Doctors Notes:

UPDATES ON COVID 19 (SARS-CoV-2)

Lauren Mortensen
Posted on by Lauren Mortensen, MD

Recently, it has been hard to stay up to date with the latest recommendations regarding COVID 19 (SARS CoV 2). Today, I will summarize the most recent recommendations from the CDC as of July 2, 2020.

Who should get tested for the virus (nasal swab)?
This type of test is testing for an active virus in your body to determine if you currently have COVID 19 – an acute infection. Many of these tests are rapid and can come back in an hour or so, but these are usually reserved for patients sick enough to seek medical attention at a hospital. Otherwise, this test usually takes 1-2 days to report your results. Testing more than one time in a 24 hour period is not recommended.
You or your child may be eligible to get tested if you have one or more of the following:
  • Individuals with signs or symptoms consistent with COVID-19
  • Asymptomatic individuals with recent known or suspected exposure to SARS-CoV-2 to control transmission (testing is recommended for all close contacts of a person with a confirmed COVID 19 test)
  • Asymptomatic individuals without known or suspected exposure to SARS-CoV-2 for early identification in special settings
  • Individuals being tested to determine resolution of infection (i.e., test-based strategy for Discontinuation of Transmission-based Precautions, HCP Return to Work, and Discontinuation of Home Isolation)
  • Individuals being tested for purposes of public health surveillance for SARS-CoV-2

If you feel you or your child need a test to check for active illness, the current testing sites are listed on the Michigan.gov website. If your child is having any symptoms of breathing difficulties, dehydration,  prolonged fevers or other symptoms that you are worried about than call our office to have them evaluated.

Who should get tested for the antibody?
When we get sick with a virus, our body mounts an immune response and creates specific proteins (immunoglobulins) that help to fight off the infection. We can then test for these specific proteins via a BLOOD test. Currently, the CDC does not recommend using antibody testing as the sole basis for diagnosis of acute infection, and antibody tests are not authorized by FDA for such diagnostic purposes. In certain situations, serologic assays may be used to support clinical assessment of persons who present late in their illnesses when used in conjunction with viral detection tests.  In addition, if a person is suspected to have post-infectious syndrome (e.g., Multisystem Inflammatory Syndrome in Children) caused by SARS-CoV-2 infection, serologic assays may be used.

Serologic assays for SARS-CoV-2, now broadly available, can play an important role in understanding the transmission dynamic of the virus in the general population and identifying groups at higher risk for infection. Unlike viral direct detection methods, such as nucleic acid amplification or antigen detection tests that can detect acutely infected persons, antibody tests help determine whether the individual being tested was previously infected—even if that person never showed symptoms. These tests are not perfect. There can be both false negative tests (you test negative for the virus but you did in fact have it) and false positives (it shows you have had the virus but you actually did not). Additionally, even if you are positive for the antibody, we do not yet know if that means you cannot get the viral infection again! So please consider all of this when requesting this test for your child. In general, children do not like getting blood work taken and right now this test is not extremely useful. But if you think your child warrants testing give our office a call and we can set up a telemedicine visit to discuss it further!

Should my children wear a mask?
The answer is overwhelmingly YES YES YES! All children can wear a mask but they are not required in children younger than 2. Obviously, there are some children older than 2 who simply cannot wear a mask – children with developmental disabilities and Autism for example – they do not have the cognitive ability to realize he/she must keep the mask on. There are other special cases where a mask may not be required as well (ACTIVE shortness of breath, etc.). Masks are completely safe for children to wear. We have gotten the question, “My child has asthma – could a mask adversely affect their breathing?” The answer is no! Masks are safe, even in individuals with health conditions such as asthma. In fact, if your child has asthma, they are more at risk to get sick from SARS-CoV-2 and should definitely wear a mask!
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