When you should test for COVID-19 before Thanksgiving

This post originally appeared on News @ Northeastern. It was published by Cynthia McCormick Hibbert.

Whether you’ve signed up to bring mashed potatoes or cranberry sauce to Thanksgiving dinner, rapid tests for COVID-19 should be among your holiday preparations, according to experts at Northeastern University.

“There’s not a hard and fast rule on this,” says Brandon Dionne, associate clinical professor at Bouvé College of Health Sciences’ School of Pharmacy and Pharmaceutical Sciences.

Left, Neil Maniar, director of the Master of Public Health program and a professor of the practice in the Bouvé College of Health Sciences. Right, Brandon Dionne, Assistant Clinical Professor Department of Pharmacy and Health Sciences. Photos by Matthew Modoono/Northeastern University

Instead, he and Neil Maniar, associate chair, professor of practice, and director of the master of public health program at Northeastern, offer some general guidelines on how to time tests to ensure the safety of guests and hosts.

There are some considerations to take into effect when considering a testing schedule, or testing cadence as Maniar terms it.

Will any people attending Thanksgiving dinner be elderly or have health conditions that might predispose them to more severe cases of SARS-CoV-2?

Will you be traveling by air, train, or bus, or have you attended recent large gatherings or conferences?

And do you have any symptoms of respiratory illness, such as a runny nose, cough, sore throat, or fever?

Test on Thanksgiving morning

People who are asymptomatic and won’t be associating with individuals at higher risk of COVID-19 complications can get away with taking a rapid antigen test Thanksgiving morning, Dionne says.

“The closer to the event the better off you are going to be,” he says.

People who are flying or taking public transportation and arriving Wednesday night should also test Thanksgiving day, Dionne says.

The rapid test will be able to help identify if they had been exposed to COVID-19 before their travels, he says. Then they should test again in a couple of days to see whether they picked up the coronavirus in transit—and share the results with those they might have exposed to the virus.

When to test days in advance

Individuals who have respiratory symptoms, recently attended large gatherings or conferences, or who will be seeing relatives or friends in frail health will want to start testing a few days in advance of the gathering, this Monday night or Tuesday morning, Maniar says.

Depending on when you took the first test, test again Wednesday evening or Thanksgiving morning, he says.

“There’s little downside to testing,” Maniar says.

“With the current variants, the incubation time’s a little shorter,” he says. It could be two to three days or even shorter.

“I’ve seen instances where individuals are negative on a COVID test on a Monday morning. And then Tuesday morning, they test positive,” Maniar says.

What if I wake up with a sore throat on Thanksgiving?

If you can’t stay home, wear a mask and test before attending any events or gatherings, Maniar says.

Take a rapid test as close to the time of the gathering as possible, and then again the next morning, he says.

“The length of time between a possible exposure and testing makes a difference in terms of when the viral load reaches a point where it’s actually going to be detected on a test. It’s possible for a test taken in the morning to be negative and one taken eight or 10 hours later to be positive,” he says.

If you develop a sore throat, fever or runny nose after a Thanksgiving gathering, “I think it’s a good idea to test again for at least a day or two to make sure that that sore throat is not COVID.”

Photo by Matthew Modoono/Northeastern University

When to take a PCR test

The PCR test is still the most reliable method of picking up on COVID-19 infections, but big state-operated testing centers have shut down and it will take a day or two to get results back from pharmacies that offer the tests, Maniar and Dionne say.

They say the PCR test is still recommended for people going to visit relatives and friends who are at high risk of COVID-19 complications.

But remember to take the 15-minute rapid antigen test the morning of the get-together as well.

“Just because you have a negative PCR does not necessarily mean that you are 100% negative when you get together with your friends and family” a day or two after testing, Maniar says.

Follow test instructions carefully

Follow antigen testing instructions carefully, Dionne says.

Different testing companies have slightly different instructions, and it’s important to follow them to the letter, he says.

And although it’s not necessary to jam a nasal swab so far up the nose it results in “brain freeze,” there probably should be a little discomfort, Dionne says, adding the swab should circle slowly.

Mask before gathering

Few places require people to wear masks now, and the issue of masking has become one of those political footballs that threaten to wreak conversational havoc at Thanksgiving dinner.

Even so, Maniar and Dionne recommend that people who are taking public transportation, flying or attending large gatherings start masking up days in advance of seeing family and friends at Thanksgiving, particularly if those family and friends are at risk of more severe illness from COVID-19.