Syracuse, N.Y. – After a recent golf outing in Syracuse, Sharin Morin’s husband started feeling nauseous. The next day, Sharin did, too.
Worried that a co-worker was at high risk of Covid-19 complications, Morin drove from her home in the Oneida County hamlet of Deansboro to Utica last week to get a 15-minute coronavirus test. Primary Urgent Care in Utica is one of just a handful of local clinics that offer the quick tests.
“I couldn’t live with myself if I got somebody sick and they died,” said Morin, who works at a produce stand in Deansboro.
The 15-minute tests are still a novelty in Central New York, with just a handful of clinics offering them in Utica, Oswego and Pulaski. There are none in Onondaga County, the region’s most populous, county officials said, but more could be coming soon.
While the tests are quick, they’re less accurate than those sent overnight to laboratories. Some can miss 20% of positive cases, giving some people a false sense of security that they don’t have the illness when they actually do. And the federal Food and Drug Administration says the tests should be performed only on patients whose doctors suspect they have Covid-19, and only within the first five days of symptoms.
Still, the tests are so popular that the Pulaski Urgent Care has swabbed the noses of patients who drove from as far as Buffalo and Long Island, said physician assistant Rodney Richmond. The urgent care, in Oswego County, has processed samples from about 2,000 patients. That’s nearly equal to Pulaski’s population.
“I think a lot of it has to do with peace of mind,” Richmond said. “People see things on the news and they get concerned.”
Richmond said the quick test used at the urgent care, called the Sofia SARS antigen test, especially appeals to groups of people who are anxious or want results in a hurry.
“Some people who have had a lab test sent out are just so uneasy they can’t wait one more day” for results, he said. “There are folks on very tight deadlines, and folks who are concerned about people around them and they want to rapidly alert them.”
There’s a big caveat with the Sofia test, and those like it: If you test positive, you almost certainly have Covid-19. But if you test negative, the result could be wrong, and you might have the virus and be passing it on to others, according to the emergency authorization the FDA granted in July.
Richmond said the tests appear to be more accurate than the FDA’s 80% accuracy rating, which he said was based on just 10 samples. Of the approximately 2,000 quick tests the urgent care has done, he said, only a handful of patients who tested negative later tested positive on the standard tests.
Richmond said the urgent care cautions patients who test negative to get a confirmatory test to be sure. The Centers for Disease Control and Prevention make the same recommendation.
Medical experts say people like Morin shouldn’t be getting the rapid tests. While the tests are faster and generally less expensive than standard molecular testing, they should be used only for people who are mostly likely to have the illness, cautioned Dr. Stephen Thomas, head of the infectious disease unit at Upstate Medical University.
“They really should be reserved for testing people who have a higher pretest probability of being infected, like having a known high risk exposure or, most importantly, have symptoms and have had symptoms for less than seven days,” he said. “This would be an appropriate test to use and, if it’s possible, it’s probably a good idea to get it confirmed with the gold standard, which now would the PCR (molecular) test.”
The quick tests are also helpful in places where the virus is most likely to spread, such as skilled nursing facilities, Thomas said.
“Where you’re able to test people say, two or three times a week, the ability to frequently test would make up for the lower sensitivity” of the test, he said.
It was a stroke of luck that Pulaski became one of the first places in the entire region to offer rapid tests. The urgent care has been using the Sofia testing machine for several years to process more common pathogens that cause illnesses such as the flu, strep throat and Lyme disease. Then, the test’s manufacturer, Quidel Corp., won an early emergency use authorization, or EAU, from the federal government this year to roll out the tests.
“Our clinic was very lucky that we had the test analyzer that just so happened to get an EAU for Covid testing,” Richmond said. “We called the company and said, ‘What do we have to do to get supplies?’ They said, ‘We’ll set you right up.’ It put us right on the front line early in the supply chain.”
The Sofia test detects specific proteins, called antigens, on the surface of the virus. Other tests, called molecular tests, zero in on the virus’s genetic material, making them more accurate.
“Antigen tests are more likely to miss an active coronavirus infection compared to molecular tests,” the FDA said.
Even molecular tests are now entering the world of rapid testing. The Pulaski clinic now has a new 15-minute machine, made by Abbott Laboratories, that searches for genetic information and is more accurate than the Sofia. It’s been difficult to get the testing supplies for the Abbott test, Richmond said, and they’ve only processed samples for just a few patients so far.
Onondaga County officials aren’t aware of any 15-minute centers in the county but hope to get the Abbott rapid tests when they’re available, said spokesman Justin Sayles.
Sayles said the Abbott tests will cost $5. The Sofia test conducted in Pulaski are $86 if insurance doesn’t cover it, Richmond said. In Utica, patients pay $100 if insurance doesn’t pick up the tab.
Morin, after waiting about 30 minutes in her car in the Utica urgent care parking lot, had her results hand-delivered to her SUV. She tested negative, and, with no symptoms since that first day, was confident she could return to work without endangering her co-worker.
The test cost her $100.
“It was worth it,” she said.
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