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Sunday, January 17, 2021

UF navigates COVID-19 test accuracy

UF will continue providing thousands of saliva tests in the Spring

Students are seen waiting in line to be tested at the COVID-19 testing site outside of Murphee Hall on Sept. 24, 2020. Students who wish to get tested are required to fill out an online screening questionnare prior to making an appointment and are asked to bring their Gator One ID card.
Students are seen waiting in line to be tested at the COVID-19 testing site outside of Murphee Hall on Sept. 24, 2020. Students who wish to get tested are required to fill out an online screening questionnare prior to making an appointment and are asked to bring their Gator One ID card.

UF’s COVID-19 testing capacity will be accelerated in the Spring as it becomes mandatory for thousands of students. 

COVID-19 tests, which are varied in their techniques and levels of accuracy, have been scrutinized and fine-tuned since the beginning of the global pandemic. Now, the consensus is that non-rapid, molecular-based tests are the most accurate

With any COVID-19 test, there is still a small margin for error that must be navigated, including potential for false negatives and positives. UF uses PCR, or molecular-based saliva tests, which Dr. Cindy Prins, UF College of Public Health and Health Professions’ assistant dean for educational affairs, said are more reliable than other types of COVID-19 tests.

“PCR tests are what we consider to be the gold standard for COVID-19 testing because they’re more accurate than rapid tests,” said Prins.

PCR, or polymerase chain reaction, is a process that amplifies small samples of genetic material. PCR tests are non-rapid because the samples have to be processed in labs. If there is viral material in the saliva or nasal sample, multiplying it through PCR helps doctors detect it.

Rapid tests, or antigen tests, are another option. The tests detect a protein on the virus’ surface, Prins said. While these tests produce results in minutes, they’re less sensitive, meaning the results are less accurate.

“It’s a trade-off between getting a faster result versus getting a more accurate result,” said Prins, who is also a UF associate professor of epidemiology.

UF does not currently have plans to provide rapid tests, wrote UF Health Shands spokesperson Ken Garcia in an email. Students can still expect to receive results within 48 hours next semester.

The accuracy of nasal swab and saliva tests seems similar, but because there’s variation in how a nasal swab test is performed, saliva testing is a more consistent collection method, Prins said.

UF transitioned from nasal swabs to saliva tests in September, and lab processing capabilities have since grown from 1,000 tests a day to about 2,000 tests a day, Garcia wrote.

UF also streamlined access to testing through students’ One.UF portals. Chad Wishner, a 22-year-old UF computer science fifth-year, had difficulties scheduling a test at the beginning of the semester.

“They improved quite a bit on the testing process,” Wishner said.

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He scheduled a saliva test in early November and said the process ran smoothly. He was happy UF made testing opportunities more widely accessible for students.

Though uncommon, some students have run into trouble with false positive or negative COVID-19 results. 

“We run thousands of tests a week, and it is rare for false positives to occur due to a lab error,” wrote Sara Tanner, UF’s director of marketing and communications, in an email. “In the event they do, those tests are redone to ensure the accuracy of the results.”

Tanner wrote she did not have an estimation for the number of students who received false positive tests this Fall, but it’s rare. 

Patrik Raguz, a 19-year-old UF computer science freshman, was informed he tested positive for COVID-19 in late September. He moved to Lakeside — the dorm for COVID-19 positive students — that evening.

After two days in Lakeside, Raguz received another email saying his test result was negative. Confused, he contacted university housing and was told his initial test was likely a false positive.

Inaccurate results are usually due to cross-contamination of samples in the lab or human or software error, like misreading or mixing up results, Dr. Cindy Prins said.

She said lab technicians run negative and positive controls through their systems to detect whether some of these issues are happening.

Raguz said he was exposed to at least two other COVID-positive people for about three days while in the quarantine dorm.

He said UF Housing encouraged him to get tested again but also cleared him to go back to his dorm, Simpson Hall, despite his exposure. 

“When I came back, I knew that I should quarantine myself because there's an actual possibility I have it now,” he said. 

Raguz and his Simpson Hall roommate wore masks and kept themselves distanced while he waited for the results of a new test, which ended up being negative. 

Once students are notified of their test being a false positive, they are allowed to leave on-campus quarantine and return home, Tanner said. They’re encouraged to continue monitoring their symptoms.

Cecily Wood-Barron, an 18-year-old UF dance freshman, came in contact with a COVID-positive person in early October. She quarantined in Riker Hall but soon developed symptoms, including a fever, cough and shortness of breath. 

Her symptoms worsened, and two days later, UF Health Screen, Test and Protect decided to transfer her to Lakeside — she still hadn’t been tested, but she followed the university’s instructions. She was told her symptoms were too strong to be sent to Trusler Hall, the dorm for symptomatic contacts.

“I was exposed to COVID, I started developing symptoms; it just made sense,” she said. “But it was not definitive.” 

Wood-Barron received her first COVID-19 test after two days of living with a COVID-postive roommate in Lakeside. The next day, her result came back negative. 

She said UF Health Screen, Test and Protect told her the test was probably a false negative. She received a second test the day after another COVID-positive roommate moved in with her.

After another negative result, she asked UF Health Screen, Test and Protect whether she should get a flu test. She said she was told not to bother because it wasn’t flu season, and her fading symptoms would have made the test inconclusive. 

It’s possible to have the flu and COVID-19 at the same time, according to the CDC. Some doctors say the two diseases combined can exacerbate each others’ effects.

Wood-Baroon moved home, where she tested negative for COVID-19 antibodies.

During phone calls with housing and UF Health Screen, Test and Protect, Wood-Barron questioned why she was put in COVID-positive housing without testing positive. She never received an explanation.

Contact Thomas at tweber@alligator.org. Follow him on Twitter @thomasjohnweber.

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