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The plan rings so reasonable at first glance: we’ll all get together for Thanksgiving, but only after everyone – every last member of the family, no matter where they’re from or how they’re going to get there – has had a chance to obtain an appropriate Covid test.
It’s not just for the holidays. For months now, I have watched various acquaintances and their families decide to break the rules of social distancing in accordance with this same and suspicious rule of thumb: it’s totally OK to get together for a weekend … as long as everyone has been tested; it’s good to get together for a barbecue, or a visit with grandmother … as soon as everyone has been tested.
Let me say this as clearly as possible: as a means of eliminating risks in the midst of a pandemic, the everyone has been tested method is utter nonsense.
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It is true that getting a positive result gives you crucial information: it is time to cancel all your plans and isolate yourself until you are past the point of contagiousness. A negative test, however, does not guarantee that anyone is free from Covid, and letting your guard down is never allowed. For example, you could contract the virus between taking the test and receiving your results, or between getting your results and visiting friends and family. (The testing site itself might even be where this happens.) Even if you assume these tests are 100% accurate, they won’t tell you your status until the exact moment the test is taken.
Of course, the tests are not 100% accurate. In practice, their error rates may be even higher than the risk of getting infected in the first place. The likelihood that you will receive an incorrect result on a medical test depends not only on the innate accuracy of the test, but on your baseline risk. Even a very good test will give more false positives than true if you present yourself as someone who is not likely to have the disease. Conversely, getting a negative result will not give you this a lot of information that you didn’t have before. This will only increase your confidence at the margin, say 95-98%, that you are not sick already.
Typically, Covid testing is important – this is how we can identify people with coronavirus so that they can separate themselves and stop the chains of transmission. When people meet repeatedly in shared spaces, such as in schools and workplaces or on sports teams, frequent testing can reduce transmission and epidemics, but only when paired with a robust system isolation and contact tracing. As I wrote earlier, testing alone is not enough; for disease surveillance to make a difference, it must be used alongside behavioral interventions such as masking and social distancing. If you assume that a negative test means that you can give up these behaviors – that you can safely get together for dinner at a grandparent’s house or spend a weekend in a cabin with your friends – then you are asking for trouble.
This is a lesson demonstrated by our current president. White House staff believed that if you tested negative, you were quite clear about living your life without a mask and without distancing, says A. Marm Kilpatrick, an infectious disease researcher at UC Santa Cruz. This is how Donald Trump and at least three dozen of his associates ended with the virus. The same flawed reasoning explains the Covid outbreak of 116 cases at a boys’ summer retreat in Wisconsin, which was attributed to a student who tested negative days before attending the retreat. The students at the camp were high school age and the rules for participation were reminiscent of Kim Kardashian’s island birthday party Thousand Memes: All participants were required to self-quarantine for a week prior to attending the event, wear masks during travel, and show evidence of a negative PCR test result no more than seven days prior to arrival . Once there, counselors and students were not required to hide and mix freely with each other … much like how people who tested negative might behave in a meeting. family for Thanksgiving.
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