Written by JobSiteCare

June 29, 2020

Resurgence of COVID-19

1. For many reasons, the US is once again becoming the “hot spot” in the developed world. At least for now, if anyone is claiming a specific reason, be aware that they may have a non-scientific reason behind this claim, as the data is just not available to support any compelling narrative. Theories currently in the discussion are:

  1. Increase in testing
  2. State reopening’s
  3. Memorial Day weekend
  4. The younger population is more careless about stay-at-home order
  5. Heat driving people indoors in southern states

2. This is not just April all over again. Numbers are up for many reasons, but not all represent actual increases. The shifted age range for diagnoses means that we will not likely see widespread pressure on our healthcare system, the threat of which was the main driver for the shutdowns in the first place.

3. We’re not out of the woods: Physical distancing, staying home when you are at-all sick, wearing masks in public when you‘re in close proximity to others, protecting at-risk populations, and generally using common sense at stores, restaurants, etc. can all contribute to holding the rates down and keeping us from threatening the healthcare system in any meaningful way. This, in turn, combined with age shifts will reduce scientific pressure to re-institute stay-at-home orders or other holds on commerce.

Testing

PCR testing (swabs) is for diagnosing infection. There are both rapid tests on office-based machines that are reasonably specific, but they still have an unacceptably high false-positive rate. This means that if you have symptoms and go to a clinic and they run a result in 20 minutes, a positive result is a true positive with a high degree of confidence, but a negative result should be confirmed by a lab-based test.

3 important caveats on testing for the presence of COVID-19:

1. There is only marginal utility in using these tests to rule out infection in an asymptomatic person. If you were exposed to someone diagnosed with COVID-19 do not feel like you should run out immediately and get tested. A test is only positive in the two days before you would get ill and that could be anywhere from 3 to 14 days after exposure. So, testing randomly after exposure does NOT rule out infection.

2. If you have been diagnosed with COVID-19, a swab test to make sure your infection has cleared is not useful. Non-infectious particles of the virus can remain in your nose for up to a month after infection, but if you do not require hospitalization, you are reliably non-infectious 10 days after symptoms began. Time is a better gauge than testing.

3. Antibody testing has no role (except in very limited hospital cases) in telling you if you are infected and/or infectious. Antibody testing only tells you that you were infected sometime in the past. We believe that you are more likely to have some immunity if you are antibody positive, but CDC and World Health will not commit to that with the current tests.