Santa Barbara Doctors ExtraCare – December 2021 Newsletter

December 2021 ExtraCare Newsletter

As 2021 draws to an anxiously awaited conclusion our Santa Barbara Doctors family wish you all happy, healthy holidays.

Our final newsletter of 2021 focuses on providing you up to date information regarding the Omicron variant and clarifying the ambiguities surrounding COVID testing.

By Dr. Barbara Hrach

Nearly two years into the COVID pandemic and the demand for COVID testing worldwide is on an upswing. As we learn to live in the new “COVID reality” the reality is that testing is playing an important role in keeping us safe. There are many reasons to get tested including testing after a known COVID exposure, testing if you are sick and wondering if it could be COVID, pre and post travel testing and pre procedural testing. In addition, different countries, organizations, facilities have different requirements as to what kind of testing they will accept and in what timeframe the testing needs to be completed. Needless to say, this can all be quite overwhelming
Antigen, PCR, antibodies, rapid, saliva, nasal, nasopharyngeal…… These are all terms that have been tossed around in medicine for years but have just recently become part of your everyday vocabulary. I thought I would take this opportunity to try to clarify them for you to make your journey a little less confusing.
There are basically two different ways to detect active COVID virus in your system, these are the COVID PCR tests and the COVID antigen tests.

The PCR test looks for a segment of DNA specific to COVID, amplifies it and then reports the results. This the most sensitive test because even a small amount of COVID viral DNA on the specimen will yield a positive result.

This test, however, can remain positive even months after an active infection and doesn’t necessarily signify infectivity. Because of changes in the COVID genome present in the evolving COVID variants, laboratories around the world are testing their PCR platforms to ensure that they remain sensitive. So far, it appears that all of the major platforms on the market are able to detect the delta and omicron variants.

The antigen test looks for a certain protein (antigen) specific to COVID. This test requires an ample amount of COVID virus be present in the specimen in order to test positive. Therefore, it may take a day or two after exposure for this test to be positive and this test will remain positive for a shorter period of time after infection. Because of these limitations, the antigen test is not as sensitive as a PCR test (higher false negative rate) but is extremely specific (low false positive rate).

The term rapid can refer to both PCR and antigen testing. There are rapid PCR tests which usually yield a result in an hour or two, and there are rapid antigen tests which can result in minutes.
The terms saliva, nasal swab, oropharyngeal swab and nasopharyngeal swab refer to the type of sample collected. Saliva and nasal are pretty self-explanatory. Oropharyngeal refers to the swab entering through the mouth and extending to the back of the throat. Nasopharyngeal refers to the swab entering through the nose and extending to the back of the throat. The gold standard, i.e. most sensitive, sample collection technique is felt to be the nasopharyngeal swab followed closely by saliva, then nasal and lastly oropharyngeal. Saliva specimens can be affected by eating, drinking or brushing teeth prior to specimen collection.

COVID antibody testing is performed on a blood sample. There are many COVID specific antibodies that can be tested for including spike protein antibodies, nucleocapsid antibodies and neutralizing antibodies to name a few. Because COVID vaccines target antibody formation against spike proteins, a spike protein antibody test is a good marker for immunity following vaccination. Nucleocapsid antibody testing can signal whether or not you’ve previously been naturally infected and neutralizing antibody testing can signal your susceptibility to future COVID infections.

Our Santa Barbara Doctors laboratory offers blood collection for spike protein antibody testing as well as nasopharyngeal swab samples for rapid antigen testing. The rapid antigen test results are available within a few hours. We can also obtain a nasopharyngeal swab from you and send it out to PDL for PCR testing if your travel plans require PCR testing. The turnaround time on that test is generally 24 hours.

By: Dr. Sawyer Haig

There has been a lot of discussion both in the news media and in clinic lately about the Omicron variant. I thought I’d take some time to share some of the latest information available to us in the medical community.

The Omicron variant is a new variant of concern first identified in South Africa in November. There have now been cases identified across the World, including in California. There is a current possible surge in New York City, where test positivity rate has tripled in just three days. COVID-19 cases are rising across the country, where cases have increased 40% from 2 weeks ago (70% more than in early November). This is a concerning trend and indicates that we are in the early stages of a nationwide winter surge. The Delta variant is still thought to be the dominant strain, but this may not last.

This new variant has multiple mutations of the spike protein, which raises concern that vaccine and natural immunity may not protect from infection from the Omicron variant as effectively as it has for other variants. It is felt to be more infectious than prior variants and has a faster “doubling time” of infections. It’s not clear yet whether the disease it causes is more or less severe than other variants.

Although less effective than for other variants, vaccines still provide good protection against the Omicron variant. Recent studies from the UK and Israel showed that people who receive booster shots are better protected than those who received only the first vaccines several months prior. Unfortunately, people with past COVID-19 infections are getting more omicron infections (reinfections) than expected.

How can you best protect yourself and others from the Omicron variant? If you haven’t already been vaccinated, please get the initial two doses of the Pfizer or Moderna (a recent CDC panel recommended that other vaccines be preferred over J and J). We have all three vaccines in stock in our office. If you are eligible for the booster, please get it. Wear a mask. In your household, stay 6 feet away from people who are sick. Outside your home, stay six feet away from others. Avoid crowds and poorly ventilated spaces. Test yourself if you develop symptoms of the common cold or other symptoms that could be due to COVID-19. Wash your hands often. Cover coughs and sneezes. Clean high touch surfaces regularly, especially if someone is sick or has tested positive for COVID-19.
Monitor your health daily.

We are in this together, and the onus is on each of us to do our part. Ed Young of The Atlantic put it nicely:

“People who are unlikely to be hospitalized by Omicron might still feel reasonably protected, but they can spread the virus to those who are more vulnerable, quickly enough to seriously batter an already collapsing health-care system that will then struggle to care for anyone — vaccinated, boosted, or otherwise,” he wrote.
“Individualism couldn’t beat Delta, it won’t beat Omicron, and it won’t beat the rest of the Greek alphabet to come,” he wrote. “Self-interest is self-defeating, and as long as its hosts ignore that lesson, the virus will keep teaching it.”

Please note our holiday schedule below:

December 24 the offices will be closed.
December 31 the offices will be closed

Dr. Haig will be out of office December 20-26. For emergencies please contact Dr. Hrach 805-705-5929

Dr. Hrach will be out of office December 27- January 2. For emergencies please contact Dr. Haig 415-260-5269

Our mailing address is:
Santa Barbara Doctors
229 W. Pueblo Street
Santa Barbara, CA 93105-3804

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