How can I know if my child has the Delta variant of COVID?
Our clinics offer rapid antigen and PCR tests which will detect all active COVID variants but will not identify the specific variant. At this time, testing for the COVID variants is limited to some public health departments and hospitals.
What does a positive COVID rapid antigen test mean?
A positive rapid COVID antigen test means it is over 97% likely that the person has an active COVID infection, even if they have no symptoms. False positives (positive tests without the disease) are very rare, especially when community transmission is high to very high. False positives are found in less than 1% of positive tests. The most accurate test is the COVID PCR test. Our clinics do not typically follow up a positive rapid test with a PCR lab test because a positive rapid test is so reliable.
What does a negative COVID rapid antigen test mean?
A negative rapid COVID antigen test does NOT mean you or your child does not have COVID. The rapid test detects about 70% of infections in people with symptoms and about 60% of infections in people without symptoms. In times of moderate to high community transmission, it is recommended that a negative rapid test be confirmed with the more accurate COVID PCR test, which must be sent to an outside laboratory. PCR tests are about 97% accurate.
If a family member has negative COVID antigen and PCR tests, why is it still necessary to quarantine for 14 days?
If a person has been in extensive or unprotected close contact with a family member with COVID (usually in the same household), the CDC recommends a 14-day quarantine period from the day of last exposure, even if COVID testing is negative soon after the exposure. This is because the incubation period for COVID is up to two weeks, so you might not have an active infection for up to two weeks after being in very close contact with someone with COVID.
If you are tested soon after exposure, it may be too early to test positive with either a rapid or PCR test. Most people become symptomatic in about five days, so common recommendations are as follows:
Can I get a clearance note to participate in normal activities following a negative rapid antigen test?
A negative rapid COVID antigen test may miss as many as 40% of people who really do have COVID. Therefore, the CDC recommends that PCR tests be sent whenever a rapid test is negative. Our clinics follow the CDC’s recommendations that individuals with negative rapid tests have follow-up PCR tests sent to a laboratory and quarantine until the PCR test result is negative. The test results may take anywhere from a day to a week or more, depending on the number of test each lab has to process.
We cannot provide clearance notes to return to daycare, school or work while a patient has a pending PCR test, or if a PCR test was not performed.
Following negative rapid and PCR tests, why can’t I call the clinic for a note to return to normal activities?
Our clinics cannot provide advance clearance notes at the time of the clinic visit permitting a person to return to normal activities when a negative PCR test result is available. A negative PCR test result does not mean a person does not have another type of infection that should keep them home. Some non-COVID viral infections can be contagious for a week or more, which is often longer than the waiting period for the PCR test results.
We recommend that people contact their primary care provider when they receive a negative PCR test result so they can be screened again for the presence or absence of symptoms of other infectious diseases that might mean they are still contagious. We cannot perform this evaluation over the phone.
Why do I have to call or go online to get PCR test results?
High patient volumes at clinics and laboratories often prevent calling each patient individually to relay negative PCR test results. At the time of your clinic visit, you will be given information about which lab your test is being sent to and how to get results by phone or online. We cannot control how quickly your PCR test result will be ready. You may need to change plans for socializing or traveling while waiting for your results.
Why can’t my child get tested at the clinic without seeing a provider?
We offer COVID testing, but we are not legally licensed by the state as a testing center where individuals can receive a COVID test without seeing a provider. At our clinics, a provider will need to evaluate your child and order the appropriate test(s). If you do not want to be seen by a provider, you must seek testing at a community testing center.
Do you offer saliva tests for COVID?
No. The most reliable tests use nasal swabs. Other forms of testing are usually not as accurate. In addition, children often can’t spit on command or produce enough saliva for the test.
Should people with COVID be tested again once they’re feeling better?
The CDC does NOT recommend repeat testing for people who have been diagnosed with COVID—a negative rapid antigen test done less than 10 days after a positive test does not guarantee that a person is no longer contagious. Further, the PCR test may stay positive for weeks to months, even though the person is no longer contagious.
Demands by employers, schools, daycares, etc. for repeat testing may result in a person being needlessly kept from returning to normal activities (due to a perception that a negative PCR is needed) or returning to activities while still contagious (with a negative antigen test while the person still has COVID symptoms). The CDC recommends that those infected with COVID can return to normal activities once the following criteria are satisfied:
People with COVID who meet all three criteria may return to normal activities but must continue to take the same infection control precautions that are recommended in their communities.
Why do fully vaccinated individuals need to wear masks in your clinics?
Health-care facilities pose a risk of having multiple COVID patients in the building for prolonged periods of time; therefore, it’s much more likely that someone not taking precautions may become infected, whether they are vaccinated or not. In addition, even vaccinated people can catch the COVID Delta variant and transmit it easily to others, even if they do not have symptoms. Every person over two years of age is required to wear masks at all times in our clinics, including our staff, for everyone’s safety.
Should I get my children vaccinated when they are old enough?
Our strong recommendation is YES! Although a limited number of children have had complications attributed to the vaccines, those complications have been rare relative to the total numbers of individuals being vaccinated. In addition, even the most serious-sounding complications, such as myocarditis (heart inflammation), have been mild and go away over relatively short periods of time without specific treatment.
The Delta variant is hitting children harder and faster. More children are being hospitalized for COVID, and those children are sicker. We strongly urge that you consult acknowledged medical authorities such as the CDC, the World Health Organization, the National Institutes of Health and the American Academy of Pediatrics, as well as your child’s pediatrician to assist you in making vaccine decisions for your child.
Lou Romig, MD, FAAP, FACEP
Medical Director, Tampa