This is an excellent description of what is a cautionary tale.  Please consider these bullet points: 

• Ten percent of people infected with SARS CoV-2 may be responsible for 80% of infections.
• “Super spreaders” are profiled as young, social and often asymptomatic.
• SARS CoV-2 is believed to be infectious for 4-9 days, except when it isn’t:  there is debate that asymptomatic spreaders may not mount as strong a response as those who develop symptoms to which their immune system then responds.  Therefore they may not clear the virus from their bodies as quickly as those who fight the virus
• While most SARS CoV-2 infections are passed through contact with respiratory droplets (such spread is greatly reduced by the wearing of masks), some super spreaders may aerosolize the virus in large amounts, meaning it will spread through air-conditioning ventilation systems and at greater distances than 6 feet in contained spaces.

The good news to take away from this long, but highly informative article is that “Super spreaders” are not common. They are likely infectious for a short period of time, but highly infectious during that time.  Avoiding large indoor gatherings and the encounter with an unexpected “Super spreader” can impact the spread of this pandemic and it can save your life and the life of someone you love.

 Not addressed specifically in the article, is the point that respiratory droplets containing viral particles are greatly inhibited by the wearing of masks—any masks.  The concern over build up of carbon dioxide behind our masks has not panned out to be an issue in operating rooms or cities across the world that have worn masks seasonally for decades.   There is no ADA proclamation that wearing a mask infringes on the rights of any disabled person.  That is not a thing. One of my dear patients of 30 years came in with her oxygen tank and her stylish, decorated mask.

 In our office, where we see up to 200 women daily, with many pregnant, elderly or  others who are experiencing various high risk conditions, we must maintain an abundance of caution.

• A mask is required to enter our office.  We ask you to keep it on, even when you are alone in an exam room.
• Please do not wear gloves.  We are wiping down all surfaces between exams and using Lysol aerosol in each room, after each patient. 
• We will be happy to fax your order slips directly to your lab or imaging center to avoid coming in.
• We will renew medications (whenever possible, if you choose to postpone your visit to our office.
• Please call us 72 hours in advance, if you know you do not intend to come in for your visit!!!!!
• We need that time slot for other patients!
• Please be patient with us, regarding ”call backs.”  We are working with fewer staff, who are required to serve more patients than in the past.  When you call repeatedly during a single day about a single concern, it interferes with our ability to address everyone’s concerns timely, accurately and kindly.
• Minors may be accompanied by a parent or guardian.

To help clarify testing options

1) A “point of care” POC antibody test is the test commonly performed at testing sites and medical offices.  It works much like a home pregnancy test and indicates the presence of antibodies to the virus by revealing a colored line on a test strip.  This does not indicate the presence of active virus or infectivity!  It indicates previous exposure and creation of immune antibodies.

2) A “point of care” POC antigen test looks for proteins made by the virus when it “hijacks” our cells to do so. These are nasal or oral swabs that can give a result in 15-30 minutes and are reasonably accurate. They are difficult to obtain because of very high demand. 

3) A PCR test, obtained by submitting to an uncomfortable nasopharyngeal swab looks for viral RNA in the cells of the upper respiratory tract.  While very accurate at detecting small amounts of viral coding material, the result depends on the collection of an adequate sample from the infected area.  Because of demand, the “turnover time”  (from collection to reporting result) can be 7-10 days or longer, as reagents, equipment and manpower are not keeping up with the numbers of samples in the system.

Testing availability varies considerably among different locales and different times.  Call ahead to see if and when appointments can be made.  Because testing is not available to many needing  confirmation that they are virus free before leaving quarantine, the CDC states that three days without a fever (on no anti fever medications) or waiting 10-14 days after initial symptoms should be adequate time to avoid being infectious. 

 None of our current protocols, recommendations, predictions are carved in stone.  Science, and especially the science and art of medicine are fluid.  My father taught medical students for 50 years and repeated the well known meme “Fifty percent of medical knowledge that  we teach you will change, and we do not know which 50% it is…” 

And so it goes with COVID-19.   

Dr. Pamela Carbiener

Source: https://www.washingtonpost.com/health/2020/07/18/coronavirus-superspreading-events-drive-pandemic/