by Dr. Sheila Gorman
Special to the News-Ledger
Recent COVID-19 cases have resulted in many people being in isolation (for people with COVID-19) or quarantine (for people with close contact with people with COVID-19). Some of the COVID-19 cases have been confirmed cases, and others have been probable cases. Probable cases are treated the same as confirmed cases when it comes to contact tracing and issuing of quarantine for close contacts. But what are probable cases?
There are two main ways in which a person is determined to have a probable case of COVID-19. The first is a situation in which a person is sick with symptoms that are consistent with COVID-19 for which there is no better explanation, and this person has been epidemiologically linked with another case (in English, this person has been a close contact with someone with COVID-19), but there has been no testing done on this person.
For example, if Tom’s wife has tested positive for COVID-19 and he has been in close contact with her, and now he has symptoms of COVID-19 and has no other reason for those symptoms, Tom’s doctor may decide that a test would not be necessary because Tom and his wife and his doctor are all convinced that this is COVID-19. Tom is a probable case of COVID-19, and his close contacts need to quarantine. He is listed as one of the cases in McPherson County at the county level but is not listed in the Kansas Department of Health and Environment numbers. (KDHE rule.)
The other way that a person is designated as a probable case of COVID-19 is if they are tested and the test is positive, but the type of test is not a confirmatory test but is a presumptive test. Stay with me here! In our community, the confirmatory, hang-your-hat-on-it test is the PCR test that is collected then sent to an outside lab (here, either the KDHE lab or Quest) to detect the RNA associated with the virus.
It currently takes one to two days to get results. There are other tests that have only become available to us recently that give results much faster, sometimes in as few as 15 minutes. These faster tests don’t detect the RNA which is unique to this virus. They detect the proteins on the outside of the virus and are still quite reliable. These antigen tests that detect the exterior proteins on the virus are presumptive laboratory evidence of SARS-CoV-2, and people who test positive using these tests are probable cases of COVID-19.
In the previous example, if Tom’s wife was sick with COVID-19 and Tom is a close contact, and if he gets tested with an antigen test, he’ll get results much faster. But if the test is positive, he will be considered a probable case of COVID-19 because of the type of test used. He is counted as a COVID case at the county level but not counted at the state level at KDHE. (KDHE rule.)
So who gets tested with which test? Or do they even get tested at all? These are decisions to be made between patients and their medical professionals taking into account all relevant information.
Dr. Sheila Gorman is the chief of staff at the McPherson Center for Health and the medical director of the McPherson County Health Department.