I am fortunate enough to work for a large and successful company that’s riding out the pandemic without too many problems. Unusually for a corporation of its size, it appears to really care about its employees’ well-being, or at least it makes an effort.
To this end, the company is offering free weekly Covid-19 tests to employees who can’t work remotely because of their particular job function: e.g., R. & D. or package handling. I’m authorized to work in the office, and therefore considered part of this group. But I can and do work exclusively from home. Still, my status means the company offers me tests, to be self-administered and mailed in from home. (I’m in my 50s and in good health, and though I have a few mild risk factors, I am not in a medically at-risk population.)
I’m pondering two questions. The first is, although the Covid tests are not mandatory, the company strongly encourages signing up for them. Access is explicitly not contingent on work location, only on job category. Still, because I’m self-isolating pretty diligently, would I be accessing tests under false pretenses?
My second concern is this: Though my company has the resources, both financially and logistically, to secure enough tests for its employees, I fear I’m taking advantage of that capability, especially when there is a shortage of tests nationwide. I know that there’s little chance my personal test would be redirected to someone who needs it more if I don’t take it. But on the other hand, is it ethically appropriate for me to forgo testing in the absence of a compelling personal need?
I am well aware that this is a very privileged question springing from an absurdly privileged situation, but that doesn’t excuse me from trying to do the right thing. Name Withheld
In an ideal world — or simply a better governed America — you wouldn’t have to think about this question; tests wouldn’t be a scarce resource. Of course, there would still be a question about waste even if we were a country like Denmark, where, at the height of the pandemic, more than 50,000 people a day — out of a population of nearly six million — got tested. (Adjusting for population size, that’s the equivalent of nearly three million a day here; twice our actual maximum.) But as you’re aware, the waste you’re worrying about is, as the lawyers say, “de minimis.” The marginal cost to your company, and the marginal effect on our overall testing program, aren’t significant.
The interesting question is what the upside would be of your being tested regularly, given that you’re isolated and presumably adhering to the recommended precautions. To think about this, we must consider the accuracy of the tests. Assuming we’re talking about PCR tests, the false positive rate is extremely low. (When these happen, it’s typically because the specimens were mishandled in the lab.) By contrast, the false negative rate is significant, especially during the first week after infection. (These are typically due to the fact that the virus isn’t yet present in the sample in detectable quantities.) Are these test results useful to someone who, like you, has a very low baseline risk of infection?
Not very. Because you’re isolating and not working in the office, you don’t need to worry about the risk you pose to co-workers. On the other hand, a negative result could unduly increase your confidence that you’re in the clear. Suppose you have a 5 percent chance of contracting the virus. (A reasonable estimate would be way lower, but let’s simplify the arithmetic.) According to a study in the Annals of Internal Medicine, the probability of a false negative PCR result is 100 percent on the first day of infection and decreases to 20 percent by the eighth day. But estimates of false negatives vary widely; let’s simplify and say your false negative rate is going to be 30 percent, and that your false positive rate is zero. Bayes’s theorem shows that a negative test result should increase your confidence that you’re uninfected by about 3.5 percent — which is reassuring, but not in a life-changing way.
So why bother availing yourself of the test? Well, there are other factors to consider. One is that if your employer has the data for all the workers in your group, in the office and out, it can make better decisions. Having an overall picture of the rate of infection tells them something about patterns of employee behavior. If people pull out because they think they’re behaving well, that’ll skew the data. It could be best, given the concerns of data-driven management, if everyone complies.
My wife and I live in a beautiful community in the South Carolina Lowcountry that, unfortunately, uses the word “plantation” in its name. Knowing how offensive this word is, and the hurt it causes islanders of color (e.g., the Gullah Geechee people), we joined a group of residents formed to convince the governing board to replace the word “plantation” in the community’s name with something else. Ultimately, our efforts were unsuccessful. More than 52 percent of respondents voted to keep the name as is.
The Coronavirus Outbreak ›
Words to Know About Testing
Confused by the terms about coronavirus testing? Let us help:
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- Antibody: A protein produced by the immune system that can recognize and attach precisely to specific kinds of viruses, bacteria, or other invaders.
- Antibody test/serology test: A test that detects antibodies specific to the coronavirus. Antibodies begin to appear in the blood about a week after the coronavirus has infected the body. Because antibodies take so long to develop, an antibody test can’t reliably diagnose an ongoing infection. But it can identify people who have been exposed to the coronavirus in the past.
- Antigen test: This test detects bits of coronavirus proteins called antigens. Antigen tests are fast, taking as little as five minutes, but are less accurate than tests that detect genetic material from the virus.
- Coronavirus: Any virus that belongs to the Orthocoronavirinae family of viruses. The coronavirus that causes Covid-19 is known as SARS-CoV-2.
- Covid-19: The disease caused by the new coronavirus. The name is short for coronavirus disease 2019.
- Isolation and quarantine: Isolation is the separation of people who know they are sick with a contagious disease from those who are not sick. Quarantine refers to restricting the movement of people who have been exposed to a virus.
- Nasopharyngeal swab: A long, flexible stick, tipped with a soft swab, that is inserted deep into the nose to get samples from the space where the nasal cavity meets the throat. Samples for coronavirus tests can also be collected with swabs that do not go as deep into the nose — sometimes called nasal swabs — or oral or throat swabs.
- Polymerase Chain Reaction (PCR): Scientists use PCR to make millions of copies of genetic material in a sample. Tests that use PCR enable researchers to detect the coronavirus even when it is scarce.
- Viral load: The amount of virus in a person’s body. In people infected by the coronavirus, the viral load may peak before they start to show symptoms, if symptoms appear at all.
Before this issue arose (and before we were fully aware of the offensiveness of “plantation”), we were considering moving to a new home in our community; now we are not so sure we should. Given what we now know, is it ethical to buy a home in a community that affirmatively chooses to keep an offensive name? Name Withheld
I’m with you on changing the name. Plantations were places where Black people were not only denied basic human rights but were also subject to sexual assault and physical torture — a repugnant legacy to want to hold onto. But you’ve done your part to try to put this right. And if you stick around, you can try to make the change again. Leaving is giving up on that project — and on the 48 percent who agree with you. You say the area is beautiful: If you’re happy there, moving away would be a loss and inconvenience to you, for no obvious gain. The times are changing. We can hope your side will prevail sometime soon.
Some years ago, I was raped by an acquaintance. Before that event, I was warned by friends to keep my distance from him but didn’t heed their advice; I later learned that this man violently sexually assaulted another woman before he assaulted me. I went to the police following my experience, but he was never charged with any crime and he moved away soon after. I eventually moved, too.
Recently, I moved to yet another city and learned that he moved to the city where I had been living last, and where I still have many friends and acquaintances, particularly in the L.G.B.T. community. I know that he identifies as L.G.B.T.
To my knowledge, he has not assaulted anyone since I reported him to the police. He quit drinking and got married. He lost many friends and raised money for a domestic-violence organization. I developed PTSD as a result of the attack and have spent years in therapy to diminish (but not completely eliminate) my symptoms, and this led to the dissolution of my marriage at the time. I have since rebuilt a new life with a new partner and built a career that allows me to work in mental health. Is it my responsibility to warn my friends in his new city, or is it my ethical obligation to let him continue to lead his life? Name Withheld
I am so sorry to hear about what this person did to you. It’s natural, given that he never faced punishment for his crime, to want to see him pay some penalty. And you could do that by letting people in the community where he lives know about your experience. But you didn’t ask me whether you should seek to make him pay for his crime; you asked if you had a duty to tell people in the community where he now lives what he has done. You report evidence that he’s reformed — he has given up alcohol (which is especially relevant if his drinking played a role in the attack), married, committed to public service and, perhaps, paid some cost for his behavior in lost friends. So you don’t seem to think he poses a clear ongoing threat. You have no duty, then, to revisit this trauma for the sake of the safety of those in his community, particularly if doing so would risk psychological harm to you.
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