Results of Rapid Covid-19 Tests Are Not Being Counted in State Numbers
August 4, 2020 - Bexar County
The missing numbers. A screenshot of the Texas Department of State Health Services Coronavirus dashboard displays a lower number of Covid-19 cases because they do not count antigen test results. Screenshot: Texas Department of State Health Services.
By Jade Esteban Estrada - Political Columnist, San Antonio Sentinel
WHAT YOU NEED TO KNOW:
- The Texas Department of State Health Services does not count rapid Covid-19 test results which some health experts believe provides a misleading account of the pandemic
- Metro Health's interim director says positive antigen tests are "highly accurate" and should be reported to the public
A significant challenge America has in combating the coronavirus outbreak is not only mitigating the spread of the virus itself, but also countering the spread of inaccurate or misleading information that oftentimes comes from state and federal government entities. As Texas officials grapple with rising numbers of confirmed coronavirus cases and deaths, the exclusion of rapid Covid-19 test results appear to be providing an incomplete account of how the virus is affecting people across the state.
According to the Centers for Disease Control and Prevention, there are currently 4,649,104 confirmed Covid-19 cases in the U.S. As of Monday, the Texas Department of State Health Services reports 442,014 confirmed coronavirus cases in the state. In Bexar County, Monday night’s report was a count of 41,138, which includes both confirmed and probable cases.
Navigating the DSHS dashboard, one will find that Bexar County has a Covid-19 case count of 34,120. Here’s why.
Unlike 27 other states, Texas does not include the results of rapid Covid-19 tests from the totals it reports to the public, which results in a rosier account of the coronavirus pandemic. These antigen tests, which are conducted through nasal or mouth swabs and are used in hospitals and by private-sector practitioners, provide the results of a test in 30 minutes or less.
It’s important to note that antigen tests are not to be confused with antibody tests, which detect the presence of antibodies in the blood to determine whether an individual has had a coronavirus infection in the past.
Health officials consider the antigen test to be less reliable than the molecular polymerase chain reaction diagnostic (PCR) test, the 6-inch-long swab that is inserted into the nasal cavity. Though it has a high level of accuracy, it must be shipped out for analysis and can take a week or longer for the results to arrive.
According to the U.S. Food and Drug Administration, which approved the antigen test in May under emergency authorization, the risk is not that the antigen test will result in false positive - meaning that an individual will test positive for Covid-19 when they actually do not have the virus. The greater concern is that the antigen test is more likely to result in a false negative, which means the test could fail to detect when a patient has Covid-19.
Following the CDC guidance, DSHS considers people with a positive antigen test to be a “probable” case of Covid-19, which is why the state only reports confirmed cases to the general public and not antigen test results.
Some health experts believe that both tests should be reported publicly so that individuals can make more informed decisions about attending gatherings, wearing face coverings and social distancing.
Last month, DSHS axed 3,484 probable cases from Bexar County’s Covid-19 case totals. Their reasoning was that these probable cases were not confirmed cases because they were antigen test results.
“[An antigen test] is still considered an accurate positive. Experts actually prefer an antigen test be used when you’re testing large populations,” said Metro Health Assistant Director Mario Martinez in a recent press briefing. “Now in San Antonio, as we have more widespread prevalence of Covid-19, it’s definitely a good test to use in our community.”
“Probable cases do not mean ‘maybe’ cases of COVID-19,” said Dr. Colleen Bridger, interim director of San Antonio Metropolitan Health District. Antigen tests are FDA approved, and positive tests are highly accurate. To be clear, this is not an error in Metro Health’s reporting. This is a disagreement over what should be reported in total counts. We will continue to align our definitions with those from the CDC and the Texas Department of State Health Services, while honoring the states request to separate probable cases.”
Jade Esteban Estrada is a political columnist at the San Antonio Sentinel. He can be reached at jade@sasentinel.com.