• Hayoung (Talia) Cho & Kilin Tang

COVID-19 Updates Part II

#StopTheSpread




Introduction


COVID-19 (formally called SARS-CoV-2) is a virus that has currently infected over 3.3 million Americans (in addition to over 12 million worldwide) that has been declared a pandemic by the World Health Organization (WHO). With over 135,000 American deaths as a result of the disease and counting, COVID-19 is a serious public health threat to everyone. However, given that this is a developing situation, COVID-GCA Mutual Aid has decided to compile updated information about the diseases’ symptoms, transmission factors, and testing.


According to The New York Times, North Carolina ranks in the top 25th in the world for the worst COVID-19 outbreak. In particular, as of July 16th, 2020, Mecklenburg County tops the case count in North Carolina with 16,360 confirmed cases and 164 deaths just from the county (Read more for daily updates). Last Saturday, North Carolina confirmed a record-high 2,462 new cases in one day in addition to 20 new deaths, bringing NC’s total death toll to 1,598 (Read more for daily updates by The New York Times).


Unfortunately, with cases in Charlotte continuing to rise, many are worried about the future unavailability of intensive care unit beds, as 80% of hospitals are full in Charlotte. The Charlotte Observer also reports that Governor Roy Cooper and DHHS secretary Mandy Cohen are extremely concerned about the situation; Mr. Cooper has stopped the reopening of more businesses and has ordered for masks to be worn in all public areas. Given the increasing possibility of a second lockdown (which would be devastating to the economy), COVID-GCA is committed to slow the spike in COVID-19 cases that has occurred in recent weeks. 


In the first part of this blog series, we’ve provided an updated guide on COVID-19: how it is transmitted and what symptoms are prevalent. The second part will discuss the different types of tests, the importance of those tests, the procedures during testing, and where to get tested.  


Getting Tested in the Greater Charlotte Area


Quick Resources


1. Take a COVID-19 Risk Assessment from Atrium Health. 


2. Read about what to do if you are sick from the Centers for Disease Control and Prevention (CDC)


3. Visit the North Carolina Health Department website for more information. 


Diagnostic/Coronavirus Testing


This test determines whether or not you are currently infected with COVID-19 (SARS-CoV-2). Note that this is different from the Antibody or Serology Testing which will determine whether you were infected in the past. There are currently two types of diagnostic testing approved by the U.S. Food and Drug Administration (FDA): molecular and antigen tests. 


Molecular test (PCR test): PCR tests detect the COVID-19 virus from nasal or throat swabs, and sometimes from saliva. The fluids are then analyzed using a technique called polymerase chain reaction (PCR). If the sample is sent to a lab, the results may be available in a few days; results can take a few minutes if analyzed on-site. These tests are reliable but rapid on-site testing has missed some infections. 


Antigen test: This detects proteins that appear as a result of the COVID-19 virus from nasal or throat swabs. The fluids are then analyzed for the proteins, producing results in minutes. These tests are cheaper and generate results faster. Positive results have been considered accurate, but there have been many cases of false-negative results since antigen tests are not as sensitive as molecular tests. 


The Centers for Disease Control and Prevention (CDC) has found evidence showing that an  infected person can spread COVID-19 from 2-14 days to your friends and family before developing any symptoms. You also might be asymptomatic (experiencing no symptoms) but still be able to transmit the virus to your loved ones at home.


Diagnostic Testing General Process:


1. Set up your appointment. Continue reading to find the nearest testing site.


2. Nose/Throat Swabs. The swabs are flexible sticks with cotton tips and should collect a sample of your mucus. These samples should be sealed and sent to a lab or sent to be analyzed on-site. Sometimes saliva samples will be used and you should be expected to spit into a tube to be sent to a lab. 


3. Get Results. The results will be positive or negative. 


Tip: Watch this video from the Mayo Clinic on how to prepare your child for a swab. 


Testing Sites:


1. Click here to find the closest COVID-19 test site near you!


2. Gets tested from CVS for $0 per test!


Learn more to find out which CVS is available for testing in the Charlotte area. 


Antibody/Serology Testing 


This test is designed to detect antibodies produced in response to COVID-19, allowing you to estimate whether or not you got infected in the past even if you did not show any symptoms. However, these assays should NOT REPLACE tests diagnosing COVID-19.


Those with antibodies may donate their blood to aid those severely suffering from COVID-19 (read more) and distribution of convalescent plasma. These tests will provide crucial information on how our immunity fights COVID-19, how long our immunity will last, how much of the antibody will be necessary, and determine one’s eligibility on whether or not one can donate blood.


*Note: 1-3 weeks after showing symptoms, you will have developed some degree of immunity and thus antibodies will be best detected. There has been no conclusive evidence on how long the antibodies remain in the body, so make sure to test early because every test will provide significant data on herd immunity. 


Antibody/Serology Testing General Process:


1. Set up your appointment here at Atrium Health


2. Blood is Drawn. An antiseptic should be used to clean the skin and small blood samples must be drawn from a vein, most likely from the inner elbow. An elastic band or tourniquet may be used to put pressure. For infants, blood may be drawn by puncturing the heel with a lancet or small needle. 

Note: for point-of-care (POC) tests, they will most likely use blood samples from fingerstick and not venipuncture as described above. 


3. Blood is Processed. The blood will be screened for antibodies such as IgM and IgG by a machine.


4. Get Results. The results will most likely be available within a few days, and they will most likely come back faster than diagnostic tests. The authorized tests will provide qualitative results: positive, negative, or indeterminate. 


Tips: Make sure to wear short sleeves and help your child prepare for the appointment if they are afraid of needles. Explain the importance of this test and ease the fear because it will be more painful to draw blood with tense muscles. 


Types of antibodies detected:


IgM (Immunoglobulin M): These are found in the blood and lymph fluid and are made to fight newly developing infections. IgM antibodies will be one of the first ones to be detected in blood samples, indicating the occurrence of a previous COVID-19 infection. 


IgG (Immunoglobulin G): Most common antibody found in all body fluids to protect your body against bacterial/viral infections. These are seen to develop after the presence of IgM, indicating the occurrence of a previous COVID-19 infection. 


IgA (Immunoglobulin A): Mostly found in the mucous membranes, these line the respiratory and gastrointestinal tracts. SARS-CoV-2 specific IgA has been reported but not as frequently as for IgG or IgM. These may remain detectable for months or even years, possibly indicating the occurrence of a previous COVID-19 infection. 


IgE (Immunoglobulin E): Produced during allergic reactions, they are found in mucous membranes. However, the presence of this antibody does not indicate a previous COVID-19 infection. 


IgD (Immunoglobulin D): Found in the blood, these antibodies are the least understood and may appear in one’s blood samples. However, the presence of this antibody does not indicate a previous COVID-19 infection. 


Stay safe!

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