of the thing we're talking about, and the hospitals want to test them for that thing, even if they've been in self-quarantine, because symptoms.
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Old 03-22-2020, 08:53 PM
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Does the test also test for antibodies?

I am thinking supposing I had a mild case. Now a a few weeks later I test and come up negative for the virus. But I would think I could still get it, with antibodies, I know I couldn't get it again or reinfection would be less likely at least.
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Old 03-22-2020, 10:02 PM
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You want people tested so you know who has immunity (or probably has immunity). There have been a few anecdotes of people getting covid twice but I haven't seen anything that suggests this is actually the case versus people that were not fully recovered who developed symptoms.
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Old 03-22-2020, 10:40 PM
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Originally Posted by Dr_Paprika View Post
The retesting point is relevant, and would also be necessary (but not necessarily beneficial) to strictly prove recovery. No one even knows if and when you could recatch coronavirus.
That's similar to what food employees have to do for specific illnesses. If they're diagnosed, they have to get a note from a doctor stating they're clear to work. What any specific doctor does to decide you're in the clear likely varies. However, the docs are usually working with local health departments and health inspectors tend to follow the letter of the law.

Quote:
Originally Posted by CarnalK View Post
Do you realize how many test kits and lab capacity we would need to test everyone every week?
Cut me some slack, it was a hypothetical. Besides, as far as I know, we don't even have the resources in place to test everyone once.
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Old 03-22-2020, 10:58 PM
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I screened positive, but cannot get tested. It would be nice to know. Like, really nice. It would also make a difference if my symptoms worsen, and I have to go get care. I do/do not have Covid-19 is way more useful info to intake personnel, than “maybe I got it, maybe I don’t”
Lastly, were I found positive, and survive it, I could act and live differently in the months to come, and if things really go to hell, volunteer because of presumed immunity. Even right now, a negative diagnosis would mean the end of me and those in my house maintaining social distancing from each other while in quarantine
I understand that limited availability means tests should go to those with severe symptoms, and frontline personnel (and other essential people, like NBA players apparently). I take issue with the fact that the supply is limited. I’m not saying that everyone should be able to get tested whenever they feel like it - but when you have the symptoms, not being able to find out is a ridiculous situation to be in in an advanced economy in the 21st century.
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Old 03-22-2020, 11:37 PM
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Good information helps us target the level of social isolation we need in different places. If we had perfect information about who was exposed, we could probably get through this without much disruption.
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Old 03-25-2020, 10:47 AM
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It's a absolute travesty that more cannot be tested, and the CDC guidelines are so strict that people are seeking testing, getting denied, and then later entering the hospitals in critical condition. You pretty much to be in the high risk category and be exhibiting the worst symptoms to even get a test.

This is ridiculous. I understand their is scarcity of test kits, but isn't this what we were promised weeks ago would be resolved? This is a huge failure, and IMHO likely be design - limiting testing limits confirmed cases, and our president likes "low numbers" in relation to this. Meanwhile, there are hundreds of thousands showing some symptoms that can be sure what they have, whom likely are spreading it, even when they self quarantine, to family member.

I've had persistent symptoms for a week but cannot get tested. My wife is a healthcare provider who needs to be back at work, and the uncertaintly of whether she's been exposed is uncalled for. We need to start broader testing ASAP to better understand who has it and may be contagious without knowing it.

--Joe
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Old 03-25-2020, 10:49 AM
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Testing would provide data, but also testing will allow a person to know they had it, once recovered would be immune to it. Without the testing the person could never know.
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Old 03-25-2020, 02:22 PM
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Testing would provide data, but also testing will allow a person to know they had it, once recovered would be immune to it. Without the testing the person could never know.
This is unknown. You can get the seasonal flu more than once. It's not necessarily like the chicken pox.
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