Cedars Sinai doctor just told my partner.

Even though his test was positive, he said it was definitely a coronavirus diagnosis regardless of the result.

Has anyone seen news about this?

Perhaps the Abbott test is more reliable albeit slower.

I just saw a story on this. Will try to find and post.

(Edit: I've been helping some at work do some situation assessments of some foreign countries. I'm not a public health professional but there has been some work regarding looking at reported testing numbers.)


The short of it you realize quickly that a bunch of different numbers are being tossed around. I've heard various things from doctors in a few different places. As to 40%, that's mostly been tossed around by some as a high end estimate.

Improved testing combined with antibody tests/serology will be required to place the globe on truly solid statistical footing.

Anecdotally we've had several people test negative that had all the classic signs and symptoms, including labs, radiology, and typical progression of symptoms. A few of them got better and discharged, one went into ARDS. Ended up doing a retraining to ensure swabs were being done correctly, just out of suspicion and as an extra precaution.

Any sort of meaningful false negative rate puts a lot of healthcare workers at risk. The short supply of PPE means the people who test negative despite symptoms are not being placed in a strict isolation protocol. We are still wearing droplet masks for the most part with these people and are asking them to put one on when we enter the room but that's about it.

depends on what tests. we know the test kits from China are not accurate.

The first batch of test kits in the US had very high rates of false results, which is why they were pulled.

Pelayo said:

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30-40% is consistent with what we're seeing

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Would you mind elaborating on how this has been determined? Is the same person given multiple tests? Are people showing symptoms but testing negative?

rayneag said:

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Pelayo said:

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30-40% is consistent with what we're seeing

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Would you mind elaborating on how this has been determined? Is the same person given multiple tests? Are people showing symptoms but testing negative?

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It's about the amount of people with classic symptoms and findings that have had negative test in our clinics.

Pelayo said:

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rayneag said:

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Pelayo said:

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30-40% is consistent with what we're seeing

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Would you mind elaborating on how this has been determined? Is the same person given multiple tests? Are people showing symptoms but testing negative?

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It's about the amount of people with classic symptoms and findings that have had negative test in our clinics.

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OK, thanks. Do you consider anosmia a classic symptom?

Well said

rayneag said:

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Pelayo said:

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rayneag said:

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Pelayo said:

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30-40% is consistent with what we're seeing

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Would you mind elaborating on how this has been determined? Is the same person given multiple tests? Are people showing symptoms but testing negative?

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It's about the amount of people with classic symptoms and findings that have had negative test in our clinics.

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OK, thanks. Do you consider anosmia a classic symptom?

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Haven't seen enough cases to have a feel for that. Less than half the cases I've seen admitted to it.

That's good to hear. Hope more folks begin to follow that logic.

My question is if the negatives are really true negatives (questionable obviously) and we're only testing sick people, what the hell is going around that's causing the illness? Obviously flu is out there but I would hope we're still testing for flu since that's easy test. It just seems like there can't be this many anecdotally sick people and this many negative tests without something falling apart somewhere.

Pelayo:

I think that I recall that you are outpatient, is that correct?
I am also outpatient and have done a number of tests, some of which I just had a gut feeling in terms of symptoms, some really met all criteria.
What I find odd is that, aside from the flu season, I just don't see that many true fevers in clinic generally but the number I have seen in the last 2 weeks has surely spiked. No tests so far have come back positive and all are negative for strep and flu.
I know I am testing right, and Quest is primarily being used to date.
So two questions:
1) Do you really believe we are missing 30-40% of cases?
2) Are you starting plaquenil and azithromycin in an outpatient setting? We have been advised against it unless hospitalized

Now, we have been further restricted in terms of testing based on priority levels (which may change tomorrow for all I know). This has frustrated me to no end
I can tell patients to quarantine but they truly will not do so in many cases if they are not confirmed positive. It all makes me wonder if we can do much of anything to halt the spread despite whatever measures we take.

Anyway, just asking some questions and also thinking out loud I suppose.

Thanks for your work, look forward to hearing your thoughts.

A sensitivity of 60-70% is being quoted in the medical literature for nasopharyngeal samples based on China's experience.

queso1 said:

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Why do we (and the press) automatically jump to believe bad anecdotal stories, but when it comes to good news all we hear is "we won't know if this is true until we conduct a 50 year double blind study with miniature ponies and Russian cosmonauts that returned from space during the periods of 1964-1967 and also enjoy listening to pre-Dookie Green Day?"

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Positive news doesn't get the clicks negative news gets

Pelayo said:

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Player To Be Named Later said:

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Pelayo said:

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30-40% is consistent with what we're seeing

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If that is even close to the true number, then we are really dropping the ball by requiring a positive test before offering people HCQ/Azithro.

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If it's clear they most likely have it we Rx it.

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Can not blue star this enough.

Yes, I own and operate a small chain of UC centers. Independent. I do work in an ED every other month 1-3 shifts a month to keep my skills up.

Quote:

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1) Do you really believe we are missing 30-40% of cases?
2) Are you starting plaquenil and azithromycin in an outpatient setting? We have been advised against it unless hospitalized

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1. If we are relying on the Throat and NP swabs sent out for rRT-PCR we are definitely missing somewhere in that ballpark.

2. Absolutely I am. As compared to other UC we tend to see higher acuity patients, we do treat the ones that are approaching the point of needing hospitalization. Patients right now are not coming in until day 5-9 of illness, so really haven't seen a lot of 'mild' early patients that I feel comfortable clinically labeling as classic COVID.

Quote:

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Now, we have been further restricted in terms of testing based on priority levels (which may change tomorrow for all I know). This has frustrated me to no end
I can tell patients to quarantine but they truly will not do so in many cases if they are not confirmed positive. It all makes me wonder if we can do much of anything to halt the spread despite whatever measures we take

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.That's unfortunate, seasoned physician judgement has great value.

Our patients have been more than happy to quarantine. Then again, we are so slow right now that we are only seeing the sicker more willing compliant bunch.