The latest spike in COVID-19 infections in California may top last winter’s tidal wave, health officials say. And judging by the sewage tests, the infections may be even more widespread than the official numbers .
One reason is that some people’s symptoms are so mild that they don’t seek treatment or get tested. But another big factor may be the sheer number of people who use home tests and don’t report the results.
“Home testing leads to marked underestimates of case numbers,” dr Robert Watcher, chairman of the UC San Francisco Department of Medicine, said in an email. “Clearly, hundreds of thousands of people are now diagnosing themselves with positive home tests (usually more symptoms), and this is underreported.”
Some test kits advise you to call your health care provider. Others who want to use the test maker’s app.
The problem, however, is that the health system frowns on user-generated test results: local health officials prioritize quality over quantity when it comes to data. In Los Angeles County and many other jurisdictions, there is no way for people to report the results of store-bought home tests.
“COVID-19 surveillance continues to be based on lab test results,” not self-tests, Centers for Disease Control and Prevention it says on their website. Although data on new cases helps public health agencies in their attempt to slow the spread of COVID, “the public health community, including the CDC, is confident that situational awareness remains strong without receiving self-test results.” “.
So what should you do after taking a test? If it’s positive, health officials sayshould isolate at hometell the people you’ve been with close contact and tell your health care provider. The Los Angeles County Department of Public Health has a hotline that you can call (833) 540-0473 if you have questions, need referrals, or need help notifying your close contacts. (Times columnist Robin Abcarian recently called the hotline and reported a smooth and helpful process.)
A spokeswoman said the Department of Public Health “will document and interview those who call us with positive results.” But the department does not want to be contacted about negative test results.
Therefore, the more people who get tested using the free kits provided by the federal government or the boxed tests sold at pharmacies, the fewer official figures on new infections and positivity rates (that is, the percentage of tests that detect the virus) will provide an accurate picture of public health.
That’s not necessarily a bad thing, it’s just a note of caution about the data we’re relying on as we chart a course through the pandemic.
Why are there sub accounts?
Experts say there has always been a disconnect between reported coronavirus case counts and the truth. Because many people who contract the virus experience few or no symptoms, many infections go unreported.
Similarly, test positivity rates tend to be inflated, because the people most likely to show up at a testing center are those with COVID-like symptoms. Large organizations that require all members to be tested regularly invariably have lower positivity rates than sites that only test people they think might be sick.
Testing more people more often, as other developed countries do, could help identify outbreaks and limit their spread. But for a variety of reasons, the growing reliance on rapid home test kits may not help public health officials in their battle to track and understand the pandemic.
There are a number of situations that can prompt people to prove themselves. the CDC Suggest doing a self-examination. “if you have symptoms of COVID-19 or have been exposed or potentially exposed to a person with COVID-19.” (The symptoms to watch out forthe agency says, include fever or chills, cough, shortness of breath, fatigue, and sore throat).
Another good time for a self-screening, the agency advises, is before meeting with people who are at higher risk of becoming infected, such as those who are not vaccinated, the elderly, or those with weakened immune systems. Or maybe you want to attend an event that requires proof of a negative test.
Health officials generally do not include the results of home tests in confirmed case counts. One reason is that low-cost rapid tests are antigen tests, while county clinics and testing centers use polymerase chain reaction, or PCR tests, which are better at detecting infections in their early stages. Then there is the question of whether the people doing the home tests are doing it correctly or reporting the results accurately.
“Result verification is a big deal” for rapid home tests, he said. Gigi Kwik Gronvall, a senior fellow at the Johns Hopkins Center for Health Security. After some initial confusion, states are now reporting the results of the antigen tests they collect separately from the PCR results, Gronvall said.
How much do undercounts matter?
dr Sara H. Cody, a health officer and director of public health for Santa Clara County, agreed with Wachter that the new infections reported by health officials each day are “an undercount.” But that may not be as big of an inconvenience as it would have been at the start of the pandemic.
Back then, Cody said, health officials “followed each case so carefully” because it “really, really mattered in our understanding of the pandemic and informed our policy choices.” But now, he said, “we are in a place in the pandemic that is quite different.”
Wachter, Cody and other health experts said policymakers’ focus has shifted away from case counts to other metrics, such as hospitalizations and positivity rates. Of course, positivity rates are affected by the exclusion of home test results. But Cody said it’s still meaningful to have an apples-to-apples comparison of positive test rates over time.
Despite the data problems they create, home antigen tests are an important complement to PCR tests, Cody said. They alert people that they need to isolate themselves and “reduce the chances that they will go on and infect others, which is important broadly for public health.”
Also, says the Los Angeles County Department of Public Health, coronavirus case counts aren’t nearly as significant as the trends they reveal.
“As with many notifiable diseases, the reported figures have never captured all cases,” a spokeswoman said. “But they have provided us with trend lines to better understand what’s going on and help model what are likely to be the most accurate numbers.”
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