I had sent out the following inquiry with some commonly anticipated responses.  Here is what I had posted:

 

Are you going to go with the test-based strategy of a 2-swab negative test of cure?  Why or Why Not?  Here are some of the answers that I might expect.

 

___We are going with the 2-swab because it can give us some confidence that the  HCP case is no longer capable of infecting susceptible co-workers and patients

___We are going with the 2-swab because CDC said that it is the preferred method

                ___We are relying on CDC expertise

                ___We feel obligated to go with CDC’s guidance because of medicolegal implications

                ___Our state health regulators have codified CDC guidance

 

___We are going with the non-test based strategy because we don’t know which of the RNA detected in the PCR is from viable virus or just old fragments

___We are going with the non-test based strategy because we don’t have the resources available to do the tests and get the results back in a reasonable turn around time

___We think that the asymptomatic carrier state is widespread in the community and limits the usefulness of the PCR test.

 

___Something obvious that I have missed altogether:

 

 

Summary of Responses

 

7 responses were received, evenly divided between those who will be using the test-based strategy and those using the non-test strategy.

 

Among the reasons given by those choosing the test-based strategy were 1) the test result provided some confidence that the HCP is no longer infectious; 2) they relied on CDC;  and 3) they felt obligated to use the test-based strategy for medicolegal implications. 

 

Among the reasons given by those choosing the non-test-based strategy were 1) they didn’t know which of the RNA detected were from viable virus or just old fragments; 2) they didn’t have the resources to do the tests or the turn-around-time was not reasonable.

 

Several respondents mentioned issues with persistent positives.  One respondent said that for his persistently positive swab tests, he would switch over to the non-test based strategy.

 

 

Thanks to all who participated.

 

Ed Galaid

 

 

 

Edward I. Galaid, MD, MPH, FACOEM

ABIM, ABPM (OM)

Medical Director, Roper St. Francis Physician Partners Occupational Medicine

Charleston, SC

Member, ACOEM Task Group,  Guidance for the Medical Evaluation of Law Enforcement Officers

Special Expert, NFPA Fire Service Occupational Safety & Health (FIX-AAA) Committee

(O) 843-402-5053