Once is not enough when it comes to COVID tests

COVID is on the rise again, workers are calling out sick, and discerning whether that tickle in your throat is a potentially deadly virus is becoming increasingly difficult and costly. The Southern Nevada Health District reports more than 16,000 new cases in seven days.  

Rapid antigen self-administered tests are notorious for false negative readings – and while they detect the omicron variant, they “may have reduced sensitivity” to the strain, the FDA posted last week.

One negative self-test is not enough to go about your business normally if you have symptoms, according to national and local health experts. If at first you don’t test positive, try, try again. 

“A negative self-test result means that the test did not detect the virus and you may not have an infection, but it does not rule out infection,” says the Southern Nevada Health District website. “Repeating the test within a few days, with at least 24 hours between tests, will increase the confidence that you are not infected.”

Repeating self-administered tests can be a challenge. They are currently hard to find and a package containing two tests is about $14. Last month, President Joe Biden ordered 500 million self-tests that will presumably be available to individuals via mail.

“It isn’t just an issue for home tests,” says Dr. Brian Labus, Associate Professor of Epidemiology at UNLV’s School of Public Health. “Even the PCR test can result in false negatives, especially if someone is tested too early.”

Labus says an asymptomatic, unvaccinated person exposed to COVID should quarantine for five days and wear a mask for another five, even if they test negative.  

“If they are vaccinated, testing is recommended to identify a possible asymptomatic infection, but quarantine is not necessary,” he said.

On Tuesday, the CDC updated its guidance, suggesting individuals who have a self-test should take it toward the end of the five-day isolation period.

Even positive results should be confirmed, health experts say. 

“False positives are unlikely on an antigen test but they can happen,” says Labus. “The purpose of confirming the at-home test with a PCR test is to make sure that we are not unnecessarily isolating people and quarantining their contacts.”

Confirmations also allow the government to document self-test cases that would otherwise go uncounted, and ensure optimal treatment. 

“While we don’t want people to go out in public unnecessarily if they are sick, having the infection confirmed by PCR may be necessary for that person’s care, such as giving them monoclonal antibodies,” Labus says.  

Some hotel workers have protections via union contracts, while others in the hospitality industry can rely on provisions of the Nevada Hospitality and Travel Workers Right to Return Act.

Employment attorney Joshua Sliker of Jackson Lewis says that law “provides certain testing requirements, time off of work requirements, and pay requirements for folks who may be exposed, are confirmed to have tested positive, or may have also been showing symptoms.” 

Companies with 50 or more employees must provide leave that is accrued based on the number of hours worked. 

Employees earn 0.0197 of an hour leave for every hour worked.  

“If you work a full-time job, that would give you approximately 40 hours of paid time off per year,” Sliker says.

A new law says that leave can be used for any purpose, including to care for a family member.  

“If you have paid time off, whether it’s under the Nevada law, or a more generous policy from the employer, the law allows you to use that time off for any purpose, not limited to care for yourself but to care for a family member,” Sliker says. “If you need to take time off to receive testing, you can also do that.”

But what about workers in smaller companies where paid leave is not required? 

“Sick people should stay home so that they don’t infect others, no matter what is causing it,” says Labus, noting COVID isn’t the sole culprit for respiratory infections. 

But in reality, sick people who have no paid leave go to work every day out of economic necessity.  

“From a legal standpoint there doesn’t seem to be any sort of requirement to provide those folks with any kind of paid time off or paid leave,” says Sliker. “I can tell you, just as a practical matter, everyone appreciates the gravity of the situation and the sort of ebb and flow we’ve been going through with both the initial onset of COVID and the variant surges coming in the fall and winter.”

Employers, already navigating a tight labor market, are making concessions. 

“What we’re seeing is employers who are having folks stay off for a few days until they can get a test, if they’re symptomatic,” Sliker says. “They’re working with those folks to see if they qualify – whether it’s for disability leave or [the federal Family and Medical Leave Act], or other types of protected leave. There does seem to be a willingness to work for whatever is possible to make sure folks have what they need.” 

The Vegas Chamber, which represents the interests of small business, did not respond to requests for comment.