We’re facing the third year and the fourth major surge of the pandemic. The omicron variant has brought the largest swell of new cases to date, with demand for testing again at an all-time high.
I was curious how the city manages this, and what the public should know about testing at this point. So I reached out to City Health Officer Dr. Anissa Davis to get some answers.
This interview has been edited for space considerations.
HAYLEY MUNGUIA: First, can you walk me through the difference between antigen, rapid and PCR tests?
DR. ANISSA DAVIS: There are different tests, so there’s the PCR, and that’s a test where you send it to a lab, and it takes a day or two, and the lab does it and sends you back your results. Then there’s the antigen—that test is looking for the actual genetic material of the virus, so that’s what it’s detecting. And then there’s the rapid, which is looking for part of the virus—and
that is done, like it says, rapidly. It takes about 15 minutes or so.
As far as the effectiveness of the tests, the PCR is very sensitive. That means, because it’s picking up genetic material, it will turn positive if you have any type of genetic material of the virus. So that’s good because it will pick it up and it will give you a positive result. But sometimes, after you get COVID, you can shed little dead virus particles for several days to weeks after you’re done with infection and you’re no longer contagious. That’s the downside of PCR, is that it’s picking up so much of your infection that might not necessarily be a problem for other people around you.
The antigen test is really good at picking up if you’re contagious, so you need to be at a certain load of virus in order for antigen to become positive, and that also is the level of virus where you’re contagious. So that’s kind of its claim to fame. It may not pick up every single infection you have, but it is really good at telling you whether you’re contagious to other people.
That being said, because omicron gives you milder symptoms, you don’t have that same level of viral load as with other variants, especially early on in your infection. And viral load is what you need for antigen, so an antigen test might not pick it up. So what we usually say is that you have symptoms, you might want to get tested again, like in another day.
This is kind of how the tests have been all along. No test is 100% effective at finding every case.
HM: OK. And was the Health Department prepared for the current surge in demand for testing?
AD: I would say yes. I don’t think we predicted it, but I think that we rose to the demand, so you can get a test in Long Beach. We’ve expanded our testing sites. We have a site for LBUSD students and staff. We have a site at the airport. So I do think we met the demand. I think that’s been kind of our response as a city and as a Health Department since the pandemic started, is ramping up quickly for the next thing in front of us.
HM: We’re entering year three of the pandemic, and some people still have difficulty finding a test or waiting in long lines for testing appointments. What challenges still exist to respond to major waves of testing need?
AD: I haven’t heard that you cannot get a test. Yes, there may be a wait, but we continue to adjust. I think that is one of the strengths of the city and the Health Department. We are very nimble, and we continue to do quality improvement. For example, there was a period when we were noticing that demand for antigen or rapid tests were going up, and not as much of a demand for PCRs. So we adjusted and kind of split the lanes up so people weren’t in line for such a long time.
I think we’ve been really nimble and have been able to meet the demand and deal with the glitches in the system, if you will. I’m sure it’s still not perfect, but I feel really confident that if you need a test in Long Beach, you can get one the same day.
HM: We’ve seen some different approaches from employers and school districts when it comes to requiring testing. How important is testing for in-person gathering at this point?
AD: I think the important thing is: You need to do a bunch of stuff in order to be as safe as possible. I think hanging your hat on any one thing—”I’m just going to have everybody be vaccinated and that’s it”— we’ve seen with omicron, you can get infected even if you’re vaccinated, even if it’s a lot less severe, and you can spread it to other people.
And I think the same thing goes for testing. We’ve talked about the caveats with testing. The issue with testing is testing is very good, but it’s not 100%. It’s not foolproof, so just to hang your hat on that and just say, “OK, maybe you’re vaccinated, maybe you’re not, but we’ll just require you to get a test”—that is not going to do it either. You have always needed a certain viral load to test positive. You can still be infected, and the day you take the test it’s negative, and you go to work the next day thinking you’re fine, and that’s when you start being contagious.
Relying on any of those things is not recommended. Rely on as many things as you can—make sure your ventilation is as best as it can be, make sure you enforce masking, be careful about staff eating together, be careful about gatherings, make sure if you can distance staff to distance staff. Make sure you encourage vaccinations, and then testing is another layer of that safety, so that’s what I would recommend for employers.