Quick Test Question for the Docs

1,454 Views | 10 Replies | Last: 3 yr ago by Kool
falconace
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On Wednesday, I had 6 symptoms and felt pretty crummy. My wife, a RN, set me up for a quick test at the earliest available slot which was 7 pm last night. Thursday and Friday symptoms started to improve.

Yesterday, when I took the test, I was prepared for them to shove the swab past my brain. She only put it partially up my nose... tickled a bit but nothing like I was expecting. I commented that it wasn't as bad as I was prepared for and she said it only had to go as far as a flu test for a second or two.

I waited 20-30 min and the test was negative. The doctor seemed a bit surprised based on the symptoms but said it must have been something else. That was fine by me, I figure they know what they are doing. However my RN wife (who hasn't been practicing for 6 years since we had our first kid) claims that they don't have any nasal tests that aren't as invasive as a brain probe yet (she still talks to her nurse friends that are on the front lines) and thinks the test was done incorrectly.

Can one of the docs on here help settle this debate with my wife? Are there quick tests that just require a swab similar to the flu test? All I know about the test I took was that it was EUA Authorized Rapid COVID-19 Antigen Swab Testing. Did this nurse administer the test incorrectly?

It won't change my course of action (e.g. I won't go get another test) unless I start feeling worse, but based on my quick google searches, I can't find anything that talks about a simple nasal swab so she might be right.

PS - I felt pretty bad on Wednesday and thought if I felt this bad this quick, it was likely going to be a rough couple of days/weeks based on friends that have had it. I started using Afrin Wednesday evening so I could breath and things have progressively improved as I've been keeping my sinuses clear.
zachsccr
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AG
I had to go to the ER back in early July and because I was displaying a couple of symptoms they COVID tested me (negative, and I knew that why I was in the ER wasn't close to COVID).

My testing experience was exactly like yours. Even down to the nurse saying they didn't have to go as far up. Not sure it helps you, but this was in San Angelo for reference.
He Who Shall Be Unnamed
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It's not the test that's the problem, it's the technique. I've heard your same story multiple times. Not everyone sheds the same amount of virus with the disease, and it can also vary during different times of the disease. An inadequate sample can definitely produce a false negative result. Maybe not the answer you wanted, sorry.
bigtruckguy3500
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There are different types of lab tests. The antigen test is typically done quickly and is probably what you had. It is not as sensitive as PCR, nor as specific. I believe it still requires the deep swab though.

LabCorps is doing some tests for our facilities, and their test kits are still PCR, but they told use it is a patient administered anterior nasal swab. There are some studies indicated that a patient performed anterior nasal swab is about 80-90% as sensitive as a healthcare worker performed deep nasopharyngeal swab. When you're looking at a test with 80% sensitivity as it is, 80% of that and you're potentially looking at only 64% sensitivy. (Forgive me, but I don't have the actual numbers off the top of my head)

That's not great at all.

Additionally, you're supposed to blow your nose prior performing the test in order to bring up potentially fresh viral particles from your lungs.

It's possible that they are out of the swabs that are designed for the deep nasopharyngeal swab, or it's possible that they're doing what're more comfortable for more people, and thus what's likely to get them more customers ($$$). Not sure.

Just treat yourself as if you were positive, and stay away from others for 10 days since symptom onset, and you won't spread to anyone.
falconace
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Thanks. Either of you a doctor? I know not everyone has the icon.
BiochemAg97
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AG
The initial tests were nasopharyngeal swab which is up your nose basically to the back of the throat. Since then, the FDA has approved less invasive testing protocols, including mid nose and even spit in some cases.

Each test has been approved with various allowable sampling protocols based on the validation done, and some have expanded allowable sample collection methods later. So what sample protocol used would depend on which test is being administered and possibly what sample collection kit is being used.

Not that kind of doc, but I work for a company that makes the tests and sample collection kits, so I have been followed the various approvals. We have even gotten to the point of at home self sample collection (I know Uk is doing a bunch of that) when you get the kit, swab yourself, then send it in to be tested. And you would be hard pressed to get someone to stick something up their own nose far enough for the Nasopharyngeal swab
jopatura
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AG
My kid gets them before her medical procedures every few months and it's mid-nose only. The nurse does swirl it around a bit, at least five seconds on each side.
88planoAg
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AG
Not a doc. But I needed a rapid test and went to urgent care with one mild symptom. Got the non yuck nose test. The nurse who did the test said specifically that the rapid test was not all the way up the nose.

This was July 4.
falconace
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Awesome. Thanks!
Demo_Slug
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AG
I'd think that if you very contagious, you wouldn't have to go in that far to find the stuff.
nawlinsag
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AG
At least a dozen different tests were manufactured in the US. Probably the most prevalent are the ones made by Abbott. They have a rapid antigen test that is just a nasal swab that takes 15 min to run. They have a PCR test that calls for the deep nasal swab that takes about 4 hours to run. None of them are very good. The country is spending a small fortune on tests yet not demanding an improvement in the testing accuracy. Just one of the many mind-boggling problems with our response to this pandemic.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Kool
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AG
No test is 100% accurate, and as is previously stated lots of people have had initial negative tests followed by positive tests as their symptoms worsened. National People's Radio was chronicling two such stories this am. The test technique as well as the test itself can make a big difference. Best advice is always to assume you're positive and if your condition worsens, especially to the point you think you might need hospitalization, re-test. Best of luck
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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