COVID testing for US return - Marriott properties Aruba

[klkaylor]

The biggest take home for me was that I was a little lazy about re-reading the Aruba covid testing site every few days - they changed the rules on the Abbott ID NOW test between the time we committed to that test (cheeper faster than a standard PCR test) so look carefully at that testing page just before you commit to a test for entry and understand what they want as Aruba is being a little more picky - safe travels. I am now trying to figure out the Maldives rules - yes a PCR test is required but which molectular test are allowed. Retesting if travel is over 24 hrs - ours it 27 - 16 to Dubai, 7 layover, 4 to Male - how do your retest and get a result back?

 

[GrayFal]

The biggest take home for me was that I was a little lazy about re-reading the Aruba covid testing site every few days - they changed the rules on the Abbott ID NOW test between the time we committed to that test (cheeper faster than a standard PCR test) so look carefully at that testing page just before you commit to a test for entry and understand what they want as Aruba is being a little more picky - safe travels. I am now trying to figure out the Maldives rules - yes a PCR test is required but which molectular test are allowed. Retesting if travel is over 24 hrs - ours it 27 - 16 to Dubai, 7 layover, 4 to Male - how do your retest and get a result back?

I follow the points guy. I feel he posted they had in airport rapid testing in Dubai? Check his site as well as the airport site.

 

[gln60]

My daughter and boyfriend took their PCR Covid test this morning at the Surf Club before their departure from Aruba on Wednesday....did the required paperwork and were walking out in less than 15 minutes.....super easy

 

[klkaylor]

My daughter and boyfriend took their PCR Covid test this morning at the Surf Club before their departure from Aruba on Wednesday....did the required paperwork and were walking out in less than 15 minutes.....super easy

Still not sure why folks are paying twice as much as they need to for a test they do not need. Antigen testing will do and is half the price. Marriott's vendor has antigen testing but does not let you schedule it on line-forcing you to pay for and get the higher priced PCR test. The system they have set up is easy but unnecessarily expensive. I would tell them to upload the document to their airline at check in but also get/keep a printed copy with them as they go to check in at AUA. We had to show a hard copy. There are public computers and printer available just past the marketplace - again a great effort by Marriott to keep travel easy. Also get to AUA early as you have to do both Aruba Passport control and security then again do the US immigration and customs and repeat US security in Aruba. Make US connections easy but add some time to getting through to your gate in AUA. Safe travels

 

[Dean]

Still not sure why folks are paying twice as much as they need to for a test they do not need. Antigen testing will do and is half the price. Marriott's vendor has antigen testing but does not let you schedule it on line-forcing you to pay for and get the higher priced PCR test. The system they have set up is easy but unnecessarily expensive. I would tell them to upload the document to their airline at check in but also get/keep a printed copy with them as they go to check in at AUA. We had to show a hard copy. There are public computers and printer available just past the marketplace - again a great effort by Marriott to keep travel easy. Also get to AUA early as you have to do both Aruba Passport control and security then again do the US immigration and customs and repeat US security in Aruba. Make US connections easy but add some time to getting through to your gate in AUA. Safe travels

I think some are concerned about the false positive rate of the antigen test.

 

[gln60]

I think some are concerned about the false positive rate of the antigen test.

That's the EXACT reason

 

[gln60]

I think some are concerned about the false positive rate of the antigen test.

Daughter and her boyfriend received their Negative PCR test back pretty fast today...they are good to travel back on Wednesday..very happy about the negative test...very sad they have to leave beautiful Aruba.

 

[klkaylor]

I had taken the false positive rate of antigen tests as a fact but the push by gin80 made me go back and look at the study data of the Binax NOW Abbott test and compare with PCR testing for Specificity - the term for true negative with the false positive being the residual. Sensitivity is the true positive rate. Positive predictive rate (PPV) and negative predictive rate (NPV) are based on how common the disease is - key for clinical trial but not germain to this discussion.


Here is a journal article for the eval of the antigen test
Testing among symptomatic participants indicated the following for the BinaxNOW antigen test (with real-time RT-PCR as the standard): sensitivity, 64.2%; specificity, 100%; PPV, 100%; and NPV, 91.2% (Table 2); among asymptomatic persons, sensitivity was 35.8%; specificity, 99.8%; PPV, 91.7%; and NPV, 96.9%. For participants who were within 7 days of symptom onset, the BinaxNOW antigen test sensitivity was 71.1% (95% CI = 63.0%–78.4%), specificity was 100% (95% CI = 99.3%–100%), PPV was 100% (95% CI = 96.4%–100%), and NPV was 92.7% (95% CI = 90.2%–94.7%). Using real-time RT-PCR as the standard, four false-positive BinaxNOW antigen test results occurred, all among specimens from asymptomatic participants. Among 299 real-time RT-PCR positive results, 142 (47.5%) were false-negative BinaxNOW antigen test results (63 in specimens from symptomatic persons and 79 in specimens from asymptomatic persons).

Here is the PCR False Positive rate
Evidence for a Significant False Positive Rate (FPR) in PCR Tests for COVID-19

Data from External Quality Assessments of PCR tests for other RNA viruses	• FPR usually between 0.8% and 4.0% • Median = 2.3%; Pooled mean = 3.2%
Data from External Quality Assessments of PCR tests for COVID-19	• FPR between <0.4% and 0.7% • Pooled mean = 0.6%
Data from actual use of PCR tests for COVID-19	• FPR usually between 0.2% and 0.9%

Based on these two studies it the FPR for PCR is 0.6% and the Antigen test (Binax NOW) is 0.2% so less false positive. The real issue is that in all tests for a disease with a low prevalence even small false positive rates stack up. If you test 10,000 for a disease with a 1% prevalence then the numbers are a little crazy -
100 people have the disease, 9,900 do not. Looking only at FPR if it is 0.6% then saddly 59 folks will have a false positive (the PCR data) if 0.2% then 20 folks have a false positive (the antigen test). So asymptomatic screening of lots of folks with a low prevalence disease gets a lot of false positive no matter what test you use.

Based on this I think the antigen test is the way to go - new data but it made me look. Something we all should be doing. I would encourage folks to not just read a newspaper article as there is really poor editing and bias control. Find the real journal articles and ....

 

[Dean]

I had taken the false positive rate of antigen tests as a fact but the push by gin80 made me go back and look at the study data of the Binax NOW Abbott test and compare with PCR testing for Specificity - the term for true negative with the false positive being the residual. Sensitivity is the true positive rate. Positive predictive rate (PPV) and negative predictive rate (NPV) are based on how common the disease is - key for clinical trial but not germain to this discussion.


Here is a journal article for the eval of the antigen test
Testing among symptomatic participants indicated the following for the BinaxNOW antigen test (with real-time RT-PCR as the standard): sensitivity, 64.2%; specificity, 100%; PPV, 100%; and NPV, 91.2% (Table 2); among asymptomatic persons, sensitivity was 35.8%; specificity, 99.8%; PPV, 91.7%; and NPV, 96.9%. For participants who were within 7 days of symptom onset, the BinaxNOW antigen test sensitivity was 71.1% (95% CI = 63.0%–78.4%), specificity was 100% (95% CI = 99.3%–100%), PPV was 100% (95% CI = 96.4%–100%), and NPV was 92.7% (95% CI = 90.2%–94.7%). Using real-time RT-PCR as the standard, four false-positive BinaxNOW antigen test results occurred, all among specimens from asymptomatic participants. Among 299 real-time RT-PCR positive results, 142 (47.5%) were false-negative BinaxNOW antigen test results (63 in specimens from symptomatic persons and 79 in specimens from asymptomatic persons).

Here is the PCR False Positive rate
Evidence for a Significant False Positive Rate (FPR) in PCR Tests for COVID-19

Data from External Quality Assessments of PCR tests for other RNA viruses	• FPR usually between 0.8% and 4.0% • Median = 2.3%; Pooled mean = 3.2%
Data from External Quality Assessments of PCR tests for COVID-19	• FPR between <0.4% and 0.7% • Pooled mean = 0.6%
Data from actual use of PCR tests for COVID-19	• FPR usually between 0.2% and 0.9%

Based on these two studies it the FPR for PCR is 0.6% and the Antigen test (Binax NOW) is 0.2% so less false positive. The real issue is that in all tests for a disease with a low prevalence even small false positive rates stack up. If you test 10,000 for a disease with a 1% prevalence then the numbers are a little crazy -
100 people have the disease, 9,900 do not. Looking only at FPR if it is 0.6% then saddly 59 folks will have a false positive (the PCR data) if 0.2% then 20 folks have a false positive (the antigen test). So asymptomatic screening of lots of folks with a low prevalence disease gets a lot of false positive no matter what test you use.

Based on this I think the antigen test is the way to go - new data but it made me look. Something we all should be doing. I would encourage folks to not just read a newspaper article as there is really poor editing and bias control. Find the real journal articles and ....

The problem with any antigen test is that it's more user dependent. Personally I wouldn't be concerned about false positives but false negatives are very high to the point that the CDC recommends if you actually needed to test and the antigen test is neg, you then need to do a PCR. It probably is more perception than reality but that is some people's fears.

 

[klkaylor]

The problem with any antigen test is that it's more user dependent. Personally I wouldn't be concerned about false positives but false negatives are very high to the point that the CDC recommends if you actually needed to test and the antigen test is neg, you then need to do a PCR. It probably is more perception than reality but that is some people's fears.

You have to understand your goal of testing
Confirm a diagnosis or meet a regulatory event.
If I want to confirm a diagnosis of flu v. covid then PCR is the only choice the false positive rate is too high on the antigen side ..
If I want to get back into the country - even if positive then the antigen test is the no brainer - low positivity rate on true infections and lower false positive on non infection.
After having to do the research I am more confident that the right choice for meeting the US flight rule is to use the antigen test. [Political content deleted.]

 

[Dean]

You have to understand your goal of testing
Confirm a diagnosis or meet a regulatory event.
If I want to confirm a diagnosis of flu v. covid then PCR is the only choice the false positive rate is too high on the antigen side ..
If I want to get back into the country - even if positive then the antigen test is the no brainer - low positivity rate on true infections and lower false positive on non infection.
After having to do the research I am more confident that the right choice for meeting the US flight rule is to use the antigen test. [Political content deleted.]

No doubt but if a worker bee calls it positive, you're stuck. And working with these type of tests daily, the variability where the boots hit the ground is amazing.

 

[gln60]

No doubt but if a worker bee calls it positive, you're stuck. And working with these type of tests daily, the variability where the boots hit the ground is amazing.

100% correct

 

[Fred Garvin]

I just returned from the Aruba Surf Club last week. With Marriott's vendor onsite, while you do have to sign up online for the PCR option($100), when you go for your appointment you can request the cheaper Antigen test ($40). The results were available after about 5 hours and as mentioned you can print them out at the computers by the Market Place. We had a group of 7 and all used the Antigen test, showed our printed results to AA when checking in at the airport, no issues for any of us.

 

[SueDonJ]

Moderator Note: TUG has a COVID sub-forum in the Lounge where all the talk about biases and politics and conspiracies is being corralled. Keep this thread to the nuts and bolts about what's required to travel in/out of Aruba, and keep the politics out of it, or it'll be moved to that forum.

 

[gln60]

No doubt but if a worker bee calls it positive, you're stuck. And working with these type of tests daily, the variability where the boots hit the ground is amazing.

My daughter returned from Aruba this afternoon...everything went smooth.....except she was randomly stopped inside the airport in aruba and they swiped her Palms looking for chemical residue from explosives...go figure

 

[starzim]

Heading to Aruba from NY beginning of May, are there any rapid testing sites other than in Marriott surf club?
Thanks

 

[Dean]

My daughter returned from Aruba this afternoon...everything went smooth.....except she was randomly stopped inside the airport in aruba and they swiped her Palms looking for chemical residue from explosives...go figure

Great, I'm glad it worked out OK.

 

[Luvtoride]

Yes, they are all over the island. It’s become as big a business as the t shirt vendors along the strip in the hi-rise hotel area. Just look for the signs or ask the concierge where you are staying. We came back earlier this month and the testing at the surf club was easy and fast.


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