Monroeville urgent care center offers antigen covid test results in 20 minutes

Dr. John Kolonich of Monroeville thinks people need to be talking much more about covid-19 testing, and that those doing the testing should be talking much more to their patients.

“No test is 100% sensitive,” said Kolonich, a physician with iCare Urgent Care on Route 22 in Monroeville. “I think it’s very important for people to understand that all these tests are out there under the FDA’s emergency-use authorization order. They want to put forth the best tests we have at the time.”

The iCare facility has invested in a system to process what is called a rapid antigen test, which returns covid-19 test results in about 20 minutes. The test detects a protein on the covid-19 virus.

Patients wait in the parking lot, where they’re assessed by a physician and given a swab similar to those used at other testing sites in the region. The sample goes into one of two analyzers to be processed.

“Everyone who comes here sees a physician assistant or a provider,” Kolonich said. “We can evaluate them at their vehicle, we can get vital signs, we can do the test there.”

It’s the evaluation that Kolonich felt was most important, in part because of the occasional false negative results, which can be produced in not just the rapid antigen test but other types as well.

“The goal is to get a test that’s at least 80% sensitive,” Kolonich said. “But you’re always going to have false negatives.”

To Kolonich’s mind, that’s where the evaluation becomes crucial.

“If a symptomatic person who has severe allergies has a negative test, you can feel pretty confident in that negative,” he said. “But if someone just got back from a trip to the beach, you might want to do a second test.”

Kolonich said his concern is a patient receiving a false negative test result and then potentially infecting others.

According to the Centers for Disease Control and Prevention, the effectiveness of rapid antigen tests “largely depends on the circumstances in which they are used. Rapid antigen tests are particularly helpful if the person is tested in the early stages of infection with SARS-CoV-2 when viral load is generally highest. They also may be informative in diagnostic testing situations in which the person has a known exposure to a confirmed case of covid-19.”

The CDC notes antigen tests are less sensitive than the polymerase chain reaction, or PCR, tests used at most regional testing centers, which take several days to return results and detect genetic material.

There also is a rapid PCR test, being used to test White House staff, which Kolonich said he hopes to be able to offer patients by early fall.

The iCare centers, with locations in Monroeville, Ebensburg and Westmont, offer the PCR test, which is fully covered by insurance, and the rapid antigen tests, which costs $90.

Jeanna Albright, practice manager for the iCare centers, said the antigen test’s cost is a function of being able to process tests right there in the office, “versus running them in large volumes on standard slow machines.”

“This is an option for the patients who do not want to wait and elect the rapid test,” Albright said.

Kolonich said they all have their place.

“I think all of these tests have their role in combating this disease,” he said. “But to use them properly, you have to allow providers like myself to assess the patient.”

Kolonich felt context was critical in determining a testing strategy for a given patient.

“At a drive-thru clinic, you can test a lot of people,” he said. “But the problem is, if they have covid but get a false negative, they get a call and then they think they don’t need to self-quarantine and they go out and possibly infect other people.”