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In order to shift the health response to COVID-19 from the community level to a personal level, getting a COVID-19 test is a key element in drawing up a good battle plan. But if you do seek out testing, there are some basic things you need to know.

Sometimes those tests throw false positives and negatives. In the past, access to testing has been restricted, now it’s not. Some businesses aren’t requiring their employees to wear masks.

Michael O. Frank, Medical College of Wisconsin
Dr. Michael O. Frank

Why is that?

In an exclusive interview, Racine County Eye owner Denise Lockwood spoke to Dr. Michael O. Frank, Chief of the Division of Infectious Disease at the Medical College of Wisconsin about testing and workplace protocols.

COVID-19 testing and masks

Q: How accurate are the tests?

A: There are two parts to the answer to that question. However, before I even get into it, it depends on the type of test, and it depends on the vendor. So, I know here at Froedert that we don’t use the less reliable tests. We use three different vendors, and they’re all equally good.

The rapid tests, which can be done with just a specimen real quickly like 10 minutes — is a notoriously unreliable one. That’s what they were using in the White House. And it turns out it missed two people who now have tested positive, so the rapid test is so unreliable we’re not even using it here. The other test, which takes a day to come back, is a very good test.

So the first part of this is how good is the test the actual test is very good if you have a virus there and you collect it on the swab, the chance of a test missing it is very very low. It’s like 99%. But that’s not the problem. The problem is that people don’t get a good specimen. So, they swab the nose rather than going back in and getting the back of the nasal pharynx — the back of the throat through the nose. So that’s why you’ll hear stories about how uncomfortable that is for people. If it’s not uncomfortable when it’s done, it probably wasn’t done right.

Q: Why is the test sometimes throwing false positives and false negatives?

A: It probably would have been positive the first time, it’s just that the second time the person got a better sample. And then the other part of it is that people can shed (when a virus replicates inside your body and is released into the environment) intermittently. They can be negative one day and positive enough next because they were just starting to shed. They were infected previously, but they were just starting to shed virus and so the test missed it even though they were infected. And to be honest, we don’t know how often that happens.

Q: Early on, there was a testing shortage, so we were restricting who got tests. Are we limiting who receives the tests now?

A: We do not any longer have a shortage of tests. So we’re much more open now to repeat testing when we’re really worried about someone because sometimes you may just miss it if it’s too early.

Q: I’ve been doing a lot of stories around like factories and restaurants having positive cases of COVID. One of the things that I’ve noticed is a lot of them are taking temperatures of their employees at the door before their shifts start. How accurate is something like that in predicting whether or not you have COVID?

A: Yeah. I have to say I have mixed feelings about that. Yes, if someone’s got a fever, they should not be coming in. But that doesn’t mean they have COVID. They may have an illness for some other reason. Also, we know that a lot of people with COVID will not be running a fever.

In fact, we know that some people don’t have any symptoms. We don’t know how many yet. But it may be a third of the people who get infected don’t have any symptoms ever, much less of fever. And a lot of the people who do have symptoms and are ill, don’t have a fever. So the temperature thing is useful in that if somebody does have a fever, you can keep them out. But I almost worry about creating a false sense of security, because you’ll miss a lot of people with COVID just by checking for fever.

Q: There are a lot of essential businesses that have had people test positive for COVID. Some have shut down and cleaned. But they don’t require workers to wear masks at all. Is that is that an acceptable practice?

A: Yeah, so you said a couple of things that were important. Number one, cleaning down. As we know, surfaces can stay positive day after day. Cleaning them down regularly — everything that people might touch or come in contact with — is very important.

The mask thing depends on the kind of work that’s being done and how close together people are. The reason there have been these outbreaks in meatpacking plants is that the people are elbow to elbow. I mean, they’re right next to each other. And there’s no way you can distance doing that kind of work. Often, in factories, there isn’t much space between people, and that’s when I would worry about not wearing masks.

Now sometimes it’s tough to wear a mask. It’s hard for me to wear a mask all day. And I’m not doing labor that is physical where I would get sweaty or something. So it’s easy for me to sit here and say yes, they should all be wearing masks all day or their whole shift. But I know that that’s hard to do. It’s hard. It’s uncomfortable. So, it’s easy to say one thing, but I know the reality is sometimes difficult.

Want to know more about how to keep you and your family safe? Check out our story about hygiene tips.

Denise Lockwood has an extensive background in traditional and non-traditional media. She has written for, the Milwaukee Business Journal, Milwaukee Magazine and the Kenosha News.