1/ Why would I, a physician, "downvote" a true statement about a negative COVID test giving an individual person false reassurance? B/c it missed the public health forest from the individual patient level trees. https://twitter.com/FettigLyle/status/1252917925352296450?s=20

2/It's true that an asymptomatic person who has been exposed to a person with #COVID19 should still quarantine, even if the asymptomatic person had a negative test themselves.

3/ Individual physicians/nurses/others should routinely counsel patients that a negative test does not entirely rule out COVID. But this doesn't change the fact that testing contacts of COVID + people can be helpful from public health standpoint.

4/ Here's what I would encourage talented and earnest journalists such as @adamwren and @smbahr14 @IndyMonthly to do. They rightly referred to a public health expert: https://www.wgvunews.org/post/public-health-expert-testing-everyone-covid-19-crucial-component-flattening-curve

5/ So they did their homework. But when an official gives a statement that points to one of the downsides of the approach, it's important for them to keep in mind the "forest" v. "tree" analogy, and think of this as balancing risks vs. benefits on a broader societal level.

6/ No one factor is probably going to "win the day." But individual patient downsides related to false negative testing are outweighed by public health upsides. Physicians can counsel individuals on the test downsides-we do it all the time- uncertainty is common in medicine

7/ Plus, let's also trust the population a little bit. I think most patients/families I have been talking to are concerned about false negatives. We can continue to educate on that, and move towards a more sound testing policy.

8/ So the follow-up question is "ok, so there are downsides to having a test that isn't perfect. Imagine a world where we had adequate testing supplies and infrastructure, what would be the upsides of testing asymptomatic contacts of COVID + people?"