OPINION | The Local Views
‘Not Detected’ in COVID terms By Dave Lawrence Richmond Suburban News et me tell you a cautionary tale. A couple of weeks ago, I was covering the Dominion Energy Charity Classic when I felt what I thought was an old friend coming on: allergies. My nose was getting itchy. Drainage was irritating my throat. But it didn’t feel like a big deal and I wasn’t worried. I was wearing a mask, keeping my distance, and being careful about not touching anything more than I absolutely needed. Overnight, while I was trying to prepare the forthcoming sports sections for the week’s Locals (Mechanicsville and Ashland-Hanover), it started to feel like more than mere allergies. I was stuffy, sneezing and coughing. By Monday morning, all I wanted to do was slap my sections together and go back to bed. By Monday night, I was running a fever. By Tuesday morning, I had met enough criteria for COVID-19 that I went to my doctor to get tested. Because of the usual trajectory my body typically takes with any kind of respiratory infection, she also began treating me for bronchitis. I spent the ensuing two weeks in isolation. I got tired of being stuck at home. But that is irrelevant. I’m not writing all this to kvetch to you readers. I’m writing because there’s an important lesson to be learned. When the nurse called me to give my result, she said it was “negative.” I used the term “nega-
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tive” myself in describing the result. Most people, after getting a similar result, would likewise use “negative” to describe their COVID status. Here’s where the cautionary bit comes in: The lab report does not say my result is “Negative.” Instead, it says, “Not Detected.” You may be guessing the punch line at this point. … Yes, there is a difference between “Negative” and “Not Detected.” In my years as an environmental regulator reviewing toxic substance monitoring reports, I never saw a report that said a chemical was not present. If the substance was detected, there would be a number representing the concentration of the pollutant in the sample. If the sample was not detected, there would be some notation like “DL” that was shorthand for “below detection limit.” Most biological or chemical assays are only so sensitive in that there must be a minimal amount of whatever of interest for the test to register. That is referred to as the detection limit. At or above that minimal amount, the test can quantify how much is there. But, if the amount of the thing of interest is below the detection limit, you cannot do the opposite and conclude it is not in the sample. It might very well be in sample, but in an amount too small for the test to be able to measure. We run into this dilemma with the COVID19 tests. If the results say the virus has been detected in your sample, odds are you are infected. The tests have not had a big problem with false positives – except where, as with the initially rolled out version of the Centers for Disease
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Control and Prevention test, the test kits (or samples) are contaminated in some way. If you have no COVID symptoms and your sample comes back “Not Detected,” it may be reasonable to conclude that you are not infected. Nevertheless, you could be mistaken. If you’ve had a recent close contact, you still need to be careful. Testing of my sample was done via LabCorp. The results of my sample came back “Not Detected,” but that’s where the detection limit comes into play. I could still be COVIDpositive, yet shedding virus at levels too low to register. According to LabCorp’s emergency use authorization documentation, the viral test – which looks for copies of viral genetic material, not the antibodies we may (or may not) produce against the virus – has a detection limit of 6,250 copies per milliliter. Other tests have been developed that can detect far lower concentrations of virus, but some can only detect higher concentrations. As with everything, cost/benefit considerations apply, and the LabCorp test is intended for a mass, not a niche, market. “The LabCorp test is likely sufficiently sensitive to identify patients who are ‘infectious’ on the day of testing assuming the sample was collected appropriately,” wrote Harvard University researcher James E. Kirby via email (response slightly edited for clarity). “It is one point in time. Detected viral load usually precedes symptoms; see COVID, pg. 8
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LETTERS | Reader Views
Hickory Grove rezoning impacts East Ashland The proposed Hickory Grove mixed use rezoning on Route 54 east of the Town of Ashland features traffic manipulation and deception. The developer’s traffic study falsely denies the existence of the massive, approved but undeveloped East Ashland project which would add over 33,000 vehicles across from Hickory Grove. East Ashland impacts traffic on Route 54 and the Interstate 95 Exit 92 interchange and has proffered road improvements along Route 54. In 2016, the General Assembly passed legislation specifying that a proffered road improvement should be attributable to a development creating the need for it. If East Ashland’s traffic and road improvements had been included in the traffic study in compliance with express VDOT (Virginia Department of Transportation) guidelines, Hickory Grove’s development would create a need for major proffered road improvements to the Exit 92 interchange and likely Route 54. By denying the existence of East Ashland, however, Hickory Grove falsely claims a temporary traffic signal on a wooden pole at the Exit 92 southbound off ramp as its only proffered road improvement. How convenient. Hickory Grove can claim compliance only because its traffic study ignores East Ashland, cumulative impacts, and VDOT guidelines. There’s more. Although East Ashland’s traffic is ignored and it pays no cash proffers, county staff resurrects the 33,000 vehicle trips in calculating Hickory Grove’s cash proffers. Without support, traffic from far away developments near the U.S. 301/ Rural Point Road intersection also is included. Because these vehicle trips see LETTERS, pg. 8
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The Mechanicsville Local
November 4, 2020
