When first presented with the opportunity to receive a diagnostic test for SARS-CoV-2 — the virus that causes COVID-19 — I had my qualms.
For weeks, my media colleagues and I had been reporting on the lack of available tests, and how those that our counties do have were being reserved for those who were hospitalized and the health care workers and emergency response personnel who look after and interact with them.
Additionally, though I had been experiencing my typical seasonal "sniffles," I had not noticed any of COVID-19's trademark symptoms: fever, cough or shortness of breath.
But Hudson Headwaters Health Network Community Relations Manager Jane Hooper, who offered to help set me up with a test at Champlain Family Health, reassured me that numbers were not an issue.
“We have enough that we’re able to open it up to the general public," she said.
That includes non-patients, like myself.
And simple, yet wise, words from my good friend and co-worker, Ben Rowe, helped put things in perspective.
“As far as preventing the spread … everybody should be tested," he told me Wednesday night.
While I have been working from home since the end of March, I am no hermit.
I do a grocery run once a week and spend time with my family on socially-distanced walks, and my boyfriend is an essential worker who has to leave the house six days a week.
These potential exposures were my personal justifications.
On Thursday morning I contacted Melissa Gooley, a registered nurse and Champlain Family Health's practice leader.
She quickly registered me, and was able to skip certain portions of the process since I am not a patient there.
“We are trying to expedite the process so that way we can get them (non-patients) in and then get them to their tent visit,” she said.
Gooley said nurses will talk to people who call to set up a test about their risks, such as any recent travel or exposure, their jobs or if they have had any symptoms over the past few weeks.
These questions aim to identify sick respiratory patients who are prioritized for testing over people who are completely asymptomatic, and to figure out if diagnostic testing is the right move.
For example, it may be more appropriate for those who were sick weeks ago to undergo antibody testing instead.
But at this point, antibody testing is not nearly as readily available as diagnostic testing.
“We’re not offering antibody testing to everybody,” Gooley said.
“It has to be ordered and deemed a need by a provider.”
Gooley scheduled my appointment for 3:15 p.m. and gave me directions to the practice as well as where to go when I got there.
Patients who are symptomatic and/or are receiving a COVID-19 diagnostic test are not being brought inside the practice; testing takes place from their cars under a tent outdoors.
Gooley explained that your highest risk of spreading the disease, if you have it, occurs when the nasopharyngeal swab is taken.
That is because SARS-CoV-2 is an aerosol that gets released by the swab.
After linking up in the nearby Price Chopper parking lot Thursday afternoon, Ben — my photographer that day— and I drove caravan-style to Champlain Family Health on Route 11.
I drove around the right side of the building until I came to the testing tent, then was checked in over the phone.
CAME OUT TO CAR
Shortly after, family nurse practitioner Nicole Baker approached my driver's side window donning a pale yellow gown, safety glasses, a duckbill-style N95 mask and a work belt holding a bunch of medical gadgets.
She asked me the purpose of my visit, then inquired about various symptoms, including fever, chills, nausea, vomiting, diarrhea, cough, wheezing, shortness of breath, loss of taste or smell, fatigue or a runny nose.
I told her about my "sniffles," and acknowledged some fatigue earlier in the week, which I believed to be emotional, not physical, in nature.
Baker then took my temperature with a forehead thermometer.
“You’re actually 99.8; maybe you’re just nervous,” she said. I chuckled, nervously.
Baker then placed the thermometer on my dash board, explaining that she would do that with her other equipment as well since it needs to be cleaned after it touches me.
She got my oxygen levels; took my pulse; checked my ears, nose and throat; and listened to my heart and lungs.
Next, Baker had me blow my nose. Gooley had advised I bring tissues for that purpose, and because the swab would make my eyes water.
Then came the moment I had thought most about over the past several hours.
Baker explained that the nasopharyngal swab is “not the most pleasant thing in the world,” and would feel like she was touching my throat.
“It stays in there about 10 to 15 seconds. We turn it to make sure we get a good sample.”
She had me lean my head back against my head rest and put my nose up a little bit, then placed her hand in the top of my head to remind me not to jerk.
Instructing me to take slow, deep breaths, Baker inserted the swab up my left nostril.
Now, I have heard people say that the sensation makes it feel like the swab touches, then tries to pull out, your brain, so I had prepared myself for a simply unimaginable discomfort, or even pain.
But psychological over-preparedness paid off in this case; the stinging sensation, though quite noticeable, was not unbearable.
I later told Baker and Gooley, along with my co-workers and family, that it was similar to how it feels when water gets up your nose, as if Baker had instead shot a tiny jet of water up my nostril.
My left eye watered, I felt Baker spin the swab a few times and it was over.
SENT TO LAB
The sample was labeled with my name and date of birth, then given to a LabCorp representative to be brought to Glens Falls for analysis.
Baker explained that, if my results came pack positive, I may hear from the Health Department before I hear from Hudson Headwaters, since the labs report to both entities simultaneously.
Fortunately it was Baker, not the Health Department, who called me fewer than 48 hours later to let me know that my sample had come back negative.
But, as I would learn Monday morning during my telemedicine appointment with her, it is important not to just take those results at face value without context.
Sensitivity is the ability of a test to correctly identify those with a disease as positive, while specificity is its ability to identify someone who does not have it as negative.
Current literature says the those numbers range from 60 to 70 percent for the nasopharyngeal swab, Baker said, compared with more than 90 percent for the SARS-CoV-2 antibody tests.
Essentially, there is a decent chance that my negative result was a false negative.
“Some of that is based on margin of error,” Baker explained.
“It could be the test’s fault, the person that did your test’s fault.”
And there is a chance the virus had not colonized enough to be detected, she added.
MORE ACCURATE DATA
I choose to take my negative test as a positive indicator, both for myself and the data it helps provide.
Baker said the benefit from expanded SARS-CoV-2 testing is more accurate data.
“Health care usually takes years to get good, qualified statistics about data and we’re trying to do that in a few weeks or a few months," she said.
"So the more testing we do, the more accurate our testing is.”
Towards the beginning of the outbreak, Hudson Headwaters was testing two to three people each week; now they test from six to 10 daily, Baker said.
She noted that, though antibody testing is an option for people who believe they have been exposed to or even had the coronavirus, it is not yet known if a positive test means you have long-term immunity.
For right now, it is another tool for determining the virus’s prevalence in a population.
WASH YOUR HANDS
On what is important for people to know as reopening begins, Baker reiterated the mantra of many other health care workers.
“The best thing you can do is really, simply, washing your hands."
Though masks help keep sick people from transmitting the disease, not washing your hands defeats the purpose, she said.
Baker also wanted people to know that they’re not alone in their anxiety about COVID-19.
My takeaways from this experience?
Don't fear the swab, take care of yourself and, even if you test negative, keep social distancing and washing your hands.
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