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By Paul Han MD
Photo credit: AKAM
As COVID-19 cases continue to decline and many individuals recover, new questions emerge regarding the safety of returning to workplaces. After months spent at home with fear, people are eager to resume normal lives, including meeting friends and relatives, attending church, and dining at restaurants. However, safety cannot be ensured at any location or time.
There are currently two types of tests for COVID-19. The first is the PCR test (Polymerase Chain Reaction), which amplifies genetic material to detect the virus's genetic material. The second is the antibody test, which checks for an immune response to COVID-19 and can be used to confirm infection. These tests serve as a protective measure against the dangers of COVID-19.
The safest individuals are those who have recovered from COVID-19 and developed immunity. People with positive antibodies from a prior infection do not contract COVID-19 again, nor do they spread it to others. Although doctors aren't certain how long this immunity lasts, no cases of reinfection have been reported. The best method for confirming immunity is through antibody tests. Unfortunately, the current accuracy of available antibody tests is low. Tests are useful for patients who were hospitalized but may not detect antibodies in those with mild symptoms. Those who have been infected and undergone PCR testing do not need antibody tests. Although recovery from COVID-19 presumes non-infectivity, PCR tests may show positive results due to viral remnants for weeks post-recovery, but this does not indicate infectivity. Most studies suggest the COVID-19 virus cannot survive beyond two weeks after symptom onset. The CDC states that workers can return to work if at least 72 hours have passed since fever subsided and respiratory symptoms improved, alongside more than 10 days since symptoms first appeared.
If you haven't contracted COVID-19, you fall into this category. Most people remain at risk of infection and must practice social distancing. This is crucial, especially for patients with severe condition risks such as the elderly, diabetics, and those with heart disease. The virus is most transmissible before symptoms appear, and individuals without COVID-19 antibodies can spread it before falling ill. The only way to detect asymptomatic spread is via PCR testing, which is conducted for procedures requiring close contact and in some industries globally. However, a negative test today does not preclude infection tomorrow, and positive patients might still test negative on PCR. More than 30% of cases confirmed as COVID-19 positive showed negative nasal swab results.
Author: Sethuraman, Nandini; Jeremiah, Sundararaj Stanleyraj. Interpreting Diagnostic Tests for SARS-CoV-2. JAMA: May 6, 2020.
Patients who contracted the COVID-19 virus are at the highest risk of spreading it. Diagnosis depends on symptoms and confirmation via PCR tests or chest CT scans. It's noteworthy that those who contacted an infected individual are highly likely to have contracted the virus, with symptoms potentially arising after an incubation period of 1 to 14 days. Quarantine for contacts is essential to prevent virus spread.
Though the worst of the pandemic may have passed, without a vaccine or widespread immunity, normal life remains perilous. As individuals gradually resume daily activities, it is vital to remember the absence of a cure or vaccine. Continued practice of social distancing (6 feet), wearing gloves and masks, and frequent cleaning is necessary to safely navigate the journey back to normalcy.
AKAM, located in New York and New Jersey, is a volunteer organization devoted to enhancing the health and welfare of the community. We focus on volunteering, education, research, and mentorship for physicians and students interested in the medical field. For further information, please visit www.akam.org.
