CLEVELAND, Ohio — The news that Ohio Gov. Mike DeWine had tested positive, then negative, for COVID-19 added to the confusion surrounding testing for the virus.
Like, are false positives from antigen tests inflating Ohio coronavirus case numbers? If you test positive multiple times, do you count as multiple cases?
Dewine tested positive on an antigen test required to meet President Donald Trump Thursday. The test delivers fast results by testing for the presence of antigens in the body, but is a relatively unproven technology and is viewed as less accurate.
DeWine’s second coronavirus test was a polymerase chain reaction, or PCR, a more sensitive test that detects genetic material from the coronavirus.
Regardless of how you explain it, DeWine’s conflicting test results dredged up myths and misinformation about how cases are counted and the accuracy of various kinds of COVID-19 tests.
Here’s what experts have to say:
MYTH: Rapid antigen tests are as accurate as other kinds of COVID-19 tests.
REALITY: Antigen tests are fast and fairly accurate, but are not as accurate as the PCR test, Dr. Peter Mohler, chief science officer, Ohio State University Wexner Medical Center, said during DeWine’s Friday press conference.
The PCR test is the most accurate, Mohler said. But it cannot determine if a person had COVID-19 two weeks ago, or will have it two weeks in the future, he said.
The question of how early an infection can be detected is still being studied, Mohler said.
Positive PCR test results are used for the statistics collected by the Ohio Department of Health, DeWine said.
Rapid antigen tests offered by walk-in clinics are not as accurate as the PCR test, said Lorain County Public Health commissioner David Covell.
MYTH: False positives from antigen tests are ratcheting up the case numbers in Ohio.
REALITY: Antigen tests are only included in the probable case count if they meet another criteria in addition to being positive, such as having symptoms or evidence the person was exposed to someone else with COVID-19, the ODH said in a statement.
Antigen tests are not reported in ODH’s daily testing number by the state.
PCR tests are included in the daily confirmed case counts if they are positive, ODH said.
MYTH: People who test positive for COVID-19 develop immunity and can’t get the illness again.
REALITY: The question of whether people who recover from the illness develop immunity still hasn’t been answered, Covell said.
Other viruses convey immunity, so the same might be true with COVID-19. “We don’t have proof of that yet,” Covell said.
People with mild cases of COVID-19 may not have long-lasting immunity to it, according to a study from the University of California at Los Angeles. Levels of antibodies against coronavirus dropped dramatically over the first three months of infection in 34 people who had mild cases, the study said.
As a point of comparison, COVID-19 vaccines under development will deliver four times more antibodies than occur naturally in a body that’s fought off a coronavirus infection, Covell said.
MYTH: If you get tested on your own and it comes back positive, then later your workplace asks you to get tested and it is positive too, you are counted as two COVID-19 cases in Ohio statistics.
REALITY: ODH flags the two tests and counts them as one, Covell said. Cases are not double- or triple-counted.
MYTH: Children don’t need to be tested.
REALITY: Testing should be based on clinical findings assessed by a qualified health care provider, not rather than determined by age, said Dr. Gary Procop, vice chair of the Pathology Education, Pathology & Laboratory Medicine Institute at the Cleveland Clinic.
“Providers should be aware of ways in which children may present with disease that is different from adults,” Procop said in an email.
MYTH: People who die from another cause, but test positive for COVID-19 posthumously, are counted as a COVID-19 death.
REALITY: Untrue, Covell said.
Let’s say a person is injured in a car accident, and is tested for COVID-19 at the hospital so that health workers are aware of the patient’s status. If the patient tests positive, and later dies, the death is not counted as a COVID-19 case.
MYTH: The case count goes up because more people are being tested.
REALITY: Increased testing is not the only reason why the case count can rise, Covell said. Young people becoming less careful about social distancing and contracting the illness also are a contributing factor.
The rise in COVID-19 cases can be attributed to increased testing and community spread. “It’s a combination of both,” Covell said.
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