Who You Calling Covid Queen, You Lint Licker?!
By the way…
As a Technologist with a specialized license in Molecular Biology and having worked with various viruses, it has become apparent to me that people actually value my opinion on this whole Covid-19 pandemic thing. With that being said, I wanted to put together some information to share with you all about what exactly Covid-19 is, the different testing options, what is actually happening with each analysis, what type of test to order to ensure accurate representation of your status, and how I feel about the vaccine.
DISCLAIMER: My license is not in medical practice. If you are concerned with the validity of anything I put in this post, I highly encourage you to Google these for yourself. I have done the best I can to ensure I am spreading the correct information, but I am human. Do not take my information as law, or as medical advice.
1. What is Covid-19?
Let's start with information about viruses. You can see a virus under a microscope, but not with the naked eye, much like bacteria but significantly tinier. For this reason, you don’t know you’ve contracted one until you are already symptomatic (or you won’t know at all in asymptomatic cases). Common viruses are the Influenzas, Zika, HIV, Dengue, HPV, Hepatitis, the Herpes Simplexes, West Nile, Ebola, etc.
Trigger warning: Viruses are disrespectful; forcefully penetrating and impregnating your cells with its genetic information, hijacking your machinery and using it to transcribe (make RNA—the single stranded version of DNA) and translate (use of the RNA to make proteins of that information). This damages the original cell from which it invaded; the cell literally bursts at its seams with viral material (called lysis) and the cycle repeats itself. For this reason, it needs a living organism and is unable to thrive independently. These living organisms (you and ya mama, but hopefully not) would be known as “vectors” or “host cells”.
Covid-19, also known as Coronavirus, is a respiratory virus acquired through droplets from an infected person or touching infected surfaces and then touching your face. It gets its name from its spherical structure with outward spikes that bind to receptors that we have on the outside of our cells which act as the security into the club, and since that security is familiar with the receptors, he gets right the hell into VIP.
2. What is the process when I get tested?
Get swabbed somewhere and they will likely send your specimen to a lab for testing. I work at a reference lab, which means there are no patients at my job (thankfully) but only samples that are imported from different laboratories, doctor’s offices, clinics, testing sites, etc.
They get in the hands of the Molecular Tech, and we test and release these results back to the provider through which you tested. We give ourselves an internal turnaround time of 24 hours within receipt for PCR, but oftentimes it exceeds that due to high sample volume or repeat testing if the results come out unclear. All-in-all, your results may take a couple of days to get back to you as we are running literally thousands of samples daily. I’m sorry your one measly sample in a sea of several thousand is not our most important.
3. What is the difference between the tests? Which should I order?
Always order the RT-PCR, even if you order the other options also. PCR is going to give you the best idea of what is going on in your body at the time of sample collection. ‘RT-PCR’ is short for a process called Real-Time Polymerase Chain Reaction. That’s a fancy way of saying that this type of testing breaks open the walls of the cells found on your swab and looks for a specific target sequence of genetic information that can be found specifically in Covid-19, and once identified, makes thousands and thousands of copies of it. So many copies are made that a fluorescent signal is emitted at the exact doubling of copies created and continues to emit this signal until the number of copies plateaus and the doubling ceases. With the methods used in my lab, the prep for this test takes a solid 45 minutes per plate of almost 100 patients, plus 1.5 hours to run on the instrument, and another 10-15 to enter the results into our Laboratory Information Management System. It doesn’t seem like a lot of time considering the wait for the verdict, but again, THOUSANDS of samples run daily. In my workday, I probably process about 3,000 samples before I clock out for the evening. That is only the day shift.
This graph is called an amplification plot, and this is the curve of a positive sample. Past the green dotted line is where we can see exponential growth, or doubling, of copies of the Covid-19 target gene sequence as the fluorescence increases.
Rapid [antigen] testing has a significantly shorter turnaround time. When we do antigen testing at my lab, we only have a window of 2-6 hours after COLLECTION to get the results out depending on the submitting facility and sample load, as opposed to a day or two with PCR. The typical run time for one sample is about 15 minutes and is determined through a cassette, much like a pregnancy test. Instead of detecting target genetic sequences from the swab, this test looks for proteins (antigens) made by the virus. Antigens are molecules that trigger an immune response and can be found oftentimes on the surface of a pathogen. This method of testing is best for people in early, more contagious stages of the infection and maybe beginning to exhibit symptoms. Testing your antigens too early or too late can lead to hit-or-miss results due to viral antigen load falling below a detectable limit at that time. This permits the possibility of a negative rapid test result, yet you’re PCR positive.
It should not be used as active or preventative analysis. PCR is the gold standard poster child of diagnostic tests. The genes are either in your system or they are not.
An antibody test is completely irrelevant information unless you’re just trying to see if you’ve ever been infected with the virus. Your antibodies are what develop when you have received exposure to a pathogen, which is the basis of vaccines.
4. How accurate are the results?
People have lost faith in the efficiency of these results but fail to understand the variables involved in each sample. Pre-analytically:
· The sample collection can vary in its effectiveness depending on if they did it correctly and swabbed at the right site.
· The date collected versus the date tested tends to generate unclear results. It is imperative for those swabs to get to us as soon as possible after collection to preserve sample integrity.
· Proper transport and storage are also important for sample integrity. They need to be kept at a certain temperature before testing.
· Stage of infection is reflected in the testing. Perfect timing yields amazing results, late-stage detection may not have the same viral load as early detection.
Either way, the PCR (or any nucleic acid amplification-based testing) is more sensitive than the antigen tests and should be, at the very least, used in confirmatory testing for positive antigen/rapid tests.
5. Which sample should be collected and tested?
Nasopharyngeal is the best site to collect a sample for your Covid-19 test (through your nose and to your pharynx). It is probably more annoying than anything ever, but the highest viral load is found in your throat and nasopharyngeal samples yield results with a higher sensitivity .
6. What is pandemic etiquette?
Wear a stupid mask. Just because you don’t care about contracting it does not mean others don’t. They should not have to be subjected to your irresponsibility. I have immune compromised family for whom I am a caretaker, and though I wear my mask, the best prevention is everyone around me wearing one too. Keep your germs to yourself. Also, viral particles are super tiny, so wearing a bandana or a thin piece of cloth is not as effective as your N95s, KN95s, surgical masks, and anything that has a filter in it. You can google videos of some of the most effective masks you can use to protect yourself and others. If you’re going to be inconvenienced by being forced to wear one, it may as well not suck, right?
If you wear a shield, wear a mask also. The shield buffers the droplets but does not contain your emissions.
Don’t wear gloves. Most of you don’t know how to use PPE properly, which comes as no surprise because most people don’t work in laboratories or medical facilities that require proper use of them. But bear with me on this concept: if you wear gloves to prevent the spread of germs, it becomes ineffective when you also touch your glasses, your keys, your iPhone, your steering wheel, etc. You are better off using your hands to touch everything and then washing them (and maybe spraying down your belongings at some point). Gloves should always be removed before touching personal items, otherwise they are just a second skin and act as though you’ve just wasted your damn money.
If you must sneeze or cough, please keep your mask on (that’s what it’s there for) and do so in your arm crease.
7. How is Covid treated?
I don’t know much about the treatment of Covid and I attribute that to the extremely variable symptoms. They may just treat those as they come. All I know is y’all better leave my momma’s Hydroxycholoroquine alone! She’s been on that prescription for many years for her Sjrogren disease and now she can only order in small doses. It has been said that this medication blocks some of the known cell receptors that Covid binds to.
You can’t treat viruses with antibiotics, as they are for bacterial infections (which can possibly occur as a secondary infection after viral infection). Maybe you can use antiviral meds, but most healthy people that I know who have contracted it basically just let it run it’s course in their bodies, just like the flu.
If you find you’ve been exposed to someone who is positive, you feel symptomatic, or you are unsure of either of the above, a test will only confirm your suspicions (if positive). If you are normally healthy, you will not be treated unless you have severe or life-threatening symptoms. Isolate yourself the best you can for 14 days minimum and allow the virus to run its course. You should also be isolating while results are pending.
8. Do you plan on getting the vaccine?
No. At least not yet. I am a scientist; I believe firmly in the benefits of vaccines, generally speaking. Thankful that I am protected against things that could have taken the population out, like measles or poliovirus. I trust our medical professionals and scientists who created it because I know and respect that I do not possess the knowledge to create this thing, for the same reason that I trust my doctors, mechanics, and eyebrow girl, and anyone who knows more about things I know nothing about. I believe they are doing the best that they with the timeframe they are working with. I don’t, however, trust that they know everything there is to know about the product they put out (side effects, long term effects, efficacy) because there is not enough data after having distributed it to the public for me to be comfortable. The Covid vaccine was developed and tested on its first patient in 65 days. Typical development and clinical trials for a vaccine can take up to 10 years from beginning to end. It takes longer than 65 days to decide on a contender to make it in the first place, I’m sure!
You have heard all the horror stories about people getting vaccinated against Covid and then die, become violently ill, develop some sort of temporary or long lasting side effect. You run the risk of side effects to literally anything you put in your body. The media publicizes this, but no one talks about the hundreds of thousands of people who are and will benefit from theirs. There will always be outliers.
The way vaccines work is to give your body the antibodies that will recognize the pathogen at the time of infection, thus mollywhopping them to the point where you get rid of it before it becomes a problem for you. That being said, please don’t be one of those people walking around without a mask because you think you’re Captain America.
I would still consider that irresponsible.