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COVID-19 Serology Testing, COVID-19, Retesting, & Mask Use

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COVID-19 UPDATE April 1, 2020
Newsletter
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SEROLOGY TESTING
 
Testing patients for COVID-19 is a key component of care in this pandemic, and you’ve all probably heard about new tests for COVID-19 in the market.  Given the limited availability of highly accurate molecular tests that detect presence of the virus from a nasal swab (currently being used primarily for symptomatic patients with exposure to COVID-19) there has been a lot of news about blood tests, also referenced as serology tests that detect antibodies developed by your immune system in reaction to an infection.  In the case of the Coronavirus, these are IgM and IgG antibodies developed by your immune system to fight off the virus. 

The FDA has made it clear that these antibody serology tests can’t be used as the sole basis for the diagnosis of COVID-19.

Again, an antibody serology test measures the presence of antibodies in the blood when the body is responding to a specific infection. It can take 2-10+ days for the antibodies to show up in the bloodstream after exposure to the virus. An antibody serology test doesn’t directly test the virus itself as molecular tests do. Rather, it measures the patient’s immunological response to the viral infections.
  • These tests have NOT been reviewed by the FDA.
  • Negative results DO NOT rule out COVID-19 infection, particularly in those who have been in contact with the virus recently. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals.
  • Results from antibody testing SHOULD NOT be used as the sole basis to diagnose or exclude COVID-19 infection, or to inform infection status.
  • Positive results may be due to past or present infection with non-COVID-19 coronavirus strains.
  • More specific serology tests for antibody detection are in development that could more reliably identify prior exposure to COVID-19 and assess recovery from/suggest immunity to COVID-19
In summary, current immune related tests do not give us helpful information at this time. We hope this changes in the near future.

covid-19 RETESTING


A word about retesting patients who are positive: 

As the weeks progress, we will have more and more patients who have been given a positive diagnosis of COVID-19.  Some will have positive nasal PCR swabs, and some will just be presumptively positive as they cohabitate with patients who are known positives.
 
The CDC recommends two potential pathways for stopping home isolation depending on the availability of follow up testing, and the patient’s willingness to be re-tested.  Right now, there seems to be plenty of available testing in and around Indianapolis, but this may change.  Given this available testing, your Priority Physicians doctors recommend following the first of these two protocols for the time being.

If you will be tested to determine if you’re still contagious, you can leave personal quarantine after these three things have happened:
  • You no longer have a fever for 24 hours (without the use of medicine that reduces fevers)
AND
  • other symptoms have improved (for example, when your cough or shortness of breath have improved)
AND
  • you received two negative tests in a row, 24 hours apart. Your doctor will follow CDC guidelines.
If you will not have a test to determine if you are still contagious, you can leave personal quarantine after these three things have happened:
  • You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers)
AND
  • other symptoms have improved (for example, when your cough or shortness of breath have improved)
AND
  • at least 7 days have passed since your symptoms first appeared

If you have tested positive for COVID-19, stay in touch with your physician to discuss our recommendations for your specific case. 
MASK USE
 
The World Health Organization recommends wearing a mask if you are taking care of a person with suspected COVID-19 or if you are symptomatic with coughing or sneezing.  During this COVID-19 pandemic, some healthy people are using masks when they go out in public to protect themselves from infection.  While this isn’t recommended by WHO or the CDC, wearing a mask could reduce your risk of infection if used properly.  Here are some detailed instructions on the proper use of masks. 
  • Wash your hands or use hand sanitizer before putting on the mask.
  • Cover your mouth and nose with the mask.  The mask should fit snugly over your mouth and nose with no gaps between the mask and your face.
  • Do not touch the mask again until it’s time to remove it.  If you happen to touch it, wash your hands or use hand sanitizer again.
  • When removing the mask, grasp it from behind without touching the front of the mask. 
  • For disposable masks, the usual guidance is to then immediately discard the mask.  In this time when supplies are running short, you could hang the mask to dry, or store it in an open paper bag. 
  • After removing the mask, immediately wash your hands again. 
The most important way to prevent the spread of COVID-19 is to distance yourself from other people.  Minimize your contact with anyone who doesn’t live in your home.  If you are even mildly symptomatic, send someone else out to do your essential errands.  If you must go out in public, please consider wearing a mask, especially if you are experiencing mild symptoms that could be consistent with COVID-19.  Those with mild symptoms can still spread the virus, and mask use can help.  If you have known COVID-19, you must stay in quarantine in your home.  Mask use in public is not enough in this case.  However, wearing a mask in your home could help to reduce your chance of passing the virus to family members.  We recommend that you not purchase medical grade masks due to the supply shortage that healthcare workers are facing.  Use masks that you may have on hand for other purposes, or consider buying or making a cloth mask. 
 

8333 Naab Road, Suite 360
Indianapolis, IN 46260
317.338.6400

13914 Southeastern Pkwy, Suite 208
Fishers, IN 46037
317.415.9900

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