The most reliable test is taking as much as 14 days to process.
LAKELAND — Imagine getting tested for COVID-19 and having to notify your family, friends and employer of positive results, only to find out it might all be a mistake.
It happened in Lakeland last week as city officials moved quickly to shut down Camp Blast on Tuesday after receiving news that one of the summer camp counselors tested positive for COVID-19.
Signs were posted around Kelly Recreation Complex to notify residents of what happened, according to Parks and Recreational Director Bob Donahay, and to let them make their own decision about whether to use the facility.
Hours later, city spokesman Kevin Cook said the counselor had been sent for a rapid COVID-19 test and antigen test with negative results. The city thought the counselor’s first test might have been a “false positive,” Cook said.
So, which set of test results is accurate?
The Ledger reached out to local health care professionals to find out what could cause a false positive or negative when getting tested for the virus.
Dr. Steven Achinger, managing partner of Watson Clinic, said factors including what type of test is administered, when a person is tested and others can influence an individual’s final results.
“Outside of hospital settings, there is no easy access to rapid and reliable testing yet for COVID-19,” he said. “This has been a source of frustration for our physicians and staff as well as our patients.”
Achinger said that different tests for the novel coronavirus, SARS-CoV-2, that causes the disease COVID-19, give more unreliable results than others. The most widely used test is a RT-PCR, or reserve transcriptase - polymerase chain reaction, a molecular test where a nasal swab or saliva sample is tested for the virus’ genetic material.
“This test is highly accurate and in my opinion the results can be trusted as long as proper technique is used,” he said. “The problem we are currently facing is that turn-around time for RT-PCR tests have become quite long.”
Watson Clinic’s patients are waiting an average of two weeks to get their COVID-19 test results back, according to Achinger.
“This renders them not very useful in patient care since patients are typically done with their two week quarantine time before they even know their test results,” he said.
Lakeland Regional Health’s Respiratory Care Clinic is also waiting 10 to 14 days on average for patient test results because they are sent out to a commercial lab for processing, according to spokeswoman Jennifer Audette. Lakeland Regional is looking for a way to do these test in house to reduce the wait time.
Rapid tests, also known as antigen tests, offer the promise of quicker results in 15 minutes or less. Achinger said that some of these rapid tests can be prone to false positives because they are not specific to the SARS-CoV-2 virus strain.
“What this means is that these tests cannot differentiate between SARS-CoV-2 and other coronaviruses that cause mild infections but do not cause COVID-19,” he said. “So a positive result might not mean that you have COVID-19.”
The U.S. Food and Drug Administration has approved nearly 200 tests for COVID-19 through its Emergency Use Authorization, Achinger said. Under the EUA, manufacturers are not required to follow normal guidelines to get their tests approved and on the market, as that normally takes several months and data to prove the clinic sensitivity and specificity of the test.
In mid-May, the FDA issued a public warning that Abbott Laboratories’ COVID-19 Rapid Test, which offered results in 5 minutes, could give patients the wrong results, as reported by Kaiser Health News.
On June 6, the FDA sent another letter to health care providers warning that approximately of 3% of results from BD Max System’s COVID-19 diagnostic tests were false positives.
The FDA has pulled about 85 different serological tests it once approved for COVID-19 off the market as of Friday. Reasons for this include that the manufacturer doesn’t submit the necessary paperwork in the required period of time or “if significant problems are identified with such a test that cannot be or have not been addressed in a timely manner,” according to the FDA’s website. This list includes about 48 “rapid” tests and roughly 35 antibody tests.
The blame for incorrect COVID-19 test results doesn’t always lie with the manufacturers. Achinger said it’s important that health care providers use proper techniques and laboratory procedures.
“A false negative result may occur if a specimen is improperly collected or the specimen is not handled properly between the time it is collected and the sample is run,” he said.
The timing of a test for COVID-19 can also be a deciding factor. Achinger said it’s possible to get a negative result and have already contracted the novel coronavirus. He said it’s a “common scenario” where a person gets tested shortly after learning they were exposed to someone with COVID-19, but doesn’t have symptoms yet. This can influence their tests results, as COVID-19 is believed to have an incubation period from two up to 14 days.
“For example, if someone is tested four days after an exposure, their results may be negative initially,” he said. “If this individual then develops symptoms eight days after the exposure and is retested, they will then likely test positive.”
Achinger stressed the need for better COVID-19 tests.
“Access to rapid, reliable testing will greatly enhance our ability to care for patients during this pandemic,” he said.
Sara-Megan Walsh can be reached at email@example.com or 863-802-7545.