As most of the country, including Washington State, finally start to loosen draconian orders and ReOpen, we find one major caveat: The positive tests must stay low. Months have passed, businesses are failing, people are suffering from the economic collapse, and COVID-19 has consistently proven to be less and less severe. Many are eager to move through the phases of “Safe Start”, however, there are two problems: COVID testing accuracy is a joke, and Inslee (along with many of the nation’s governors) wants testing to increase.
More tests will equal more cases.
Hopefully that is evident. When we’ve only reached about 6000 tests per weekday and Inslee’s goal is 20,000 – 30,000 tests per day. Inslee’s requirement to keep cases under 25 per 100,000 in each county is not justified by reason, not when the virus is already widespread in the community with a survival rate of 99.8%+ of the population. Instead of offering a way to move forward, his “Safe Start” plan is more of a “No Start” Plan.
Even if Inslee’s plan to test more made sense, there are significant problems with ALL three types of testing…
Antibody, Polymerase Chain Reaction (PCR), or Antigen
PCR (nasal/throat swab) has the most accuracy, and was first available, but had a shortage of supply and was skilled labor intensive, which meant it took a long time to get results. Antibody testing (blood prick/draw) had terrible accuracy, but was simpler/faster to test and allowed many more people to get tested. Some studies of the antibody test accuracy showed false positives were nearly half of all results. PCR, though fairly accurate, still has false negatives in some studies of 3%. Antigen testing (also nasal/throat swab) was just approved May 1st, is as inaccurate as antibody, but was desired for its speed.
Now, further problems: PCR and antigen testing test for fragments of the virus in your body, which means you need to currently be sick, or within days of being sick to test if you have/had COVID. Antibody testing tests to see if you have developed antibodies. These only develop after an infection starts and there are sufficient antibodies produced to detect. Problem with that is antibodies don’t stay in your blood permanently. They dissipate weeks to months after an infection. The ability to produce these antibodies to fight a specific infection is retained by Memory Cells, but there is no test to test Memory Cells.
Never has been.
More Antibodies will develop with a stronger infection, so since most people have mild symptoms to none, the presence of antibodies in their system is likely low and can go undetected.
In the end, you have to either:
- Be sick with COVID during testing with PCR/antigen testing
- Or you need to do an antibody test shortly after being sick
If you are tested early in your COVID infection with an antibody test, you will likely be negative. If you are tested right after being sick with a PCR/antigen test, then you will likely be negative, and of course if you are tested weeks to months after being sick with any of the tests you will likely be…negative.
Now, that’s assuming you didn’t test as false positive, which the antigen and antibody tests are notorious for. And if you had COVID, but tested negative because of bad timing… The point of testing starts to become comical, like some bad joke about a priest and a barber.
Except this bad joke is making policy decisions that affect every citizen of Washington State.
Inslee is still holding your rights hostage until positive cases are less than 25 per 100,000 (and perhaps far longer). But there are major accuracy issues with testing, in particular for antibody and antigen tests, and he wants to ramp up testing multiple factors higher. Even if accuracy at time of test was better, the timing of the test compared to your sickness is extremely relevant to find a positive result, and confounding that is the mild symptom to asymptomatic response for the vast majority of people. So how will we know when is the optimal time to go get tested? Perhaps we should just test everyone in the state once each week?
Considering it took us 3+ months to reach 6000 per weekday and the tests are rife with errors, that seems as “logical” as anything Inslee has decreed.