- The White House relied on rapid coronavirus tests to determine whether event attendees were infected, while deemphasizing mask wearing and social distancing.
- Experts say the tests shouldn’t be the sole precaution and can’t be used as a pass to safely get close to other people.
- A new CDC study reveals that rapid antigen tests — which differ from nose and mouth swab tests — can often give a false negative.
- The study results came just five days after President Trump tested positive, part of a White House coronavirus outbreak that has hit at least a dozen people.
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The White House has not required staff or event attendees to wear masks or social distance throughout the pandemic.
Instead, the main precautionary measure the Trump administration relied on was rapid antigen tests, which detect specific proteins in the new coronavirus. The tests can identify a person’s infection when at its peak, which is when an individual is especially likely to spread the virus.
Specifically, the administration has used Abbott Laboratories’ ID Now rapid test to determine whether those coming into contact with the president were coronavirus-free. That was the case on September 26, when President Trump hosted the Supreme Court nomination ceremony for Judge Amy Coney Barrett in the Rose Garden. All guests were tested before attending; then, comfortable that all results were negative, maskless guests hugged, mingled, and remained in close proximity to one another over the course of at least 20 minutes.
Less than a week later, Trump had COVID-19. At least 11 other White House and GOP officials — Most of whom were at the ceremony — have also tested positive since Friday.
New research from the Centers for Disease Control and Prevention suggests that the White House’s reliance on rapid tests in these instances may have been unsafe. A CDC study published Monday describes a case in which a 13-year-old was exposed to the virus, tested negative using a rapid test, then vacationed with her family.
The teenager’s result turned out to be a false negative, and she ended up passing the illness on to a dozen family members.
Rapid tests are faster but less accurate
Rapid diagnostic tests for the coronavirus, unlike the traditional RT-PCR swab tests that get sent to a lab, can take as little as 15 minutes to yield results.
Most of these fast-turnaround tests look for antigens, bits of protein that sit on or in the virus. By contrast, the PCR tests do a more in-depth scouring for the virus’s genetic code, which is why it often takes days to get results.
The problem with speeding up the process, however, is that the rapid COVID-19 tests we have now may only pick up about 70% to 80% of infections, and they can produce false negatives. The Food and Drug Administration cautions that negative rapid-test results may need to be confirmed with a lab test, and the CDC says the tests are “generally less sensitive than viral tests.”
“What seems to have been fundamentally misunderstood in all this was that they were using it almost like you would implement a metal detector,” Ashish Jha, dean of Brown University’s School of Public Health, told the Wall Street Journal, adding, “a metal detector that misses 10% of weapons — you’d never, ever say that’s our only layer of protection for the president.”
Some studies have found that about 9% of Abbott ID Now tests produce false negatives. PCR tests, on the other hand, “would be pretty close to 100% accurate” if performed correctly, Dr. Emily Volk, an assistant professor of pathology at the University of Texas-Health in San Antonio, told Healthline.
A family gathering gone awry
The new CDC study describes a family that put their faith in rapid antigen testing. Among 14 people who stayed in one house together following the teenage family member’s negative test result, 12 contracted COVID-19.
The 13-year old had been exposed to the coronavirus while away from home, and she was experiencing nasal congestion but no other symptoms when she took the rapid test. After her negative result, the family deemed it safe for her to travel to the five -bedroom, two-bathroom vacation house with the group.
The family members staying at the house did not wear masks or practice social distancing, though six other relatives who visited the family gathering remained outdoors and socially distanced. Those six people did not get infected.
“I would still say that distancing and outdoor air are your best friends,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, previously told Business Insider. “To me, that would provide me much more assurance that I was not going to either get infected, or infect others, than would a rapid-detection test.”
Based on their results, the CDC study authors said the case study shows why “regardless of negative test results, persons should self-quarantine for 14 days after a known exposure.” They also reiterated that results of rapid antigen tests need to be confirmed with PCR tests, especially in people “with high pretest probability of infection, such as those with a known exposure.”
When rapid tests can be useful
While they shouldn’t be the only precaution people take, rapid tests can help screen large groups for the coronavirus, according to Anne Wyllie, a researcher behind the rapid saliva-based test SalivaDirect, which got emergency FDA authorization in August.
“This is definitely more for screening,” Wyllie previously told Business Insider. She added that the tests could be useful for “frequent testing” in group settings like schools and workplaces.
Still, it’s easy to see how the tests can foster a false sense of security.
“It does send a message basically that if you’re negative at this point, you must be doing something right,” Osterholm said. “When I would say [if] you’re negative at this point, you might just be lucky, and your luck’s going to run out.”