It’s just a test

Jeffrey I. Barke, M.D.

I heard this startling story from a patient the other day: “I got a phone call . . . telling me my Covid-19 test came back positive. But I never had the test done, I told the caller. I checked in and completed the paperwork but I left because the wait was too long. They never [actually] tested me.”

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Incredibly, the caller didn’t believe my patient. “No,” she insisted, “I am sorry . . .  your test results were positive.” Worse, I suspect that these bogus “results” were sent to the state data bank that reports “new cases” to the CDC. One more error in the Johns Hopkins numbers that most of the media rely on.

I have read numerous other accounts similar to this on social media. They never seemed credible until several of my own patients reported directly to me that this is exactly what happened to them. Then, a member of my office staff reported the same experience. Concerns about the accuracy of the multitude of Covid-19 tests being used are commonplace and with good reason. But now, the issue of ghost tests calls into further question the validity of the whole testing process itself. 

Why would Covid-19 results be fabricated? Is it a simple clerical error? Are financial incentives being given for increased testing productivity? Are politics at play — the more tests administered, the better the bureaucrats in charge look? 

But here’s the important thing: If we can’t get the basics right and if the numbers are wrong, how can we expect the experts to make the best possible public policy decisions for the country? We can’t, and we can end up doing things which are actually inimical to the well-being of the people of this country!


Another real life story: One of my patients owns a business in the city of Long Beach, California. An employee of his, with whom he had direct contact, tested positive for Covid-19. As a result, he decided to get himself tested. So, he drove to a Covid-19 testing center. The Sofia rapid nasal test was used at this site. This testing system uses an immunofluorescence-based assay. To my patient’s consternation, he, too, tested positive. All of a sudden, he faced a cascade of unpleasant but necessary decisions including the cancellation of a long anticipated golf trip to Bandon Dunes, Oregon. The next day he took his wife to the same testing center; he also figured he would have himself re-tested just to be sure. Naturally, both he and his wife tested negative for the virus this time. 

So which of the tests is correct, he wanted to know? Both my patient and his spouse had no symptoms. We are taught in medical school to treat the patient, not test results. So, no treatment was instituted. But I wanted to know whether my patient’s positive test from the day before had been reported?

Many of my patients that test positive go back and retest - sometimes multiple times until they get a negative result that conforms with how they feel. They do this for a variety of reasons: Legitimate concern about being contagious, mixed with paranoia, return to work policies of their employers, and lack of confidence in any single test, to name a few. 

If a patient were to test positive three times over a couple weeks, is every one of those positive tests sent to a central data bank? Could this be in part why we have seen the number of cases escalate? More positive tests lead to more multiple testing of a single patient. What if I test positive while on a trip to a different state and then test positive when I come home. Are my results counted twice with each state registering a new case? If the basic data begins to be suspect, how can you trust the effectiveness of the public policy on which it is based?

A recent Journal of the American Medical Association research article in JAMA Pediatrics indicated that children could be spreaders of the virus as they have a higher viral load when tested. 

“Our analyses suggest children younger than 5 years with mild to moderate COVID19 have high amounts of SARS-CoV-2 viral RNA in their nasopharynx compared with older children and adults.”

More fake news? What the JAMA article failed to tell readers is that the Covid-19 test the researchers used was the new Abbott Laboratory test that is not FDA-approved to provide quantitative data. That test is approved for qualitative data only. In other words, the Abbott test is meant to answer whether there is virus present, not to determine how much virus is present. Scroll down to the end of the JAMA article and note what you see: Harsh criticism from physicians and PhDs who call the findings reported in the article misleading at best and fraudulent at worst. 

The author of the report is William Muller, MD, PhD. He is on the staff of the Ann & Robert H. Lurie Children's Hospital of Chicago, a part of Northwestern University’s Feinberg School of Medicine. He responded to the outpouring of criticism this way:

We very much appreciate the attention this paper has received and the comments left by different readers. Several readers have left comments on technical characteristics of the assay used to generate the reported data. (While it is correct that the clinical application of the assay is for qualitative detection of SARS-CoV-2 RNA, the cycle threshold data reported in this study were gathered for research purposes. 

Fine. But what does all that mean? The mainstream media ran pieces about this article and never saw the criticism calling the conclusions patently false. It should not be forgotten that just a short time before this episode two of the leading medical journals in the world, The New England Journal of Medicine and The Lancet, both retracted separate research articles that were critical of hydroxychloroquine within hours of each other. 

It is no wonder that so many people have lost faith in our so-called healthcare experts and seem hopelessly confused as to what is to be believed about the dangers to their kids, their parents and themselves.

When the basics are wrong, how can anyone trust that the larger public policy decisions are right?


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Highwire with Del Bigtree Featuring Dr. Jeff Barke