‘When you get tested matters,’ experts say after some antigen tests result in false negative

Coronavirus

HONOLULU (KHON2) — As cases surge, testing lines are also ramping up. The state is averaging anywhere from 8,000 to 10,000 tests daily.

But unlike last year, more tests are now available, and some health experts warn some are better than others in certain situations.

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“All tests have a false positive rate and a false negative rate, and it’s something to bear in mind that you can’t put your faith in a single test when you get tested matters,” explained Dr. Jonathan Paladino, Hawaii Pacific Health critical care director.

Some Hawaii residents had COVID-like symptoms and opted to do at-home tests which came back negative at first.

“I had two rapid at-home tests, and what’s interesting is on day one of my symptoms, I didn’t test positive,” explained Oahu resident Doorae Shin. “A few days later, luckily, I had a second test, and I did test positive, and my partner tested positive on his test as well.”

She said she felt so sick she didn’t leave her house between taking the two tests.

Another Oahu resident got a negative reading on an antigen test and ended up hospitalized when his symptoms got worse.

Even a fully vaccinated resident had COVID-like symptoms and took an at-home test on her second day of symptoms, it came back negative. She said she took a PCR test the following day which confirmed she had contracted COVID.

“You have to take the test during your infectious period,” explained Dr. Paladino. “It can’t be too early and it can’t be too late, you have to be actively replicating the virus.”

He said how the test is administered is also important.

Doctors and experts say at-home rapid antigen tests found at drugstores and used at some pop-up testing sites are good for consecutive testing every other day at places like schools which can help detect a potential outbreak.

“It is not the standard of care where you just use them one time for an event because it’s only valid for 12 hours, maybe 24 hours. And the next day, you could be positive, and you could be shedding this virus,” explained Dr. Scott Miscovich, Premier Medical Group president.

“They’re supposed to be really positive if you have symptoms, but even then, we’re lucky in the peak are they barely 80% accurate, so it’s being used in replace the gold standard, which is that PCR test,” he continued.

According to the FDA, molecular tests like PCR and Nucleic Acid Amplification Tests (NAAT) don’t require a follow-up test because they’re highly accurate. The FDA says antigen tests are highly accurate if positive but negatives may need to be confirmed with a molecular test.

Rapid antigen tests, like the ones sold at drugstores, are used at Aloha Stadium. The health department says if a person tested positive, they undergo a second test to make sure.

Dr. Miscovich hopes the state can ramp up testing to help push the state out of this surge.

“At best, I’m seeing we’re doing 10,000 tests across the state in the day. We should be over 20,000, probably closer to 25,000 if we want to get this under control,” he said.

KHON2 reached out to Kaiser Permanente and HMSA to see who is covered for COVID-19 tests.

Kaiser said in an email: “At this time our members will not be responsible for any co-pay for COVID-19 testing, regardless of where they go for testing. On Oahu, Kaiser Permanente has drive-thru testing. On Neighbor Islands testing is by appointment which can easily by made via KP.org or the mobile app. We recommend patients test five days AFTER exposer or sooner if symptomatic. Members do not need a doctor’s note/order and do not need to provide information about COVID-19 exposure in order to get a test.”

HMSA has a different criterion, to see if you’re covered under HMSA click here.

Find more COVID-19 news: cases, vaccinations on our Coronavirus News page

Health officials recommend staying home if you’re sick, even if you’re vaccinated, and to take a molecular test to verify if you are sick before returning to work or school.

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