Which COVID-19 test is best? NJ reviews LTC standards

"We’re looking for guidance that we really don’t feel that we have at this point" COO Rhea Goodwin said.

Healthcare workers across New Jersey are demanding better oversight and COVID-19 testing at long term care facilities where more than 7,000 residents and staff have died during the pandemic. But dueling state and federal regulations over issues like which COVID-19 test to use, create tension for nursing home operators.

“We’re looking for guidance that we really don’t feel that we have at this point,” AristaCare’s Chief Operating Officer Rhea Goodwin said.

AristaCare runs six nursing homes in New Jersey. They are among 14,000 long term care facilities nationwide that got free BD Veritor rapid antigen tests from the Trump Administration. Antigen tests give lightning-fast results just 15 minutes. The downside, they’re less accurate than the COVID-19 tests called PCRs that most people get at clinics. And that’s why New Jersey’s Department of Health requires long term care facilities to give the PCR tests once a week. They’re more trustworthy, even though it can take days to get results.

“Right now, we’re confused. Because we’re forced to select between state and federal guidance which either direction is going to yield a compliance issue for us,” Goodwin said.

“We should be using all the technology that’s at our disposal,” Andrew Aronson said.

Aronson represents a coalition of large New Jersey nursing homes. He says using the cheaper, faster antigen tests two or three times a week would root out false results by repetition.

“So you would have to test more often with the antigen testing, but the antigen testing has other uses. You can test visitors coming into your building. So there are clear advantages by using antigen testing. I think the optimal would be to use a combination of both,” Aronson said.

“The more testing we do, the better,” Epidemiologist Stephanie Silvera agrees. Even though rapid antigen tests can give false results they are a good screening tool when used along with PCR tests.

“That combination of the rapid test and the PCR test which takes a few days is probably gonna be your best combination. Especially since you’re talking about our most vulnerable community in terms of COVID deaths. And we don’t want to see happen in the fall, what happened in the spring,” Silvera said.

“This is part of an entire protocol. You have the testing, but you also have the social distancing. Then you also have the personal protective equipment. And the isolation. So it’d be nice if we could have a standard that we could look on that state and federal government could do together,” Sen. Joe Pennacchio (R-Morris) said.

Sen. Pennacchio says health officials should run a pilot program to determine best testing practices. New Jersey’s Health Commissioner said they’re reviewing test policies.

“We’re working very closely with Dr. Kirn, head of our labs to develop a directive that we will be sharing with the LTC industry about use of antigen tests and how to follow up with a PCR test if you get a false positive,” Commissioner Judy Persichelli said.

Persichelli also said the state’s reviewing yet another discrepancy with federal guidelines which now permit indoor nursing home visits if no one’s tested positive in the past 14 days,  that’s versus New Jersey’s 28-day requirement. But with so much pandemic polarization, it’s tough to find a standard.