We can’t test our way out of this

In April when I last laid out our short, mid and long term testing goals for responding to COVID-19, we were still of the mindset that we could test our way out of this virus. We know now that just isn’t the case.

Don’t get me wrong, testing — having an abundance of tests, getting results quickly, and the affordability of tests — makes a huge impact on our ability to slow the spread of this novel disease. But it does not stop the spread.

We need to continue to apply a collective layered efforts and I love this graphic for demonstrating what I mean:

Rapid testing is on the way, here’s what you need to know:

Here in the next few weeks we’ll add a rapid COVID-19 antigen test to our quiver. The equipment and technology that make that possible will also allow us to perform rapid antigen tests for strep and Respiratory syncytial virus (RSV) and influenza.

This new rapid antigen test will be used alongside, and in some cases in addition to, the PCR tests (spit / nasal) that we currently employ.

What is a rapid COVID-19 antigen test? These tests, which produce results in 15 minutes, look for a component of the COVID-19 virus, which implies current viral infection. More on that here. 

Like many COVID-19 tests, our rapid antigen test will not be 100 percent accurate, but it will be the most effective test we have to date. For this reason, however, we may choose to layer a negative antigen test with a confirmatory PCR test in certain clinical scenarios.

This is not unlike when we have a negative rapid strep test but then send a confirmatory throat culture to the lab.

Because testing is not perfect, Public Health and CDC guidelines dictate that anyone with respiratory symptoms or those who have had close contact to a person with a known COVID-19 infection, to quarantine for 10 days even if they receive a negative result.

False positives for both antigen and PCR tests are very uncommon, so if the result is positive, we do not require a confirmatory second test.

Who is eligible for rapid antigen testing? Our rapid COVID-19 tests are limited and for the foreseeable future we will use this method, primarily, to detect infection in symptomatic patients as deemed necessary during evaluation.

In other words, the rapid antigen test is not a test a patient can request, but rather a tool our providers may elect to use as they see fit.

PCR tests will remain available for anyone who wants a test

We will continue to use the PCR tests (spit / nasal swab), which produce results generally within 2-5 days, for asymptomatic patients.

Anyone can receive a PCR COVID-19 test at our clinic and we do have a fund to help with the cost for those who are eligible for assistance. (Can you sponsor a test for a neighbor in need?).

What does rapid testing mean for the community? We have one more very effective way to detect the disease and slow the spread through contact tracing and isolation efforts.

And we’ll also be able to quickly distinguish between four respiratory diseases, each of which have their vulnerable populations.

The new rapid testing, and the continued availability of PCR testing, will have a massive impact in our community, but only in tandem with other efforts, like the swiss cheese image indicates.

Until we have an effective and widespread vaccine, our best outcomes will require we practice good social distancing, personal hygiene and get tested and isolate when we’re sick.

The Five Commitments

Everyone can protect their own health, the health of the community and the health of the local economy by making these five commitments:

More on prevention, exposure risks, testing and next steps here.

More on prevention, exposure risks, testing and next steps here.

Things change, we know this. We’ll continue to look at new science and technology and will always work to share what we know, as we know it, with the community.

We’re all in this together.


Dr. Koelliker

Diana Koelliker | MD
Medical Director Emergency & Trauma Services
Telluride Regional Medical Center