March 21, 2020

Testing, testing

For gardeners, some plants cause trouble; repetitive trouble. You may start out loving them, until they overwhelm you. You dig it out, or so you think, and then it pops up again and again and again. Jamie and I had some Aspens in our back yard when we lived in Leschi. I don’t know who thought it was a good idea. We took them down when we did work on that old Victorian house. Or so we thought. We spent the next year and half pulling up shoots that the roots sent up, or at least until we moved to Santa Fe. Who knows if the present owner has Aspens growing in the back yard now? At our house here, there are Japanese anemones that are beautiful, but took over, so I dug them up, or so I thought. But their roots broke off and here they come up again, and again, and again.

Today was a beautiful spring day and I took advantage of it to dig up a mistake I made a few years ago. I had noticed what looked like a clematis growing up the back wall, so I let it grow to see what it would do, hoping for a beautiful flower. Bad mistake. Sadly it turned out to be a wild species, gangly and invasive. Did I mention ugly? And by the time I got around to digging it out today, the trunk was two inches thick with multiple roots that were so deep and I couldn’t get I all. I know it will be popping up again and again to haunt me this summer and the next.

I am hearing from friends and patients who are worried. I have also read a lot of press about people wanting to be tested for the SARS-Cov-2, which is the name of the virus that causes COVID-19 disease. It seems everyone wants immediate testing and are frustrated. Why that is not happening now is not simple. To start with, the tests being used are actually pretty good for being so new. They are pretty sensitive, meaning they find most, but not all, positives. They seem to be specific, meaning that there are not a lot of false positives. But remember the virus is just an infant, only 4 months old, so there is not a lot of data still. Despite reports to the contrary, there is not enough capacity to test everyone in this country at this one point in time. This is not as simple as a blood test. The test involves deeply swabbing a patients nose, exposing the health care worker to respiratory droplets, which means the health care worker should wear personal protective equipment, which we are running out of. Without the shields, this is considered a moderate to high risk exposure to the health care worker. To add to the situation, we are running out of the nasal swabs and the reagents used for the test, which are made in Italy and Germany. It takes time and equipment (and people) to run the test as well. Also understand that if we had wide spread testing to begin with, like Korea, testing everyone might have made a difference. But it is too late, the virus is everywhere now, too many asymptomatic carriers now.

But here is the thing that I don’t think many people understand about getting tested. This tests for actual viral genetic material, the RNA of the virus. It does not test your immunity (as of yet there is no test for immunity). Just because your test is negative today, doesn't mean it won’t be positive tomorrow or the next day. People get a false sense of security if they hear their test is negative. I have heard of more than one patient that is told they are negative, and within a few days they are in the ICU. Either they got a new exposure or more likely tested too soon to have a lot of viral RNA in their nose. And then they crashed. People get complacent. The test is just one point in time, we don’t know what lies underneath. Just like gardening, I may think I’m done with that plant, and then it pops up again. Vigilance is needed.

Wash your hands.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.