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Good Morning.

Have you ever had a Covid-19 test? Pam Marino here, and I had my first one recently. I had some important events coming up (socially distanced, of course) and suddenly I had a sore throat. It’s probably allergies, I told myself, but I was nervous about not wanting to potentially spread the virus.

I decided to get tested, just in case. I long ago had set up an account with Logistics Health Incorporated, the company that does online intake for OptumServe, which is the company contracted by the state to do polymerase chain reaction (PCR) tests at sites all over the state. With the demand for testing way down from peak levels in December, I got an appointment at Seaside High School within an hour of logging on. There was literally no one else there getting tested. I was in and out in no time.

PCR tests are considered accurate, but they take time to get results back. At best you can get results in 48 hours. When testing demand is high, it can take days.

That’s been one of the big problems with PCR tests. Waiting more than a couple of days for a result makes the test pointless. If you don’t quarantine while you wait for results, you could be spreading the virus wherever you go. 

Another problem is that the test is a snapshot in time. If your result is negative, all it means is back when you took the test you were negative. That doesn’t mean you’re negative the day you read your results.

An ER doctor with Community Hospital of the Monterey Peninsula thinks he has a better solution to mass PCR testing that will allow us to put the pandemic behind us and save more lives. I wrote about Sameer Bakhda in this week’s paper, who says he’s been on a rapid testing “crusade” for the better part of the last year.

He calls the country’s failure to adopt mass testing—of any kind—one of the “original sins” of the pandemic. Had we tested as many people as possible starting in February 2020, we might have caught those who were spreading the virus but showing no symptoms and taken them out of the equation.

Instead, we wound up taking the approach of viewing everyone as potentially sick, Bakhda says, which meant shutting down society to restrict the spread of the virus. Other methods of screening like temperature checks are “worthless,” he says. Not everyone has a fever while they’re contagious. He sees rapid tests as a way to uncover who really is sick so those who are well can go about their business. 

Bakhda uses the analogy of hunting down the virus to hunting for wanted criminals. “Imagine Covid is a bunch of bad guys wearing red Hawaiian shirts and blue jeans,” he says, but all you’ve got is a set of fingerprints—in our case, PCR tests. You have to take the time to check the fingerprints of those who might fit the description, a labor-intensive process and not realistic, Bakhda says. 

The other option is to be on the lookout using a wanted poster. Rapid tests look out for the spiked protein, the clothes the coronavirus are wearing. “It’s really good at finding someone contagious,” he says. It’s not perfect (there are false positives), but in most circumstances it's good enough. You can at least pull someone out of the community until a more sensitive PCR test can either confirm or rule out Covid. You can also save lives by getting people into early treatment for the virus and prevent hospitalizations.

Since rapid tests only take 15 minutes to show a result (he likens it to a pregnancy test) you could test large numbers of people before letting them enter performance venues or bars. Serial rapid testing done every few days by staff and students in schools would allow in-person instruction to fully return. 

Serial rapid testing could also mean engaging in those things that make life special and rich, like visiting your grandparents and parents and hugging each other. Attending family gatherings and special occasions like weddings, even without masks. (It works by testing a couple of days before and then again “on the doorstep” to make sure you haven’t become infectious.)

It’s faster than PCR testing and it’s much cheaper. PCR tests, which are free to those being tested at government-sponsored sites, cost $100-$120 each. Rapid tests cost $20-$30. 

Bakhda makes a solid case for combining rapid testing, PCR testing and vaccinations as the way out of the pandemic. We’re not there yet. Even amid the push for vaccines, the need for testing has not gone away. 

Almost exactly 48 hours after I swabbed both my lower nostrils and handed my sample over to the woman supervising my efforts, I got a text saying my result was ready. It was negative.

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