September 9, 2021
Q. Why are vaccinated employees and students not required to be tested?
A. We recognize that vaccinated individuals may test positive or have a “breakthrough” case. However, at the present time, unvaccinated individuals appear more likely to contract COVID-19. To assess the presence of COVID-19 within the Wittenberg community, monitoring unvaccinated individuals appears to be the most efficient and effective way to do so. We will continue to monitor this protocol and remain receptive to changes as more information becomes available.
Q. Why are healthy employees and students being asked to be tested if they are already taking all the necessary precautions?
A. Short of a vaccine mandate, testing unvaccinated members of our community is a current best practice to mitigate the spread of COVID-19. We continually consult with our medical professionals and others on the COVID Response Team when considering any changes to our campus protocols. We know that asymptomatic individuals may test positive for COVID-19. National data examining the first semester of the 2020-2021 school year demonstrated that testing of asymptomatic individuals picked up cases that otherwise would not have been identified and reduced the overall viral load on campuses. This was not done at Wittenberg due to the lack of availability of testing last year. Our hope is that by following an enhanced regular testing protocol, we will be able to use early identification to decrease the overall viral load on the Wittenberg campus.
Q. Does the PCR test show what variant of COVID you have? (i.e. the Delta variant)
A. No it does not. The test only identifies several small pieces of the virus’ RNA. Only a detailed evaluation of the entire virus’ RNA (genome) can identify a specific variant.
Q. Why can’t antibody test results be used for the Pathway Program?
A. Antibody tests are only qualitative, i.e. they only identify if you have been infected. They are not quantitative, i.e. they do not establish your level of antibodies and thus your level of protection. Furthermore, we know that the level of antibodies created following an infection is variable and generally less than those produced following vaccination. Given these limitations, we do not believe antibody tests are appropriate in this context. Therefore, antibody testing is not used as a diagnostic tool at any level to identify a positive case or to document resistance to reinfection. This is a national policy which we feel is valid.
Q. Can I bring in my own test results from a rapid test?
A. You may submit an antigen test result that was proctored by a third-party provider. Test results must be submitted weekly by 5 p.m. each Friday. A home test done by an individual and not proctored is not accepted as valid due to possible errors in performing or interpreting the test. Also, reporting of the test to local and state health officials is important to track the disease and must be done by a certified laboratory.
Q. My personal doctor is not encouraging me to get vaccine and therefore why should I if my personal doctor doesn’t think I should? If I bring in a doctor’s note, will that exempt me?
A. A doctor’s note will not exempt you from testing if you are unvaccinated. A doctor’s note would need to be accompanied by valid reasons to exempt you from vaccination if vaccines were mandated.
Q. How long do antibodies stay in your system?
A. Current data suggests this varies by individual. Three months is a “rule of thumb” time for the antibodies to remain protective. Recent data from Israel showed that following vaccination with Pfizer & AstraZeneca (the two vaccines they currently use), Covid-19 antibodies remained at protective levels for about 6 months. They then begin to wane, and by eight months, levels are significantly less protective. That is why the CDC and FDA have now recommended a booster at eight months. FDA approval of the booster is still pending.
Q. Is it possible to not get antibodies if I tested positive for COVID in the past?
A. It depends on how long ago you had the original infection. As noted above, the antibodies decrease over time and could be undetectable if a long time had transpired since the infection. Another factor is how large your initial viral load was or how sick you were. We know that the sicker the individual, usually, the greater the viral load, which will prompt a more robust immune response. This, in turn, will produce more antibodies. The more antibodies the longer they will remain in your body. Some individuals, particularly immunocompromised individuals, may not respond to either infection or the vaccine with antibodies.
Q. What is the difference in quality and accuracy of tests between PCR and rapid type tests?
A. All testing in any laboratory may have some element of false positive and false negative. If these “errors” in testing fall within what is considered an “acceptable” range, the test may be used as a diagnostic test.
Rapid Tests detect protein fragments of SARS-CoV-2 virus. It tests for the presence of viral protein in the sample and is also called an antigen test.
More recent data has shown that BinaxNow, the most frequently used test by Abbott, is about 84% accurate at detecting positive cases and 98% accurate at detecting negative cases.
However, the Rapid Tests are more accurate when used early in the infection. Manufacturer’s studies have shown that the BinaxNow test is more accurate when used less than 7 days of the onset of symptoms.
The antigen tests were considered less accurate when they first came on the market. However, with continued use, they have become accepted as diagnostic tests with the recognition of false positive and false negative falling within an “acceptable” range. Therefore, the Rapid Tests are much better at detecting negativity than positivity. Thus, there is an increased chance of a false-negative result – meaning that it is possible to be infected but have a negative test.
The PCR (polymerase chain reaction), also known as a molecular test or NAAT (nucleic acid amplification test), is the “gold standard” by which all other tests are judged. It works by multiplying the viral RNA through a nucleic acid replication process and can therefore detect very small amounts of the viral genome. It is the most reliable and accurate test we have.
The PCR in a laboratory setting is almost 99% accurate at detecting COVID RNA. In the clinical environment, because of varying viral loads, timing in relation to the onset of symptoms, and the restraints of sampling, it is 99% accurate at detecting a positive sample but has an 86-88% false-negative rate. That is, reporting a negative test when the person is positive.
Bottom-line: If you have a negative Rapid Test, and you are confident that you were exposed to a proven case of COVID, or if you have or develop symptoms, you should get a PCR test within 2-3 days and continue to quarantine until you get your results.
Q. If I was tested in the past for COVID, and it was positive, why would I not have any antibodies? (false positive?)
A. There could be several factors. You are correct that it could have been a false positive especially if it was a Rapid Test (as was the case with Governor DeWine). However, it also depends on the length of time between your illness and the testing. We know that the level of antibodies produced is directly correlated with the viral load you sustained at the time of the exposure. Generally, the sicker the individual, the higher the viral load and thus the greater the antibody response. So if your illness was mild, and there was an extended time between illness and your testing, the antibodies could be below the detection threshold. Medications and underlying immunosuppressive illnesses may also inhibit your body’s antibody response.
Q. What are all of the options for testing outside of campus testing being offered? Is that testing free also?
A. You will find additional testing locations on this Testing Flyer 6.25 (ccchd.com). Some are free, and others charge for their services.
Q. Why do I have to show my insurance card if I am not getting billed?
A. Currently, the CARES Act is subsidizing some testing and vaccination clinics, and our campus testing is covered and therefore free of charge to anyone who is tested. The tests are tracked as part of the process billed for the test. Your insurance card is being asked for because your insurance will be billed for the test. The amount that they choose to pay or not to pay will be accepted as payment in full, and you should not have any “out of pocket” expense. So even if you receive an Explanation of Benefits (EOB), you will not be billed.