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- Some business owners are encouraging “healthy” people to get tested for COVID-19 to lower the positivity rate and avoid lockdowns.
- The approach runs counter to CDC guidelines and may overwhelm laboratories, epidemiologists say.
- Attempts to mislead the system demonstrate misunderstanding and discontent with the way governments have handled shutdowns.
Can You Manipulate COVID-19 Positivity Rates To Avoid Crashes?
Various business owners and people seem to think so.
In recent social media posts and media interviews, they have been encouraging “healthy” people to get tested en masse.
The idea is that it can help lower the positivity rate, a critical measure government officials use to determine whether schools, restaurants, and other businesses should close.
While math may work on paper, the advice goes against
Experts say trying to play around with the COVID-19 positivity rate is deeply problematic. This is why.
There is a simple formula used to determine positivity rates. It usually involves dividing the number of people who tested positive by the total number of tests administered or the number of people who received the test on a particular day.
Some business owners are trying to lower that rate by increasing testing, according to some news reports. His reasoning is: if people who think they haven’t been exposed to the new coronavirus get tested, it can help keep COVID-19 positivity test rates below a threshold that triggers a lockdown.
A handful of social media users have also created publications urging people with COVID-19 symptoms not to get tested to avoid increasing the positivity rate in their communities.
“It’s a terrible idea,” said Dr. Aaron E. Glatt, chairman of the Mount Sinai South Nassau department of medicine, where he also serves as the hospital’s chief of infectious diseases and epidemiologist. “If you’re only testing people who are negative to artificially lower the percentage of people who are positive, that’s silly.”
While that approach may work in theory, the reality is that flooding test sites with people who think they are unlikely to test positive probably won’t give business owners the results they hope for, said Susan Hassig, DrPH, associate professor. of epidemiology at the Tulane University School of Public Health and Tropical Medicine.
“You have to recognize the extent to which people would need to mobilize for that to work,” he said, adding that inevitably there would be some additional positive cases that would reveal themselves when many people with asymptomatic infections are tested.
The increased testing of people who believe they do not have the virus is not a black and white problem. On the bright side, the approach could offer researchers more data and uncover new COVID-19 cases.
“So your contact will be traced, you will be asked to isolate yourself, and we may break a few more chains of transmission,” Hassig said.
The problem is that most communities do not have enough resources to adapt to that level of evidence. When a large number of unnecessary tests need to be processed, limited supplies are depleted and long labs are delayed.
That means everyone, including people who have COVID-19 symptoms or who have been exposed to the virus, must wait longer for results.
If they can’t quarantine themselves until the results come in, they may end up inadvertently spreading the virus to other people and increasing case rates.
“It may be diverting much-needed resources to not discriminate the infected from the uninfected in needy populations,” Hassig added. “In an environment where evidence is not readily available, I see it as counterproductive.”
The tests are not perfect and
Considerations in determining whether to get tested include having symptoms of COVID-19, being in close contact with someone who has the disease, or receiving a request from a healthcare provider or the health department.
“Rapid testing in low-risk populations means that you are more likely to get false positives,” Glatt said. “They will be isolated and quarantined when not necessary or appropriate.”
Also, people who receive a false positive may later think that they are immune to the disease, so they are at risk of contracting and transmitting the virus in the future.
The fact that people believe they can play with positivity rates reveals a growing discontent with the current approach to lockdowns in many communities.
“They perceive the benchmark as arbitrary,” said Hassig, who works with his state and city health departments to help people understand the reasoning behind public health decision making.
“Usually the explanations are longer than what people want to hear, especially when it’s something they don’t want to hear and it tells them they can’t do something they want to do,” he said.
He added that messages about testing should be more consistent and provide a deeper understanding of the role positivity rates play in determining school, restaurant and other facility closures.
“Testing is a gateway to applying those distancing and separation strategies to prevent the virus from passing from one person to another, which will slow the spread in the wider community and the pandemic,” Hassig said. “Testing is a tool, it is not an end in itself.”
Additionally, government officials must consider more than just positivity rates when making important decisions about closings, Glatt said.
Factors such as hospital capacity, hospitalization rate, and per capita positivity rate could help officials determine whether increasing restrictions are appropriate.
“There are much better markers to follow [than] positivity rate, ”Glatt said. “I am a strong advocate of keeping businesses and schools open, but we must do it in a safe and science-backed way.”
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