Many of you have asked for my thoughts on holiday planning. How can we see our family and loved ones safely when cases seem to be climbing so rapidly? Well, I would like to make some specific recommendations, though everyone needs to consider their own particular situation.
Sharing the risk of getting sick with new people by adding them to our “bubble” is scary. And these folks may be adding others into their bubble at the same time, which multiplies our risk. So, the first thing I recommend is to significantly reduce the number of people invited to such an event. And for everyone involved, I recommend they significantly modify their risk for the 10 days leading up to the event, so that they become very unlikely to be an asymptomatic carrier of the virus. Specifically, for those 10 days, I would ask all folks to distance and wear a mask all day, even when they are with their coworkers or friends with whom they already share a “bubble”. Also for 10 days, I would ask that they refrain from allowing any, or hardly any, new members into their bubble. And lastly, I would ask that they all be tested for active COVID infection at the last possible minute before getting together.
Availability of testing these days has improved drastically. In fact, we at Spring Valley Internal Medicine are now doing both the gold standard PCR test and the new “15 minute” rapid antigen test in our parking lot each evening as a “drive up” test. You can stay in your car, or walk up if you prefer. So, for this discussion, for holiday/travel screening, I am recommending that you do only the “rapid” antigen test where you will find out that evening if you are positive. If you desire, we can also send a PCR test at the same time, though you would not hear back about that test result for at least 2-3 days.
Some important considerations are that we are charging $120 for the 15 minute rapid antigen test (insurance does not apply), and we are billing the insurance companies for the PCR test. The PCR is $150 if you do not have insurance. And please be aware that there are occasional false negatives with both types of test, and the tests may miss someone who has been exposed in the last few days, but has not yet begun to shed virus. But on the bright side, most people will test positive on either test 24-48 hours after exposure.
So to summarize and to clarify the bare minimum, I recommend that everyone included in your holiday event avoid any new exposure to the virus for at least 3 days (ideally 10 days) prior to testing, and then go get a 15 minute antigen test at the last possible available time. In my office, we are asking you to schedule a virtual visit any time before your desired testing date, and then at that point we will schedule you for the drive thru test on your preferred date. Though I would prefer that you come to my office for these tests, we may not be able to get everyone onto our schedule, so you may need to look to one of several other sites where this test can be done. Two in particular are the Urgent Care Center of Arlington, and Medical Access in Germantown and Alexandria. As before, we can also arrange for you to get the PCR test at several locations, including Sibley Hospital and GW Hospital.