Evelyn Gosnell is considering a Covid-19 test ahead of a camping trip.
Evelyn Gosnell
Evelyn Gosnell and some friends are planning a camping trip for a birthday party next month. Gosnell, a Bay Area-based behavioral scientist in her 30s, said the group had agreed to quarantine two weeks prior to the trip to reduce the risk of exposure to Covid-19.
They are also considering a home coronavirus test that they each order and deliver by mail to a local FedEx or UPS location. Gosnell said she would stay home for a few days before taking the test and be careful while waiting for the results.
But she has reservations about the whole plan, because in the US there are a limited number of tests and a lag behind the labs that delay results by a week or more. Gosnell does not want to add to an already exaggerated system or remove a test from someone who needs it more.
In San Francisco, local health officials classify outdoor activities as camping as “safer social interactions.” However, guidelines do not contain information about asymptomatic people should be checked.
“The messaging is confusing,” Gosnell said.
What the experts say
Experts in public health and infectious disease doctors are happy to weigh the matter, but their views differ, because the testing infrastructure is so cluttered, the situation varies by region and there is no coherent national strategy.
Susan Butler-Wu, an associate professor of clinical pathology at the Keck School of Medicine of the University of Southern California, said it is problematic that these decisions are largely left to individuals, but they are important questions that you should consider before engaging in activities.
“I love that people think about it in such a fun way,” Butler-Wu said. “It’s about considering the needs of their community.”
Some regions will have greater capacity to test asymptomatic people than others, they added. In other states, supplies are not directed where they are most needed.
“It has to be free and it has to be widespread,” he said. Peter Chin-Hong, a professor of infectious disease medicine at the University of California, San Francisco. “With Covid-19, you can have the virus and be asymptomatic, so knowledge is power.”
But Chin-Hong acknowledges that resources are limited and that the situation could worsen as more schools and offices reopen. Many organizations will require students or staff to test before returning to school or work. That would make it more challenging for people like Gosnell to get a temporary result.
“This whole discussion is painful because it’s so anti-public health,” he said.
Even those who are tested before seeing friends and family should take additional precautions, he said. Tests can show false negatives, and the delays in the system mean that people could be exposed between the time of their test and the time they get their results.
‘I’m scared of it’
“It can give people a sense of confidence that can be unfair,” said Dr. Steven Pergam, an associate professor in the vaccine and infection control division at Fred Hutchinson Cancer Research Center. “I’m scared about it.”
Pergam is worried that people with negative outcomes will not wear masks or will choose not to maintain social distance. His concerns could be addressed if a new test came on the market that is cheaper and has a fast turnaround time, although it still needs to be accurate.
His advice to Gosnell and people in similar situations is to see if getting the test would bring them forward for those most in need.
‘Be mindful,’ he said. “But I know it’s hard because we get unusual messages from politicians against those who are on the front lines.”
University of Washington professor and expert Carl Bergstrom said he thought a lot about this question. In Seattle, where he is based, there is pressure on more people in the community to test, especially those who have attended protests.
Bergstrom said testing before seeing an older relative or a group of friends falls into a category called clarification testing. If you’re in a city like Seattle, where doctors and public health groups want people tested for data collection, surveillance, and mitigation purposes, then it’s good to go for clarification tests, “because you contribute to a fight against disease, “he said.
But in communities where they only test people who are symptomatic, his recommendation may be different. It is an unfortunate reality for people who are just trying to stay safe in a pandemic.
“I do not feel that individuals should be taxed to make public health allocation decisions,” Bergstrom said.
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