A site in Bradley County that began providing drive-thru COVID-19 testing last weekend is now touting a 10-minute "rapid screen" — but it's not meant to diagnose a COVID-19 infection.
The new rapid test that Cleveland-based Physician Services is offering is a serology, or blood serum, test. Serology tests detect antibodies, the proteins that signal an immune response, and are used to determine past infection.
Owner Matthew McNulty said his website and patient disclaimer clearly states, "The rapid screen tests for antibodies. That's all it does."
However, virologist Clint Smith said that communicating the differences between the different new COVID-19 tests that are hitting the market can be a challenge.
"I could imagine people would be very willing to pay [for the serology test], not fully knowing that it doesn't answer the question, 'Am I currently sick?'" said Smith, who specializes in coronaviruses at the University of the South. "Where they're really useful is when we have shortages — like we do now — to be able to know which health care providers have already been infected and have already recovered. That could help hospitals in terms of some staffing questions."
Rapid tests for coronavirus are just starting to become available, and the vast majority of COVID-19 diagnostic testing — including what's provided by Physician Services — is done at off-site labs. Providers must obtain a nasal swab from a patient, ship the swab to a lab and wait. Results usually take days or sometimes over a week to return. McNulty said test results from his facility are typically ready in two or three days, which is faster than many other local facilities.
McNulty said anyone can get the serology test, but people seeking the swab test used to confirm COVID-19 infection need to show symptoms of the coronavirus.
People who want to get tested should go to clevelandtest.com to fill out the form and pay for the test for a touch-free encounter at the office, he said. The serology test — which on his website is listed as Rapid COVID-19 Antibody — is $50. If positive, the swab test — listed as Lab PCR Confirmation on the website — can be added for $150. The cost for a stand-alone Lab PCR Confirmation test is $200, McNulty said. First responders can get the serology test for free, according to the website, although the site calls the test a "rapid screening," not a serology test.
Current testing: The primary means for testing for COVID-19 at this time is through a laboratory technique (called PCR) that works by identifying the genetic signature specific to the coronavirus. A provider will use a nasal swab to collect the specimen and then send it to a special laboratory capable of performing the technique. Results typically take between 24 hours and several days, or in some cases over a week, depending on the volume of tests at the lab.
* A new serology test can detect an antibody response to COVID-19. These tests should not be used to diagnose the disease, but rather help to identify people who are past their initial infection and either close to recovered or fully recovered from the disease. People with a positive antibody test are believed to now have immunity to the coronavirus.
* The “Abbott test,” named for the company that developed it, is a new point-of-care test (can be conducted on site) that works like the current PCR test for COVID-19, expect it can be done in minutes without complex testing labs. Tests like this are not currently available in the Chattanooga region, but are expected to be soon.
Smith said if someone is positive for the serology test but negative for the nasal swab test, that is strong evidence that person was infected, has fully recovered and isn't going to transmit the virus to anyone. Those who are positive for the serology test and also positive for the nasal swab test could still be within the window of the potential for transmission.
The serology test was authorized by the Federal Drug Administration this week, but it should not be used to confirm COVID-19, because antibodies can take between five to 14 days after an infection to detect. That means a person who's only a few days into their illness could test negative and be falsely reassured when they're in fact infected with COVID-19.
"If you show negatives in your early stages, you could certainly show antibodies tomorrow, so it has limitations for sure," McNulty said. "But looking at the bigger picture, having it is better than not having it. We offer it, and we give [patients] all the information we have on our site."
The Chattanooga Times Free Press asked McNulty to email a copy of his patient disclaimer, but he failed to do so as of press time.
The serology test can potentially detect antibodies from other coronaviruses, such as SARS or MERS — producing a false positive — but people who have had those illnesses know they had them, he said.
McNulty said he converted Physician Services, a drug and alcohol testing facility, into a COVID-19 screening facility to broaden our area's testing capacity and help those who've struggled to get tested elsewhere.
COVID-19 testing has been hampered nationwide by supply shortages, high demand and a delayed response from the federal government. As a result, testing priority goes to high-risk, hospitalization patients in order to conserve scarce resources.
"We screen people who have been turned away from three hospitals in a row, and people want to know if they have it, or want to know if they've had it in the past," McNulty said, adding that his operation has been so swamped that he's barely eaten or slept all week.
McNulty said his office has struggled to obtain personal protective equipment — PPE — for staff members, as have others, but that "we're trying to be conservative."
Unlike in Hamilton County, Physician Services allows people with symptoms to be tested for the coronavirus without needing a doctor's referral. McNulty said he follows the U.S. Centers for Disease Control and Prevention guidelines when it comes to testing.
McNulty's operation is included on the Tennessee Department of Health's website for COVID-19 assessment sites. Bill Christian, a spokesman for the department of health, said that any location performing assessments for COVID-19 testing can be on the website. The state website includes a mix of county health department assessment sites, which test for free, and private ventures such as McNulty's.
Earlier this month, Gov. Bill Lee announced drive-through assessment sites across the state, but it's taken time for clinics to come online. Many other providers offer COVID-19 screening than those listed on the website.
Hamilton County just opened its assessment site Friday on Bonny Oaks Drive.
Legislation passed by Congress this month made testing free. However, people may still wind up paying depending on their insurance and where they choose to be tested.
Glenn Czarnecki, Southeast Tennessee Regional Health Department director, said the Bradley County Health Department began offering free drive-thru assessments last Thursday. Hours for the health department are Monday to Friday from 9 a.m. to noon, and the department may add weekend hours in the future depending on demand, he said.
Patients will be screened for symptoms — fever, cough, shortness of breath — and are encouraged to call ahead, he said. Turnaround usually takes two to three days.
"A lot of it depends on the number of testings, but it hasn't been more than that," he said, adding that there's potential for a rapid test to be available soon.
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