COVID-19 testing numbers expected to increase with onset of flu season
STEAMBOAT SPRINGS — Testing for COVID-19 continues to be widely available in Routt County.
And while the county’s numbers continue to show low disease prevalence in the community, as influenza season approaches, the access to COVID-19 testing will continue to play a vital role in keeping the virus at bay.
“We are starting to see the sniffles,” said Routt County Chief Medical Officer Dr. Brian Harrington at last week’s Board of Health meeting. Harrington said he encourages anyone with COVID-19-like symptoms to get tested and anticipates overall testing numbers to increase.
The influenza and COVID-19 viruses are both respiratory and have overlapping symptoms.
Steamboat Emergency Center Dr. Jesse Sandhu also warned that if COVID-19 behaves like other coronaviruses across changing seasons, most epidemiologists and virologists agree, “It’s going to get worse again in the fall. And it is complicated by the presence of the flu season.”
There remain many unknowns, such as what COVID-19 and influenza look like in the same patient, Sandhu said.
COVID-19 testing “will inevitably ramp up — if someone has the flu, we have to assume they have COVID and have to be able to efficiently test for both,” Sandhu said.
In terms of antigen testing, which is used to detect a current viral infection, the benefit is a rapid result. However, there are concerns about accuracy.
Sandhu said the possibility of a false negative has much less dangerous implications for the flu than for COVID-19. The PCR test, he said, is still considered the gold standard but does not produce instant results.
According to the Centers for Disease Control, “The sensitivity of rapid antigen tests is generally lower than RT-PCR. The first antigen tests to have received FDA EUAs (Emergency Use Authorization) demonstrate sensitivity ranging from 84.0%-97.6% compared to RT-PCR. Antigen levels in specimens collected beyond 5 to 7 days of the onset of symptoms may drop below the limit of detection of the test.”
That means out of 100 people, anywhere from three to 16 people could receive a false negative. And you don’t want a false negative if someone is getting on a plane or headed to a college dorm, Sandhu noted.
“The specificity of rapid antigen tests is generally as high as RT-PCR,” according to the CDC. “The first antigen tests that have received FDA EUAs have reported specificity of 100%, which means that false positive results are unlikely.”
However, Sandhu noted there still needs to be caution — the labels can be misleading, and he said he has seen a false positive on an antigen test. The disruption a false positive can cause in an institution or a person’s life can be very significant, he added.
Sandhu recommends that any positive antigen test be confirmed by a PCR test, and a negative test but with symptoms also be confirmed by a PCR test.
“You don’t want to sacrifice accuracy for convenience,” he said.
According to Routt County Director of Public Health Roberta Smith, the Colorado Department of Public Health and Environment changed a definition regarding antigen test results on Aug. 17. Positive COVID-19 antigen test results are now counted as probables, she said, while PCR positives are still counted as confirmed.
Prior to Aug. 17, “a positive antigen test required either epidemiologic linkage to a case or symptoms to be considered a positive case,” said Routt County temporary epidemiologist Dr. Fritha Morrison.
“I think all tests have a role,” Harrington said. “It depends on the situation.”
And there are better and worse antigen tests, he noted. An argument can be made the antigen tests don’t pick up enough, he said, and that the PCR tests pick up too much when there is no longer an active virus.
Who: Community testing is available for:
- Symptomatic individuals
- Individuals in contact with others who have tested positive
- Asymptomatic individuals
When: Testing is available
- 3 to 5 p.m. Mondays
- Noon to 2 p.m. Tuesdays
- 9 to 11 a.m. Wednesdays
- Noon to 2 p.m. Thursdays
- On Fridays or Saturdays, clinics will become available as needed.
How: There are two options to make an appointment:
- Online at calendly.com/routtpublichealth/15min?month=2020-09
- Call 970-870-5577
Where: Routt County Historic Courthouse parking lot, 136 Sixth St.
Please note that clinics will no longer be available at the Brent Romick Rodeo Arena, except for Wednesday, Sept. 16.
Instructions upon arrival:
- When you arrive, call 970-870-5342 to let the nurses know you have arrived.
- Please remain in your car in the designated parking spot and a nurse will come to you.
- At South Routt Medical Center in Oak Creek, testing is also free with no insurance required. An appointment is required and can be made by calling 970-736-8118. Tests are administered at 11 a.m. Monday through Friday.
- UCHealth Yampa Valley Medical Center lab: 970-875-2686
- Steamboat Emergency Center: 970-846-6230
- Steamboat Springs Family Medicine: 970-871-1323
- Yampa Valley Medical Associates: 970-879-3327
- Northwest Colorado Health: 970-879-1632
- Pediatrics of Steamboat Springs: 970-871-1900
- Sleeping Bear Pediatrics: 970-879-2327
Harrington provided an update on COVID-19 antibody testing in the county. Antibody tests detect whether someone has had an immune response to COVID-19. Clinics are required to report positive antibody tests to the state, but Harrington said the local health department gathered the data on the total number of antibody tests administered.
There have been 1,535 negative antibody results and 56 positives, he said, giving a positive rate in the community of 3.5%
Other than hotspots like New York City, Harrington said that rate is in line with the rest of the country.
“(This shows) most of us have not had an immune response to the virus. … It is important for us to understand how low our response rate is,” Harrington said. “And we’re not even sure if having an antibody level necessarily means immunity. The point is the vast majority of the population still remains susceptible to the virus and the complications from it.”
“We are a long way from herd immunity,” Harrington added, noting that Routt County is currently in a good spot, given the five-week downward trend in positive COVID-19 cases.
“We are where we wanted to be with low disease prevalence,” he said.
Because of concerns around accuracy, Sandhu said Steamboat Emergency Center is still debating whether it will offer antigen testing. They have contracted with a private lab to ensure as fast as possible results on the PCR test.
This week, Steamboat Emergency began offering a PCR test that uses saliva instead of the nasal swab, which Sandhu said can be more comfortable for the patient and safer for the provider, given the nasal swab can induce a cough or sneeze.
Overall turnaround time on the PCR test has improved from recent months when test results could take five to 10 days to be returned. Most providers, including through community testing, are now returning results in fewer than 48 hours.
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