by Grace Schneider | Courier-Journal; Louisville, KY; July 22, 2020

Amid a slew of troubling coronavirus developments in recent weeks — spiking case numbers, unexpectedly high rates of infected people without symptoms, rollbacks on reopenings — many people are asking a basic question:

Should I get a COVID-19 test even if I'm not sick?

The thinking behind that question is this: If someone learns they have it after all, they can then isolate themselves and keep from spreading the virus. Their results also could add needed data for epidemiologists to sharpen strategies to battle the deadly coronavirus.

More than 23,000 cases of COVID-19 have been confirmed in Kentucky, with nearly 56,000 in Indiana. The illness has killed at least a combined 3,500 in the two states. Nationwide, confirmed cases topped 3.5 million with deaths exceeding 138,000.

Yet, scientists and doctors in Kentucky and across the country are saying, in short, that they don't yet recommend getting either a live virus test for COVID-19 or the test for antibodies to see if you've previously been infected.

Like many things related to the pandemic, testing questions involve layers of complexity, and it's not a one-size-fits-all directive.

The public health experts and epidemiologists contacted by The Courier Journal were unanimous in their opinion that people who have symptoms, such as fever, chills, shortness of breath, loss of taste or smell and body aches, should get a test. Often those flu-like indicators can appear within a few days to two weeks of exposure to the coronavirus.

But those without symptoms and who don't think they've been exposed to COVID-19 shouldn't get a test now. One reason for that: The Louisville region and other parts of the country are starting to see a renewed squeeze on COVID-19 testing capabilities.

"As for Joe Public getting tested, we don't have the capacity right now," said Dr. Eric Yazel, Clark County's public health officer and an emergency room physician at Clark Memorial Hospital in Jeffersonville, Indiana.

Louisville's hospital systems have begun to see a surge of people asking for tests after business reopenings and an uptick in out-of-state travel. Those returning from vacations in hot spots and high school students who attended proms recently or who were exposed to an infected teammate during preseason athletics, are among those seeking screenings, Yazel said.

"We've seen a huge upswing," he said, and as a result "our test sites have been overrun."

More tests, longer waits for results

There's definitely more people seeking testing at Norton Healthcare in Louisville, which had more than 3,000 people arrange to get screenings at various sites over a recent three-day span.

The testing surge is stretching laboratory resources, and some patients aren't getting their results for seven days. If labs are very busy, it can take 10 to 12 days, Norton officials said in an advisory issued Tuesday.

The longer lag times are troublesome because a person carrying the virus may not take additional precautions while waiting on results, said Thomas Duszynski, director of epidemiology education at Indiana University-Purdue University Indianapolis' Fairbanks School of Public Health.

Also, a negative test represents only the results on the day the sample was taken. So it's possible for the same person to turn up positive for COVID-19 the next day because the live virus finally developed enough in a person's body to be detected, he said.

They advise patients unequivocally: "If you have symptoms, stay home. If you've been exposed, stay home," Duszynski said. In both instances, people should get a test, even if they've had one in the past.

One important directive is how to handle the hours and days after someone gets a test, added Donna Arnett, dean of the University of Kentucky's College of Public Health.

"We need the people being tested to be ready and willing to quarantine until results are returned," she wrote in an email. "If tested and diseased individuals go out and about before they get their results then they have spread the disease to others during that period between testing and reporting."

Epidemiologists recognize that people who have the virus without symptoms, those who are asymptomatic, pose a huge risk because they can transmit a disease to many others without knowing they're passing it on.

A statewide coronavirus prevalence study conducted by Fairbanks and the Indiana State Department of Health of two separate randomized samples on Hoosiers last spring found that more than 40% of those who tested positive were asymptomatic, he said.

Conducting such a sampling provides some solid prevalence data to draw a bead on how many people in the larger population are sick or have cleared the illness. It's just not practical to test everyone across a state. In Kentucky, for instance, about 500,000 COVID-19 tests have been administered since the first case was detected in early March, said Dr. Forest Arnold, associate professor of infectious disease at the University of Louisville.

However, a statewide screening for every person would involve more than 4 million tests. While it would be "awesome" to know the true prevalence of the outbreak, that would burn through needed resources. Plus, Arnold said, "in three days, everyone would have to be tested again."

What about an antibodies test?

Another hot pandemic topic focuses on antibodies. Those are the proteins that a COVID-19 patient develops showing they've previously had the virus.

Many people in Louisville and nationwide who have beaten the coronavirus and tested positive for antibodies have donated blood plasma to help others who become seriously ill with COVID-19. While there's been some encouraging results, several studies in the U.S. and overseas are still gathering evidence. Doctors generally say they don't recommend such testing for recovered patients or those just curious about whether they may have been infected — unless a physician recommends it.

There's been widespread concern about inaccurate tests and other quality measures. Some tests that hit the market have been pulled after the federal Food and Drug Administration required they first be certified, said Arnold, of U of L.

Even if a person gets an antibodies test that's accurate, scientists still don't know if or how much immunity antibodies actually provide. Some reports now, Duszynski said, show they may last in the system for as little as three months.

Grace Schneider: 502-582-4082; gschneider@courierjournal.com; Twitter: @gesinfk. Support strong local journalism by subscribing today: courier-journal.com/graces

CREDIT: Grace Schneider

Subject: Public health; Antibodies; COVID-19 diagnostic tests; Asymptomatic; Coronaviruses; Pandemics; Disease transmission; COVID-19

Location: Indiana Kentucky

Publication title: Courier - Journal; Louisville, Ky.

First page: A.6

Publication year: 2020

Publication date: Jul 22, 2020

column: coronavirus pandemic

Section: News

Publisher: Gannett Co., Inc.

Place of publication: Louisville, Ky.

Country of publication: United States, Louisville, Ky.

Publication subject: General Interest Periodicals--United States

ISSN: 19302177

Source type: Newspapers

Language of publication: English

Document type: News

ProQuest document ID: 2425781313

Document URL: http://echo.louisville.edu/login?url=https://search.proquest.com/docview/2425781313?accountid=14665

Copyright: Copyright 2020 - THE COURIER-JOURNAL - All Rights Reserved.

Last updated: 2020-07-22

Database: Global Newsstream