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The purpose of the PCR test is to determine the existence of COVID-19 in patients
Homer Simpson seemed to have some thought-provoking advice about life.
For example: “Facts are meaningless. You could use facts to prove anything that’s even remotely true!”
While showing a sense of humor, Homer’s perspective on facts may be jaded as he works at a nuclear powerplant with a dubious safety record. The daily facts and prevailing research findings can be difficult to disseminate between hypothesis, theory, and truth. In researching treatment, testing, drug therapies, and safety recommendations finding facts and truths can be maddening. Based upon my research, I’m going to share what I’ve learned on these topics from published articles and discussions with medical providers testing and treating infected individuals.
As we begin to reopen the American economy, employers are concerned for the safety and well-being of their employees in the workplace.
What is the safe way to reopen and ensure that everyone remains healthy afterwards? How to protect individual employees with health risks or those caring for those at high risk? Should an employer offer testing on a voluntary or mandatory basis? Does testing provide assurances of safety and accuracy? Knowing the best practices at this time can guide an employer’s decisions.
COVID-19 PCR & Antibody Testing
The purpose of the PCR test is to determine the existence of COVID-19 in patients. The challenge of the test’s value and accuracy is the period between exposure and administration of the test. A false negative may occur because the viral load hasn’t reached a detectable level. Individuals that are asymptomatic – those who possess the virus but showed no outward symptoms — would not need to be tested.
At the same time, they may actually be spreading the virus.
From the CDC website, “Some recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms.”
This presents a limitation of the value for mass testing and reliance upon the test results without performing 100 percent testing. Should an individual be exposed and exhibit no symptoms by day 14, evidence suggests the individual is not contagious or will exhibit symptoms from the initial exposure.
Antibody testing for COVID-19 has been developed and kits are being deployed by several companies. The antibody testing is either a blood serum or saliva test to determine the existence of antibodies which have developed as a result of the body’s immune system killing the virus.
The presence of the antibody confirms the existence of a past infection. The antibody test should not be used as a substitute for the PCR test as it cannot accurately diagnose an active virus.
Antibodies for an infected individual may take 1 to 3 weeks to develop in the body. Healthcare workers and first-responders will have access to the tests with mass availability in May 2020.
To Test or Not to Test?
Employers and individuals will need to make that decision based upon their needs and expectations.
For employers, considerations such as proximity of employees to each other and the disruption of operations will influence those decisions. An employer experiencing multiple confirmed cases, testing may become a necessity to avoid a halt to operations. For businesses able to provide adequate distancing between employees, alternative schedules, and remote working, the need for testing may be unnecessary.
The first step before testing would be to have individuals evaluate their own current health status. Reviewing the symptoms experienced by symptomatic individuals and performing a body temperature check should be part of that review. Anyone exhibiting these symptoms should be referred for a more thorough medical examination and testing.
If an employer desires to test employees, the PCR test is the best option. It can identify those with an active infection and allow for quarantine and further care if needed. Testing provides data for a “moment in time” and can provide a management team with the current health status of employees.
Increased testing capacity and more immediate results reporting create the ability to monitor and react to a potential outbreak. The contagious nature of the virus and asymptomatic individuals will continue to present challenges in eliminating and decreasing the number of infections.
The value of antibody testing to an organization or individual is still in question.There are studies underway and test kits are being released by a number of lab companies. The limitations of the antibody testing are:
- When will the antibodies appear in the individual infected by the virus? That time may be 1-3 weeks.
- Will the antibodies protect an individual from reinfection?
- How long will the antibodies remain with the individual?
- In the event the virus mutates, will the antibodies protect against the mutation?
Antibody testing at this point is a way to gather data and study the virus. Individuals with positive tests, whether symptomatic or asymptomatic, can provide information on the existence of antibodies. Over the next 3, 6, and 12 months, studying these individuals for the continued presence of the antibodies will provide data to prevent and mitigate future infections. With these limitations, performing antibody tests at this time may give individuals a false sense of security and safety. More time and study will be needed to determine ongoing immunity.
Our recommendation to clients and those seeking advice would be to define the reasons for providing testing to your employees. A single round of testing can provide a baseline for future decisions and protocols to implement within the workplace. Certainly, all employees want to feel safe and protected in their work environment. For employers wanting to provide testing Apex can assist with coordinating those resources, provide guidelines for legal compliance, and review testing results for further recommendations. As additional information and sourced data comes available, we will update our blog postings.
About the Author
Stan Jackson, CPBS, is chief innovation officer for Apex. He is responsible for leading the development of products, services and capabilities necessary for Apex to continue growing its long-term innovation strategy. He focuses on new product offerings, applications for big data, predictive analytics and AI in health benefits, and other areas to best serve our current and future clients. Before joining Apex, Stan worked for SIHO Insurance Services, IU Health Plans, and other health plans in the Indianapolis area. Stan has a bachelor’s degree from the University of Indianapolis in Accounting/Economics, but transitioned to underwriting and risk management over 20 years ago. Connect on LinkedIn.