Seems an unreasonably long time to wait though.
Is that normal?
Our LFTs all came up positive without the classic symptoms. Are we the oddities?
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Yeah, it’s complicated because of how different symptoms present.
Different ones present at different points in the progression. Some present earlier than others.
If you get the symptoms that present later, you will likely already test positive. If you get the ones that present earlier, you are more likely not to test positive right away.
I need to go pull that full explanation…
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Yip 
I’m sure this kind of thing has been discussed several times at length. It’s just fresh for me just now 
Sorry if I’m going against the general consensus on these things.
My thoughts (pre-infection) was that LFTs were a pretty unreliable way to tell if you had it or not because of so many false negatives. I was surprised at how spot on they were for us. I have more confidence in them now, but maybe that’s misplaced.
They’re actually pretty reliable, it’s more a timing thing. I listened to a full podcast on it a few weeks ago that I’ve been meaning to pull details from to share. It was too much to keep in my head!
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No. Not for Covid. But certainly for other life situations. More than slight anxiety in some cases. Possibly a better solution might be to seek some professional assistance in processing anxiety. However, living in an extremely rural area, we’re entrepreneurial about mental health as much as we are about physical health. Case in point for physical: I have stitched up a long cut in a fleshy part of DH’s hand when actual medical care was hours away.
On another subject still covid related, I was glad to see filtration mentioned further up the thread.
One of the better scary how do we go on from here moments with DH was a few years before covid when he couldn’t breathe and thought he was dying. He’s got copd and a small area of infection in an upper part of one lung had him feeling like he was suffocating. It was a scary time culminating with his being in hospital 3 days. On oxygen but not a ventilator.
So March 2020, with that episode still very vivid, covid seemed more than something that happens to someone else. Add to that DH’s increasing lack of reasoning ability and his health is my responsibility.
By April the key to better living with a pandemic seemed to be filtration. We already had 2 air cleaners in the public area of our house. I bought 2 more smaller ones for each bedroom.
We’ve had two family members with covid. No spread. DH has had one slight infection resolved in a couple days by quick antibiotics - his pulmonologist insists I have a supply on hand.
When I saw these* up thread I felt much relieved. We - he - may still get covid. I have been expecting it. But at our age, neither cares to wait at home. With N95s, boosters and clean air we might continue to be breathing as easily as possible.
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tl; dr - If available, use multiple rapid antigen tests one or two days apart for more reliable results and assume you are positive in the meantime. PRCs are more sensitive but the potential for slow turn-around times makes them less useful in breaking transmission chains,
For many of the Covid experts that I follow, the one they tag when they have a testing question is Michael Mina.
He was on Andy Slavitt’s podcast a few weeks ago. Here are some of the more interesting bits. I’ve edited rather extensively to merge in the Q&As and make it more concise but still flow.
A: So at what point in [the infection] process do you start to feel symptoms?
M: So this is one of the most confusing things for people in this pandemic. And it’s confusing everyone from the FDA, to the CDC, to individuals in their home. The most important thing when we’re asking anything about symptoms is to ask what symptoms we’re talking about. Is it the symptoms of the virus destroying your cells? Or is it the symptoms of the immune system kicking in and trying to kill the virus, for example, congestion, runny nose, and a fever, those are symptoms of your immune response; [whereas] loss of smell, diarrhea, GI symptoms, and [difficulty] breathing, of course, those are symptoms of the virus doing damage.
So before any preexisting immunity existed, [prior to when] people first get an infection [or] have been vaccinated, [there would be no early symptoms and] the virus would grow up and it was only after the virus grew for about five or seven days and it got to peak viral titers, that people would start realizing, “Oh, wow, I don’t have any sense of smell anymore.” Or “Oh, wow, I have a cough or I have diarrhea.” And so that was happening after the virus had grown so much that it did enough damage that symptoms of the virus pathology kicked in.
Now, on the other hand, what we’re seeing today is a markedly different situation. Most people have either been vaccinated or infected in this country, if not in the world, at this point. And what that means is we have preexisting immunity, [so] our immune memory kicks in fast now. So you get exposed, and then we’re seeing people become symptomatic in a day or two, but the symptoms have changed. It’s no longer loss of smell and GI symptoms. Now, it’s congestion and runny nose, and normal, cold-like symptoms people are feeling first. That’s because it’s a sign that your immune system recognizes the virus real fast, and tries to start battling it within a day or two of getting first infected.
So, you can be infectious and have no symptoms, have a lot of symptoms, have been pre-symptomatic, post-symptomatic… So, the symptoms don’t correlate perfectly but in general, what we’re finding with Omicron, is that it’s starting to spread very fast. So you get exposed, you’ll start to feel symptoms, maybe a day or two later. And what we’re finding is people are likely starting to spread the virus already, when their symptoms are just starting within a day or two, they’re actually starting to become infectious.
I would argue if you’re getting your symptoms a day after you’re exposed, you probably weren’t infectious yet. Probably if it’s been only a day, you might start being infectious a day after. But if you’re becoming infected, if you’re becoming symptomatic, say three days after exposure, you might have become infectious earlier. And just to be clear, this is a pretty big departure. For the majority of this pandemic, before there was any real pre-existing immunity, we had a good two or three days of real peak infectiousness before anyone even felt their symptoms. So things have changed. And now it’s a good thing. Because now we can actually use symptoms to rely on for our first sign of infectivity. So the moment you feel symptoms today, assume you’re beginning to become infectious, regardless of any test.
[3 types of tests: Laboratory PCR, Rapid PCR/LAMP, and rapid antigen test (i.e., at-home tests)]
Laboratory PCR…most sensitive…looks for the nucleic acids, or the genetic code of the virus…even a few molecules of [virus RNA], the PCR can turn positive…but it has to go to a lab [he compares virus RNA to forensic evidence that someone was infected, but they may no longer be infectious]…usually [turns positive] around 2-3 days after they’ve been exposed, [most by 5 days], but it could be as long as 10-12 days later, depending on how well the immune system is playing tug of war.
Rapid PCR/LAMP…They’re not quite as sensitive as PCR, but they’re a little bit more sensitive than antigen; they sit in the middle…If you’re testing somebody every hour of every day, a laboratory PCR might turn positive, let’s say at day 2-3 [after exposure], LAMP might turn positive at day 3-4, and a rapid antigen test might turn positive at day 3.5-4.5. So the PCR is about a day before LAMP which is about a half a day before antigen in general.
Probably the first day that you’re infectious with Omicron, you’re probably going to be negative on an antigen test and negative on a LAMP, and I would give it like a 50/50 chance that your swab for PCR would come back positive.
In general lab PCR will just stay positive, potentially for another week…2…3…4 weeks [while you’re no longer contagious]. [Note:] Nobody should be doing surveillance testing with PCR. If you’re doing it twice a week, then okay, but if you’re doing it once every two weeks, the chances are you’re no longer infectious by the time you’re detected on a PCR positive.
So in the timeline of this, you hit peak viral load, let’s say at day three or four [of] being infectious. And then you might stay there for a few days. And then you’ll start to come back down. And then eventually, you’ll just get down to non-viable virus, no transmission. And that will be maybe around…[well,] the CDC wants to say day five, I strongly disagree with that at the moment, because symptoms are starting really early. You know, day five was no longer infectious when your symptoms started in the middle of your peak infectivity. But now day five is right around your peak infectivity.
And then the antigen test generally turns negative, pretty much right as you stop transmitting. When you don’t have enough virus to turn an antigen test positive, you’ll probably no longer be infectious. And I would say that it tends to be around a 90% to 95% concordance between a [positive] rapid antigen test and culturable virus.
A: What are the best practices for testing? What to assume when there are mixed results, i.e, at home negative but on PCR positive or vice versa?
M: If it’s your first day of symptoms, assume you’re positive with COVID. And that means pretend like you’re positive, and take steps during that day to not infect others. If you use a test on the very first day of symptoms, it’s a good chance you’ll be negative. If you have a small number of tests available, like one or two, I would say wait until 24 hours or 48 hours before using it just to give the virus a bit of time to grow, so that actually is a chance to turn positive. [He explains to use the test right before you will see people, not before you go to bed when you are basically isolating, to maximize incubation time.]
And what we’re seeing with Omicron, especially, is it’s starting to replicate a little bit further down, it doesn’t start in the nose. But it seems to be starting in the throat and in the oropharynx, which is probably also what’s causing it to become detectable in the saliva early, it then sort of marches up as it’s infecting you, it marches its way north into the nose, and ultimately into the nasal pharynx.
…the saliva test maybe turns on a day or two before a nasal swab becomes positive, regardless of the type of test.
So a nasal swab is going to miss a day or two of infectiousness. We don’t have a huge number of saliva based rapid tests right now, and if we did, great, but we don’t and so these [nasal swabs] are some of the best tools we have to stop transmission chains. So, I would argue that the data is sufficient at this point, or is really getting there, that we could follow in the footsteps of the UK, and we could do a throat swab or kind of a cheek and back your throat swab and then still stick that same swab in your nose. You know, that’s actually what people do, I do it here at my house, the FDA won’t tell you to do that, because it’s not authorized for that. But the data shows that’s actually improving the sensitivity quite a bit. [He clarified on Twitter that he agrees that the FDA should not endorse or encourage the practice without testing it first.]
A: And for what it’s worth the last time I did a test, I did a back of the throat swab, and then did the circles in the nose.
M: So there can be marked differences in orders of magnitude for false positives…an important piece to consider if you’re going to be testing 300 people at your wedding, for example. And [if] you want to test everyone beforehand, what I would suggest is have a small handful of tests from another company. If you get a positive on somebody, and they’re like, “I really don’t know how I’m positive” [i.e., no symptoms and no known exposure], use another test just to confirm.
There’s more nuancing in the podcast, and FWIW I think it’s easier to understand when listening to it than reading the transcript.
^ That link address is misaligned with the title of the episode, but as of right now, it does link to the Michael Mina episode. 
That podcast has general data about specificity/sensitivity, but there is also a good rundown by YLE on actual studies here:
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Andy Slavitt’s Feb 14 podcast also had a couple interesting bits. Transcript isn’t out yet, so I’ll try to manually capture the key bits:
~5:00 Under 5 vaccines:
Andy “I don’t view it as bad news necessarily. I actually view it as being more likely that they feel they can resubmit the data with a third dose sooner than they thought, and it didn’t make any sense to get the FDA together to look at 2 doses when they were just about to have 3 doses that they could submit…I think that’s what’s happening here. So I’m going to go on the side of saying I think this is because there’s been a positive development. Now, do I have any inside knowledge to suggest that that’s true? Yes, I have a little knowledge. I’ve had a few conversations. I’ve had a few people been in my bubble recently. That’s all I can tell you.”
The other part of the podcast that I found of interest was discussion around latest on BA.2:
Kristian Andersen: “BA.2 is a flavor of Omicron…and they are quite different. BA.1 is the one that swept across the world first and then BA.2 came behind it. They are as different from each other as the other variants that came before them, like Alpha vs Delpha. BA.2 has slightly higher fitness, maybe even 30-40% more transmissible than BA.1.”
Andy: “Is there re-infection for people that had BA.1 with BA.2?”
Kristian: “It’s not absolute…it’s all probabilities. I think there’s a small proportion of people that had BA.1 in the past month or two that can get infected with BA.2 but that’s not what’s driving [cases in Europe]. But people that got BA.1 and might have been protected against getting another BA.1 for 6 months, maybe now they’re only protected for 2-3 months, but it’s too early to say.”
Andy: “And is the severity about the same?”
Kristian: “As far as we know, but it’s a question of just not having any data on it. There’s hardly any invitro data on it and there’s certainly no clinical data. The average case of Omicron is clearly milder, but the question is that because the virulence is substantially different or does that have more to do with the fact that it’s infecting people that have some type of immunity. I think it’s the latter and that BA.2 will be similar.”
Andy: “This is no longer a novel virus. It’s a virus we now have some protection towards.”
Kristian: “Right. But there’s still a lot of stuff we don’t understand about this virus. One of the most critical aspects of this is that we really don’t understand the virulence/immunity/transmission/emergence of new variants. We just don’t understand the mechanisms here. Could we have a variant that is even more immune evasive than Omicron and causes more severe disease in vaccinated or previously infected individuals? I think the answer to that is yes, that could absolutely happen, but should we expect it to happen? That’s what we just don’t know.”
[Basically, everyone had assumed new variants would be descendants of Delta. The emergence of Omicron has proven there is a lot more variability in what could happen. Every new infection is a dice roll on those possibilities.]
Latest US variant proportions:
B.1.1.529 = BA.1
BA.1.1 is a descendent of BA.1 (I haven’t seen much chatter on this one. Initial thoughts seem to be that it is extremely similar to BA.1, maybe just a bit more transmissible. In the regional map, it looks like they aren’t even splitting BA.1/BA.1.1.]
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This is so well explained and incredibly good to know.
Thank you 
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Not to start a(nother) debate about masking, but I do want those that are from pro-mask or mask-neutral areas to understand the extent of anti-mask sentiments in some areas of places like Florida and Texas so you aren’t caught unawares in your travels.
A friend from Florida’s DH is serving on a jury. The judge has banned anyone in the courtroom from wearing a mask, including the jury. They are limiting who’s allowed in the courtroom, but still. 
I’ve heard of this happening in private businesses, but this was the first government entity.
Did they let the potential jurors opt out of serving?
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I don’t think they told them before jury selection. She mentioned they made them remove their masks for “vois dire” questioning but I think had let them wear them until that point.
Hoping they were doing distancing at least and let them put them back on! I think that would definitely be a reason to be excused from serving and would definitely be news worthy if not. Private business I get because you have a choice to go somewhere else. Jury duty you don’t.
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Awesome!! 
Do you know if there was a rationale given? I do wonder if that’s legal. Though it’s very hard to challenge a judge in their own courtroom.
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Y’all. I’ve heard multiple sources saying now that SUPPLY is exceeding DEMAND for the therapeutics for those high risk. While thousands of people die every day.
People don’t know to ask for them. Providers don’t know to offer them. Lots of uncertainty how to actually get them.
If you know people that are high risk, the therapeutics have a short window to be administered, so it’s best to have a plan for getting them a PCR quickly and you may need to push their provider and use your liner skills to make it happen.
I know many people are frustrated with unvaccinated loved ones, but letting them know you’d be willing to help them get therapeutics is the next best option.
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About to head home from the world of WDW today. It was interesting - our first park day was masks required and our last two not.
Mask wearers are currently very much in the minority. I looked around on the bus last night and exactly my husband and I were the only people correctly wearing our masks.
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In case this thread is helpful to anyone.
https://twitter.com/bob_wachter/status/1495165503106543618?s=21
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