COVID-19 confusion: What you need to know about testing and terminology 

  • Cooley Dickinson Hospital, Monday, Mar. 2, 2020

Staff Writer 
Published: 3/15/2020 8:25:43 PM

On Saturday, two area superintendents sent out separate messages saying that two people in their respective school communities had presumptive positive cases of COVID-19, the illness caused by the novel coronavirus.

Both school leaders later clarified that the cases were based on symptoms, not the results of a test.

In recent days, COVID-19 terminology and testing have been causing some confusion. The Massachusetts Department of Public Health reports “presumptive positive” and “confirmed positive” cases on its website. But what exactly do the terms “presumptive positive” and “confirmed positive” mean?

“It’s confusing a lot of people,” said Jenny Meyer, public health nurse at the City of Northampton Health Department, noting that her office has gotten phone calls asking about the terms.

The way the state Department of Public Health defines it: “Presumptive positive means the test result has been confirmed by the state public health laboratory and the specimen will be sent to the CDC [U.S. Centers for Disease Control and Prevention] for confirmation of the testing result,” a spokesperson for the state DPH said in an email, adding that soon the CDC may not be required to validate the results.

Meyer explained that presumptive positive means that “they’ve literally stuck a swab up your nose and sent it to the state lab, and it comes back positive.” A confirmed positive case, she said, means that the CDC also did testing and confirmed the case.

Meyer added that presumptive positive “is causing confusion because providers often use this term to describe when a patient’s symptoms align with a diagnosis in the absence of testing.”

Adding to the confusion, many people are not being tested. Massachusetts doctors have said there aren’t nearly enough tests in the state, The Boston Globe reported last week. And according to Cooley Dickinson’s website, “there is a shortage of test kits so currently DPH will test only those with the highest risk.”

As of Sunday, 799 people had been tested for COVID-19 by the Massachusetts State Public Health Laboratory, according to a statement from the state DPH. The department announced that it changed its testing requirements, per CDC guidance, to require clinicians to send only a nasal swab, rather than both throat and nasal swabs. With the protocol change, the department will be able to test an estimated 400 people each day, an increase from the previous testing capacity of 200 patients each day, according to the statement.

Dr. Joanne Levin, medical director of infection prevention at Cooley Dickinson Health Care, said that another issue is a shortage of equipment. At Cooley Dickinson, she told the Gazette in a phone interview Sunday, they have a limited number of the tubes needed to send swabs in for testing that must last until their next shipment.

“As time goes by, I expect things will get better and better with testing,” she said. “Right now, things are still very tight.”

If you think you may have COVID-19, Levin recommends calling your doctor. “If people have an illness, they need to call their primary first, not walk into their office, not walk into the ER,” she said. “Call first … We do not want people with possible disease walking in and exposing other patients.”

Levin also emphasized that the CDC and state Department of Public Health are good resources for information.

Greta Jochem can be reached at gjochem@gazettenet.com.




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