TLDR background, feel free to skip): My organization has grudgingly decided to accept negative COVID test results within 72 hours of admission to our facilities, instead of proof of vaccination.
We’re not happy about it, but given our location (Hilo, HI, where there is a fairly large community of well-intended and sweet but kinda “spiritual” types whose critical thinking facilities have been damaged by woo) we need to be tolerant or we’ll lose participants and revenue at a rate unacceptable to a struggling non-profit that just wants to hold ourselves together well enough so that we can enrich people’s lives.
So …in the first real test of our recently finalized rules, it falls to me to be “Covid Police” in a couple of weeks. I will be checking people’s vaccination documentation or test result credentials. We have ruled that home test results are not acceptable - people need to bring proof of a negative PCR test if they want entry.
SHORT VERSION: How can I tell if I’m being offered results of a negative home test (not good enough) or an “official” PCR test? I’ve seen the home test, having taken one myself twice; it just looks like a pregnancy test. No dates, no indication of who took the test, so very easy to cheat. And I suspect a high false negative rate as well.
Will PCR tests be better documented? I’m hoping that people should be able to provide a document that gives name, date, and certification from a pharmacy or clinic showing that a Covid antigen test was performed and came back negative.
Antigen and PCR tests are not the same thing. Pharmacies and some testing centers do both. The antigen test is typically a rapid test. PCR tests for viral DNA. I would expect anyone who got a real official test to have a document with name, date, and results. I would hope it also includes what kind of test it was.
ETA: I just checked my healthcare app, and it shows a covid test I took and the date and result, but it does not specify that it was a PCR test. Perhaps I could get a printout from the provider with more details though.
Wouldn’t the people in your organization responsible for this decision also be responsible for providing guidance and clarity on acceptable forms of proof? Maybe ask them what, specifically, they are expecting to see, so there will be no assumptions, and you don’t get caught in the middle between your organization’s rules and the public.
The people responsible are … me and some other long-suffering volunteers.
We seek the provision of “guidance and clarity.”
That’s why I posted. You seem to assume I work in some well-funded, well-connected organization that can find easy answers to tough questions. Actually, I work with a highly committed, over-stressed group of volunteers (of which I am one) who just want to do the right thing.
There is no overarching organization that can tell us what to do. If there were, I would not ask.
Wait. So you are saying you and others in your organization made the decision to require PCR test results for people to enter, but you don’t know what one looks like?
Every PCR test I’ve taken over the last year or so has come with an official document that indicates what the results of the test are, along with name, date, lab certification, etc.
(I had to provide these for travel to other states last year.)
Maybe I should clarify, in hope of reducing the level of incredulity here. The people formally involved (virtually all long-suffering volunteers) in my organization want to do the right thing. We are all science followers, and all vexed and boosted.
Part of our mission is to help artistic expression in our community. This involves activities like allowing local amateur orchestra groups to use our theatre for practices and performances.
We would like to help such amateur music groups thrive. We also want to be responsible members of the community who don’t allow anti-vaxx nonsense to contribute to the spread of a disease that can be mitigated through science.
Hence, we want to require that everyone who enters our facility be vaccinated. Sadly, there are enough vaccine skeptics in our community that we would hurt valuable activities like community orchestra if we didn’t try to meet people half-way.
Our “half way” is to demand either vaxx proof or a negative COVID test prior to admission. This is not weird or innovative; many organizations are adopting such a rule. Why shouldn’t we?
The fact we need help distinguishing between home (unreliable) tests and genuine antigen tests suggests we need assistance. I asked for it here, and hope I’ll get it.
Home tests are antigen tests. An antigen test performed at a pharmacy will have better documentation, but it’s the same kind of test as a
rapid home test. So, you’d eliminate the problem of not having documentation of who took the test, and when, but it still won’t be as sensitive of a test, particularly with omicron.
If you want to only allow the more reliable PCR test, that’s PCR, not antigen.
My understanding (fortified through personal experience of seeing how much the home test relies on an individual’s willingness to experience the discomfort of a self-directed swirling a swab high up in the nasal passage) is that home tests, which are always antigen tests, aren’t that reliable.
PCR tests, on the other hand, are performed and managed by someone other than a possibly squeamish individual testing themselves, and are more reliable.
PCR tests are the gold standard, but the tests really fall into two types for your purposes: monitored and unmonitored.
Unmonitored tests are done by the patient and are either self-processed or sent into a lab. There are either no written results (paper or electronic) or there is no guarantee that the sample came from that patient if there are official results. Most, but not of all of these, are rapid antigen tests. No proof of who or when the test was done.
Monitored tests are either remotely proctored or performed in person by a tech/pharmacist/nurse etc. They could be Antigen (Lateral Flow to our UK) friends, NAAT, PCR-LAMP, or other PCR test. The big difference is that they will almost always come with a document from the lab with the name, date, and result.
Wow, okay, that complicates matters. So I wonder, what are all these places that demand “negative test results within 72 hours” basing the time stamp on? Just the honor system?
FWIW, none of the PCR tests I’ve seen has come with an official-looking document – in two cases I got a phone call, and in the other two they told you results were available, and let you go to a web site and log in to see what they were. My daughter’s was performed by the largest PCR-testing lab in the state, and all three of mine were done at a major hospital (but probably actually tested by the same lab.)
Maybe the lack of a formal-looking letter is why people are told to get someone else to do the test if you need proof for travel. (although this lab does almost all the tests in the state for people who actually want to know if they are sick.)
The issue with the home test is only partially that the user can mess up. One of my formal PCR tests was a “nostril swab”, the other two were the “up the sinus” swabs you describe. But there’s a lot of evidence that the nostril swab works as well as the up-the-sinus one.
The major difference is that a PCR test will show a positive result at MUCH lower levels of virus. It uses a chemical reaction to reproduce any viral particles many times before testing for them. That’s why it can test positive long after you stop being sick or infectious. Whereas the rapid tests just look directly for viral bits in the sample.
I’m going to say that what evidence you get varies from place to place, and you should probably approach whoever does the local PCR tests and ask them what you should look for.
Also, you should think about what you are trying to prove. That someone doesn’t have enough viral particles in the sinus to trigger a PCR test? That someone has ACTUALLY been tested? That the test was done right?
fwiw, the one time I required testing for a large in-person event, I asked people to do a same-day rapid test, and offered to test people who couldn’t do that themselves. I did rely on the honor system, since it was all people I knew. But I tested about a dozen people on-site, myself. I used the BinaxNow which is well set-up for that sort of thing. I prepared the test, and handed them a swab. I watched them swab their nose. (I mean, not really closely, but they did it while standing in front of me) and they handed me the swab and I did the rest. I wrote the time and the initials of the person on the cardboard card, so I could keep track of when to read them, and whose result was whose.
fwiw, this was pretty feasible, and is something you might consider, although of course you’d want to charge for the test, as they cost about $10 apiece right now.
I think that is what the OP is looking for, as it with a home test, there is no way to tell who actually took the test, and it’s hard to tell when it was taken.
The at home tests do have a control line that will not show up if the test wasn’t done right.
Assuming you can find them. All the stores around here have been sold out.
If your goal is to cheat, you could run the test without bothering to stick the swab in your nose at all. I think it would show “negative”. (I’ve never tested this hypothesis, maybe the control strip tests for something that’s always present in snot. But i don’t think so.)
My experience is that when the rapid tests are hard to get, it’s also hard to schedule a PCR test. So i suspect that if you can do one you can do the other. Of course, you are pushing the “can’t do it” into someone else if you make them find a test.