Should you get tested before you see your friends and family?

Evelyn Gosnell and a few friends are planning a camping trip next month for a birthday party. Gosnell, a behavior specialist in the Bay Area in her 30s, said the group had agreed to quarantine for two weeks before travel to reduce the risk of exposure to Covid-19.

They are also considering a home coronavirus test that they would order every order by mail and drop off at a local FedEx or UPS location. Gosnell said she would stay home for a few days before taking the test and would be careful while waiting for the results.

But she has reservations about the whole plan, as in the United States there remains a limited number of tests and a backlog in laboratories that delays results by a week or more. Gosnell doesn’t want to add to an already overloaded system or take a test away from someone who might need it more.

In San Francisco, local health officials rank outdoor activities like camping as “safer social interactions.” But the guidelines do not include information on whether asymptomatic people should get tested.

“The message is confusing,” Gosnell said.

Public health experts and infectious disease physicians are happy to weigh in on the matter, but their views differ because the testing infrastructure is such a mess, the situation varies from region to region and there is no coherent national strategy.

Susan Butler-Wu, associate professor of clinical pathology at the Keck School of Medicine at the University of Southern California, said it was problematic that these decisions were largely left to individuals, but these are important questions to consider before engaging in any activities.

“I love that people think about it in such a charming way,” said Butler-Wu. “It involves considering the needs of their community.”

Some regions will have a greater capacity to test asymptomatic people than others, she added. In other states, supplies are not getting where they’re needed most.

“It should be free and widespread,” said Dr Peter Chin-Hong, professor of medicine specializing in infectious diseases at the University of California, San Francisco. “With Covid-19, you can have the virus and be asymptomatic, so knowledge is power.

But Chin-Hong recognizes that resources are limited and the situation could worsen as more schools and offices reopen. Many organizations will require that students or staff be tested before returning to school or work. It would make it harder for people like Gosnell to get a timely result.

“This whole discussion is painful because it is so anti-public health,” he said.

Even those who get tested before they see friends and family should take extra precautions, he said. Tests can show false negatives, and delays in the system mean people could be exposed between the time of their test and the time they receive their results.

“It could give people a sense of confidence that may not be justified,” said Dr. Steven Pergam, associate professor in the division of vaccines and infectious diseases at the Fred Hutchinson Cancer Research Center. “I’m worried about this.”

Pergam is concerned that people with negative results will not wear masks or choose not to maintain their social distancing. His concerns could be addressed if a new test hits the market, cheaper and with a quick turnaround time, although it should still be accurate.

His advice to Gosnell and people in similar situations is to consider whether taking the test would put them ahead of those who need it most.

“Be considerate,” he says. “But I know it’s difficult because we get incongruous messages from politicians compared to those on the front lines.”

Carl Bergstrom, a professor at the University of Washington and an expert in infectious diseases, said he is thinking a lot about this issue. In Seattle, where he is based, there is pressure for more people in the community to get tested, especially those who have attended protests.

Bergstrom said getting tested before seeing an elderly relative or group of friends falls into a category called clearance testing. If you are in a city like Seattle where doctors and public health groups want people to be screened for data collection, surveillance and mitigation purposes, then it is good to take mine clearance tests. , “because you are helping to fight disease,” he said.

But in communities where they only test symptomatic people, his recommendation may be different. It’s a sad reality for people who are just trying to stay safe during a pandemic.

“I don’t think individuals should have the burden of making public health allocation decisions,” Bergstrom said.

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