A Few Acid Remarks about Testing
Jan. 27th, 2022 01:36 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
walkitouthttps://www.npr.org/sections/health-shots/2022/01/23/1074978193/rapid-covid-tests-omicron
I’ve been really trying to understand whether or not antigen tests are useful for being able to tell if “a cold” is omicron or not, and also, secondarily, whether antigen tests are useful for ensuring that participants in an event are all, if not covid-free, at least sufficiently covid-free to be unlikely to transmit at that event. I have a very, very, very bedrock policy of Only Test If You Will Act on the Results. If you are going to (not) behave the same, regardless of test outcome, then don’t bother to test. So: if you are not going to the party, test or no test, skip the test and the party. If you ARE going to go to the theme park, test or no test, skip the test and go to the theme park. I’m not saying this is “correct” on any particular level; this is a pragmatic implementation of a values system. The “value” part is, “I’ve decided to ignore the test” (<— I’m not saying I have, mind you!). Once you have decided to ignore a test (a value choice), you really should just skip the test (pragmatism).
I _actually understand_ that my pragmatism is another person’s second value choice. Some people _want_ to know the results of the test, _while they ignore the results of the test_. Some people think it is important to know so they can feel guilty. That’s not me. But I’m not blind; I’ve seen this in the wild. It is a True Fact.
As the NPR piece linked to above lays out, there were some small, early pre-print studies which suggested that antigen tests maybe did not do as good a job at detecting omicron as they had done with earlier variants. And also, _all_ covid testing has suffered from problems of testing (falsely) negative early on in the course of the disease, sometimes many days into being symptomatic. Also, again, since early on, but even more so with omicron, many people are (largely) asymptomatic, but may still be able to transmit covid, so testing while healthy in advance of an event, and then staying home if you get a positive, would be a very responsible thing to do. I objected to this approach, largely because I am unconvinced there are yet enough antigen tests for everyone to be doing this all the time, and my attitude (especially while in Florida) was that I just didn’t care that much about whether I might possibly be transmitting while asymptomatic. I _was in Florida_. That shit was everywhere.
Anyway. I got yelled at 2 Sundays ago on Family Zoom for “not having any evidence” in support of the assertion that antigen testing isn’t particularly accurate for omicron. I was sort of like, well, on the one hand, sure, not a bench / lab scientist, and not my field, so you are not _wrong_, per se, _I_ personally have no evidence, however, I also read a lot and I am quite competent at navigating ambiguous information and I’ve displayed a very, very well-developed ability to make judgments with insufficient information. People have _often_ taken issue with my risk tolerance, but everyone is in agreement that my risk tolerance is, at least in some respects, … very high … but I’m almost never accused me of misinterpreting the data, and it’s pretty infrequent for people to call my sourcing into question.
I’ve been monitoring pretty closely ever since, and one thing I learned (from the spouse of the person who yelled at me) was that during the weeks leading up to the Yelling, they had been using antigen tests on a symptomatic person who was apparently pretty symptomatic, and who was definitely negative on tests every day … until she wasn’t. So, I’m sitting listening to this tale, going, well, _I_ may not have any evidence, but _they_ sure had anecdata that these tests were not super effective in terms of telling you before you are symptomatic. Anecdata has its issues. Also, there are some bad actors out there doing science who have their papers retracted. It’s an imperfect world.
The article gets into the question of, well, maybe the symptoms are the result of being highly vaxxed and boosted and thus fighting off the covid cooties super early, and thus the viral load just is not there yet. And you know, that is surely possible. But I want to point something out. The advice during December 2021 was: if you have covid, isolate for 5 days, then, assuming you are getting better / not still feverish, wear a mask when indoors for the next 5 days, and then, assuming symptoms have resolved / are resolving (too many people have lingering cough to wait for _that_ to be completely gone), you’re done. My attitude was basically, if I actually have a cold, I’ll do that. Sounds about right anyway. Skip the test — do what I am supposed to do if the test says I have it.
So, you know, _not like I was being irresponsible_ while I was in Massachusetts, which is when I came down with a cold earlier this month.
Best of all, however, the article is quite clear: you can’t trust these tests to go visit grandma, so you’re going to have to pre-isolate if you want to keep her safe. If you are symptomatic, isolate and avoid people while re-testing every couple of days. Etc. Honestly, if you add up all the recommendations, you’re either well into or through the 5 days of isolation recommended by the CDC _if you had tested positive_.
Test. Don’t Test. I don’t care. If you are sick, follow the guidance of your health care provider, not quack walkitout. If you get a positive, stay the fuck away from people, unless you need to access health care. If you get a negative, but you have symptoms, _stay the fuck away from people_, ditto, because none of us really give a shit what you have; we’d rather not get it too.
I’ve been really trying to understand whether or not antigen tests are useful for being able to tell if “a cold” is omicron or not, and also, secondarily, whether antigen tests are useful for ensuring that participants in an event are all, if not covid-free, at least sufficiently covid-free to be unlikely to transmit at that event. I have a very, very, very bedrock policy of Only Test If You Will Act on the Results. If you are going to (not) behave the same, regardless of test outcome, then don’t bother to test. So: if you are not going to the party, test or no test, skip the test and the party. If you ARE going to go to the theme park, test or no test, skip the test and go to the theme park. I’m not saying this is “correct” on any particular level; this is a pragmatic implementation of a values system. The “value” part is, “I’ve decided to ignore the test” (<— I’m not saying I have, mind you!). Once you have decided to ignore a test (a value choice), you really should just skip the test (pragmatism).
I _actually understand_ that my pragmatism is another person’s second value choice. Some people _want_ to know the results of the test, _while they ignore the results of the test_. Some people think it is important to know so they can feel guilty. That’s not me. But I’m not blind; I’ve seen this in the wild. It is a True Fact.
As the NPR piece linked to above lays out, there were some small, early pre-print studies which suggested that antigen tests maybe did not do as good a job at detecting omicron as they had done with earlier variants. And also, _all_ covid testing has suffered from problems of testing (falsely) negative early on in the course of the disease, sometimes many days into being symptomatic. Also, again, since early on, but even more so with omicron, many people are (largely) asymptomatic, but may still be able to transmit covid, so testing while healthy in advance of an event, and then staying home if you get a positive, would be a very responsible thing to do. I objected to this approach, largely because I am unconvinced there are yet enough antigen tests for everyone to be doing this all the time, and my attitude (especially while in Florida) was that I just didn’t care that much about whether I might possibly be transmitting while asymptomatic. I _was in Florida_. That shit was everywhere.
Anyway. I got yelled at 2 Sundays ago on Family Zoom for “not having any evidence” in support of the assertion that antigen testing isn’t particularly accurate for omicron. I was sort of like, well, on the one hand, sure, not a bench / lab scientist, and not my field, so you are not _wrong_, per se, _I_ personally have no evidence, however, I also read a lot and I am quite competent at navigating ambiguous information and I’ve displayed a very, very well-developed ability to make judgments with insufficient information. People have _often_ taken issue with my risk tolerance, but everyone is in agreement that my risk tolerance is, at least in some respects, … very high … but I’m almost never accused me of misinterpreting the data, and it’s pretty infrequent for people to call my sourcing into question.
I’ve been monitoring pretty closely ever since, and one thing I learned (from the spouse of the person who yelled at me) was that during the weeks leading up to the Yelling, they had been using antigen tests on a symptomatic person who was apparently pretty symptomatic, and who was definitely negative on tests every day … until she wasn’t. So, I’m sitting listening to this tale, going, well, _I_ may not have any evidence, but _they_ sure had anecdata that these tests were not super effective in terms of telling you before you are symptomatic. Anecdata has its issues. Also, there are some bad actors out there doing science who have their papers retracted. It’s an imperfect world.
The article gets into the question of, well, maybe the symptoms are the result of being highly vaxxed and boosted and thus fighting off the covid cooties super early, and thus the viral load just is not there yet. And you know, that is surely possible. But I want to point something out. The advice during December 2021 was: if you have covid, isolate for 5 days, then, assuming you are getting better / not still feverish, wear a mask when indoors for the next 5 days, and then, assuming symptoms have resolved / are resolving (too many people have lingering cough to wait for _that_ to be completely gone), you’re done. My attitude was basically, if I actually have a cold, I’ll do that. Sounds about right anyway. Skip the test — do what I am supposed to do if the test says I have it.
So, you know, _not like I was being irresponsible_ while I was in Massachusetts, which is when I came down with a cold earlier this month.
Best of all, however, the article is quite clear: you can’t trust these tests to go visit grandma, so you’re going to have to pre-isolate if you want to keep her safe. If you are symptomatic, isolate and avoid people while re-testing every couple of days. Etc. Honestly, if you add up all the recommendations, you’re either well into or through the 5 days of isolation recommended by the CDC _if you had tested positive_.
Test. Don’t Test. I don’t care. If you are sick, follow the guidance of your health care provider, not quack walkitout. If you get a positive, stay the fuck away from people, unless you need to access health care. If you get a negative, but you have symptoms, _stay the fuck away from people_, ditto, because none of us really give a shit what you have; we’d rather not get it too.
I'm so sorry you got yelled at!
Date: 2022-01-30 08:57 pm (UTC)Re: I'm so sorry you got yelled at!
Date: 2022-01-31 12:50 am (UTC)I’ve done my than my share of yelling, so on some level, I definitely deserved this. And the thinking and talking about it has resulted in a lot of important insight, so I am also grateful for the learning opportunity.
Other than that, tho, yeah. The stuff they are doing themselves thing is really always amazing, even tho oh so predictable.
Literally decades ago, I had a policy — still do! — where if I had a relationship (friend, family, coworker, activity buddy, whatever) with someone who did something I really hated and reacted to, I spent a lot of time introspecting and talking to other people to try to understand how I did that same thing. I then set out upon a change journey to … do different things. Generally speaking, after that process reached something like closure, either I wasn’t that reactive to the person / behavior any more, or it was super easy to walk away.
If we are all very lucky, I will come away from this event doing a whole lot less ranting and yelling.