The most important aspect of understanding this extraordinary COVID-19 pandemic is that all of us who live, work and play in Indiana County learn what this virus can do, how it is transmitted, how we test for it and how we all can diminish its impact on ourselves, our families and our neighbors. Knowledge is power and prudence is what we need to replace fear and ignorance.
I am sure you have heard about the problems with testing for the virus. It is only with testing that we can diagnose the disease, monitor its spread and make decisions about whether a place such as a school is safe. There are three viral tests that have been evaluated by the Food and Drug Administration.
The first one that is most commonly used is called viral PCR (polymerase chain reaction). This test requires a swab from behind the nose to look for viral RNA using a method that amplifies parts that are unique to this virus. When this test is positive it means that the person has the virus in the back of the nose (nasopharynx). Between 10 and 25 percent of people who have the virus will test negative. This may be due to the quality of the sample or that the person no longer harbors virus in the nasopharynx. The second viral test is called viral antigen, which detects a protein unique to the virus. Like the viral PCR, it requires a swab of the nasopharynx. When this test is positive it also means there is virus in the patient. It also has a false negative rate of 10-20 percent. The test takes about 20 minutes to give a result. Both the viral PCR and the antigen test are usually positive two to 10 days after infection.
Finally there is the antibody test, a blood test that measures a person’s immune response to having been infected with the virus. It is useful only to know if one has had the infection in the past. It does not diagnose a new infection in most cases. The test turns positive about one week after infection and remains positive for one to two months and possibly longer.
For us to identify people with the virus we need to know the results of these tests quickly. A test result a week after being tested is too long for many decisions that we make in caring for patients. Commercial laboratories such as Labcorp and Quest are overwhelmed with test requests. Sometimes they don’t return a result for as long as two weeks.
Fortunately, we at Indiana Regional Medical Center are able to get test results completed in two days or less. We have done this by working with IUP and Dr. Narayanaswamy Bharathan, chairman of the Department of Biology. With his expertise we have our own PCR laboratory at IRMC. We also offer the viral antigen and the COVID-19 antibody tests in our laboratory. We are able to test anyone in the community with symptoms as well as anyone who is scheduled to have surgery or is admitted to the hospital.
Here in Indiana, we avoided the flood of sick patients that occurred in New York and Philadelphia during the spring. In fact, between May 10 and June 10 Indiana County averaged about one positive test per day. It is no surprise that after the lockdown ended in early June people began to change their behavior. There are many more gatherings of people without masks. People are going to bars where they drink and may forget to be careful.
Finally there is the political pressure, especially on social media, about wearing masks. As a result the number of cases here has increased in the past three weeks to nine per day. Western Pennsylvania is under threat of becoming a hot zone for COVID-19 infections.
Our county has many senior citizens, there is widespread obesity, diabetes, hypertension and people with lung diseases, especially from smoking. We must act together to prevent the sickness we are seeing now in Florida, Texas and other states. Even if we don’t know anybody who has suffered, we have to protect each other. If there is a big outbreak here we may overwhelm the medical resources that are available. If doctors, nurses and technicians get sick there will be fewer people to take care of those who need help.
It all comes back to being a good neighbor. WEAR A MASK! I wear one to protect you, and you wear one to protect me. Stay out of crowded indoor spaces and stay at least 6 feet from anyone you don’t know well enough to be sure they are safe. If we take those measures every day we will manage to get through this difficult period until there is an effective available vaccine.