Alex and Dr. Wendy Tong, MD MHA, talk about the recent events related to the COVID-19 pandemic happening all over the world and discuss topics like healthcare, eldercare, and keeping your loved ones safe.
In this episode, they are discussing the vaccine, COVID testing and more!
Listen now on all major podcasting platforms!
For more information on Dr. Wendy Tong, more COVIDConvo episodes, social media links, biography, and exclusive materials, please visit our website.
Alex and Dr. Wendy Tong, MD MHA, talk about the recent events related to the COVID-19 pandemic happening all over the world and discuss topics like healthcare, eldercare, and keeping your loved ones safe.
In this episode, they are discussing the vaccine, COVID testing and more!
Listen now on all major podcasting platforms!
For more information on Dr. Wendy Tong, more COVIDConvo episodes, social media links, biography, and exclusive materials, please visit our website.
Alex Romanovich (00:01):
Hi, this is Alex Romanovich. And welcome back to global edge talk. And specifically to our COVID convo with Dr. Wendy tongue. Today is December 12th. Hello, Dr. Wendy. Hi, Dr. Wendy, we are going to talk about a very interesting topic of testing. It is December 12th today, and we're roughly about two weeks after the Thanksgiving holidays. And we're seeing a tremendous amount of activity, not only in testing, but obviously we're seeing a spike in COVID all over the, all over the country, increased cases. Topped up ICUs. You know, our last podcast was about misinformation and how it can impact individuals and making choices and lead to a false sense of security and testing actually, or false testing, false negatives or false positive can certainly lead to the false sense of security. We know this based on our personal experience. I know this based on my experience after COVID I had antibodies and sometimes I feel a little bit of a bravado when I go outside, for example, walk my dog or, or travel or something like that. And we should always think twice and stop ourselves thinking that COVID can be very, very unforgiving. So let's talk today about the full sense of security. Let's talk about testing and can you share some of the observations you've experienced?
Dr. Wendy Tong (01:44):
Yeah. thanks Alex. Thanks for sharing your personal experience. And I have to admit that until I started preparing for this podcast and really looking at, you know, testing the different tests out there, how they should be used and the limitations behind each test, I was in that number of people who was also deriving a false sense of security in terms of negative test results. I do know that well I was getting surveillance testing every one to two weeks as well as all the adults and my manager and my company. And you know, with Thanksgiving break, I know my manager was like, okay, you know, I've got negative test results. I'm just going to, you know meet and sit down with some friends outdoors socially distance and have a meal. And yes, and she's like, everybody in our group has gotten tested they're negative.
Dr. Wendy Tong (02:42):
And, and there was that false sense of security. And, you know, there are times when I have team members who say, okay, I've gotten tested right after, like I've met with people. And then I didn't ask them if like, what, what kind of tests they get and did they get it like tested a certain period after they were exposed? In which case the false negative rate is actually really high. So, you know, I think it's very real out there, your personal experience, my personal experiences. And you know, even if we keep on top of the COVID information there's still a lot that we don't know about or we haven't really thought about deeply enough. So definitely thank you for allowing me to pick this topic about, you know, COVID testing for today.
Alex Romanovich (03:37):
No, absolutely. I think it's a very fascinating, very interesting topic. So there are a number of tests that by now there are number of tests available right now. Can you give us a quick overview of each test? What they mean, what they stand for, what they're used for and how is it that folks are getting some of the false results, both on negative and positive side?
Dr. Wendy Tong (04:00):
Yes, of course. So there are three main kinds of tests available. The first is the rapid antigen or rapid swab test. The second is the PCR test, which is also a nasal swab. And the third is the antibodies test, which is the blood test. For purpose of time, I'm just going to cover the first two tests because those were the most commonly used in the general population. The rapid test is a nasal swab and it detects the protein particles or antigens of the virus. The results are available within an hour. Usually the testing processing can be done on location. They're very inexpensive and because of the rapid turnaround time for getting results, they're widely used in settings like factories, nursing, home staff, and that's because there's that ability to detect an active infection quickly and to make quick decisions, management decisions, HR decisions about implementing immediate isolation precautions.
Dr. Wendy Tong (05:11):
So what a lot of people aren't aware of is that for the convenience of the rapid test, there's actually a big trade-off because the false negative rate is actually really high that that it's actually as high as 20% or one in five negative tests could result in a false negative. So th there's definitely a use case for these rapid tests, but then you also know that if it's a positive test, it really should be interpreted and actions should be taken as if it is a positive test. You know, don't say, Oh, it could be a false positive, but if it's a negative test, you know, take it with a of salt, still practice, social distancing masking there is a high false negative, right? So don't use, don't have like that sense of security because the false negative rate is so high.
Dr. Wendy Tong (06:13):
Now, the second test is the PCR test and PCR stands for polymerase chain reaction, which is a laboratory process for amplifying that genetic material collected from that nasal swab. And that lab process can take two to three days. And that's why for this test, there's a two to three day waiting period. The PCR is still considered the gold standard test because it has the highest accuracy rate of approximately 90%. So there's still a false negative rate of around 10%. And it's important to factor in the timing of when you get the PCR tests done. So I've heard time and time again, how somebody says, Oh, I got exposed yesterday. I'm going to get the test done today. Actually, you can't the false negative rate for doing the tests so soon after an exposure is actually going to have like a hundred percent false negative rates.
Dr. Wendy Tong (07:18):
So even if you're infected the body, hasn't had time, you know, the virus hasn't had time to replicate to actually be picked up, you know, to have a sufficient amount to be picked up by that nasal swab. And even the fourth day after exposure, the false negative rate is you know, 67%. So this is actually why CDC guidelines state that the, that when you do the PCR test, it should be done five to eight days after exposure for it to be considered a valid test. So the PCR test is, is widely available now. And I do know like again, and from personal experience, a lot of my team members went on vacation and then came back and they're like, okay, I'll get tested the day after I get back from traveling. And after meeting my family, I'm like, no, no, no, you have to count out, you know, at least five days before you get tested and I'll count it as a negative two negative test, a valid negative test not a true, a valid negative test in order to return you to work. So what I've seen is that a lot of people get these tests done and they consider it as a free pass to congregate or eliminate the need to wear masks or maintain social distancing. And that really is not the purpose of these tests. And there's such a high, false negative rate that they shouldn't be used this way, that it should not be used as a substitute, you know, doing all these other protections.
Alex Romanovich (09:00):
Very interesting, of course, there's a lot of information that's available right now. And in many cases it could be confusing, you know, especially for, for the travelers or people who must travel for living or they wanted to visit the family. You know, I've traveled the domestically internationally as well. And you know, each state, each country has its own rules and regulations. For example, when I traveled internationally recently there was a a need for me to do a test before and after the flight. But I even had to go, you know, going back into the New York state, I had to go, I had to sit on the quarantine sit in my own house for two weeks straight to make sure that if there was something even post COVID, then I would not be a spreader or I would not be exposed to it, or what have you. So there's just a lot of information from a lot of different sources. What can people do in light of this overwhelming amount of information, which is different and in different occasions or in different places all over the world.
Dr. Wendy Tong (10:10):
Yeah. And, you know, that's a very valid point, Alex. And of course the buyers is, you know, can you take two? So what we knew now might not be valid later. I think that it's always safest to err, on the side of being more conservative rather than less. And you know, in your case, you, you had COVID and you know, you've recovered and some people might say, Oh, maybe now you're super immune and you can't spread it anymore. But again, that doesn't exempt you from, you know, asking you to return from overseas travel that you get. You know, it sounds like when you were at the airports, you've got the rapid test and then you had a negative and they released you into the community, but they still advise you to quarantine and isolate for 14 days. And so, you know, I think that that is probably, you know, the most conservative approach and that you followed it.
Dr. Wendy Tong (11:06):
And that's really, the advice I recommend is to err, on the side of caution, I know that there are CDC guidelines that are shortening the quarantine period as I balance out the economic impact of COVID and, you know, what's medically advised. And at the same time, you know, if you have the capacity to then, or on the side of being cautious and do 14 days of quarantine after an exposure, there are some occasions you can shorten it to seven or 10 days. I read recently that for seniors and those who have chronic illness, that their immune system, because their immune system is not as robust as younger people, it might take them much longer, even up to 20, 21 days for them to clear the virus from their system. And they're S they're still, you know, infectious, despite, you know, 14 day usually recommended period of time. So, I mean, if you can be more cautious than not, I know that that there's always balances as to, you know, what you trade off. That's what I would recommend people following.
Alex Romanovich (12:20):
Dr. Wendy, thank you so much. I know you're very, very busy right now, keeping keeping our elders and our seniors safe, working with the caregivers. We're looking forward to our next topic of vaccines, by the way that's coming up today, actually FDA has made the final approvals and there was a press conference this morning on the 12th of December, 2020. So we will have a very exciting topic to talk about next time, very briefly, very shortly which is vaccines. So we're looking forward to that.
Dr. Wendy Tong (12:56):
Thanks for having me, Alex.