COVID-19 FAQs: Testing
Get the facts about testing for novel coronavirus, including the difference between tests, payment and what to do if you test positive.
Question: The CDC issued an update to its COVID-19 testing guidance. Does this mean I don’t need to get tested if I think I’ve been exposed to the virus, but don’t have symptoms?
A: The short answer is no. Studies show that people who are asymptomatic (don’t show symptoms) can still transmit the virus. One of the most recent is a study published in JAMA Internal Medicine on August 6, which reported that “around 30% of patients who tested positive for the new coronavirus were asymptomatic, but they still carried just as much of the virus as symptomatic patients—and for nearly as long.” Other reports suggest that people without symptoms account for up to 50% of COVID-19 transmission spread.
As flu season approaches, health experts are very concerned that thousands of flu cases could coincide with surges of COVID-19 infections.
After consulting with infectious disease experts, the key takeaways are:
- Get a flu shot.
- Get a COVID-19 test if you think you’ve been exposed to the virus.
The only caution is timing. If you get a COVID-19 test before the virus is detectable in your body, you may get a negative test, and incorrectly think that you don’t have the virus. So, experts recommend the following:
- Wait at least 10 days after you think you were exposed to get a test. If you are ok with getting multiple tests, then you take the first test between day 5 and day 7, and then get retested at day 14.
- Be vigilant about wearing a mask, practicing social distancing, washing or sanitizing your hands regularly and other activities that help to prevent the spread of the virus.
- If you develop symptoms, get a test as soon as possible.
Question: What kinds of tests are available for COVID-19 and how accurate are they?
A: There are two diagnostic tests designed to detect an active COVID-19 infection: Molecular tests and antigen tests. Molecular tests look for genetic material of the virus, whereas antigen tests search for proteins on the virus’ surface. Both tests require taking a sample from the nasal cavity, which involves inserting a long Q-tip-like swab into the nose and twirling it around for a few seconds. Some tests may use throat swabs instead, but those are thought to be less accurate.
Once a sample is collected, it is sent to a testing site or lab to determine infection. Depending on location, results from molecular tests can take anywhere from one to seven days to receive. Turnaround time for antigen tests, also known as rapid tests, is quick – usually about an hour or so. However, antigen tests have a much higher chance of missing an active infection. If you receive a negative result from an antigen test, your doctor may still order a molecular test to confirm the result.
The FDA has authorized the emergency use of some home test kits. It’s important to remember that emergency authorization is not the same as FDA-approval, and accuracy of at-home tests can vary. Additionally, at-home tests are only available through a doctor’s prescription.
Question: Who can get tested for a COVID-19 infection?
A: Though testing is more widely available, decisions about testing are still being made by state and local health departments or health care providers. If you want to get tested, talk to your health care provider. You can also check with your local health department’s website for more information. If you have symptoms of COVID-19, but are unable to get tested right away, stay home and isolate from others until you’re able to get one.
Question: Should I get a COVID-19 antibody test to learn if I’m immune to a future infection?
A: Antibody tests, also called serological tests, are blood tests that check for antibodies against COVID-19, which indicate a past COVID-19 infection. Results take about one to three days.
Antibodies are proteins that result from the immune system’s fight against a virus. In general, they protect people from getting re-infected with the same virus. But with the novel coronavirus, researchers are unsure whether the presence of antibodies gives someone immunity in the future, and if so, for how long. Currently, the CDC says it’s too early to tell if the presence of antibodies can be used to assess immunity.
Several factors can affect the accuracy of an antibody test. It can take anywhere from one to three weeks for someone to develop antibodies after a COVID-19 infection. Timing can affect accuracy. A Cochrane review published in late June 2020 found that antibody tests taken 15 - 35 days after infection accurately detected 90% of people with past infections, whereas test taken eight to 14 days after infection accurately detected 70% of people. (Note: Researchers acknowledged study limitations in sample size and quality but agreed that findings indicated a need to look further into test accuracy.)
Lastly, many antibody tests have not been evaluated for reliability or authorized for emergency use by the FDA. For more information about the performance of various antibody tests, including those authorized for emergency use, click here.
If you are interested in taking an antibody test, talk to your doctor. He or she can help you decide if antibody testing is right for you and choose a quality test for maximum accuracy.
Question: What should I do if I test positive for COVID-19?
A: Contact your primary care doctor or rheumatologist to discuss your next steps. If you test positive and have mild symptoms, your doctor will likely advise you to isolate and care for yourself at home. You may also want alert anyone you’ve been in close contact with prior to receiving your results.
If you take immunosuppressant drugs, your doctor may recommend you stop or change dose, depending on the medicine(s) you take. Do not stop or change your medication dose without your doctor’s guidance, especially if you take a corticosteroid, such as prednisone.
If you have severe symptoms, such as shortness of breath, trouble breathing or persistent pain/pressure in the chest, alert your doctor right away. You may need urgent care or be hospitalized..
Additionally, older adults (65 and older), males and those with underlying health conditions (e.g., diabetes and lung disease), are at a higher risk for developing more serious complications. If you fall into one of those categories, contact your doctor immediately, even if your symptoms are mild.
Question: Will my insurer cover all expenses for testing and treatment related to COVID-19?
A: The Families First Coronavirus Response Act requires health plans to cover the costs of “medically necessary testing.” But as testing expands to allow those without symptoms, the definition of what is medically necessary is up for interpretation. As such, many insurance plans may require a health care provider referral before paying for tests.
Additionally, several insurers have activated emergency plans, new procedures or waivers related to copayments, deductibles or coinsurance for telemedicine/telehealth services, testing and medical and behavioral treatment for COVID-19 related expenses. Some have updated procedures for prior authorizations, at-home services and prescription refills and delivery. Get more information from the American Health Insurance Plans (AHIP) health insurance provider response page or contact your health insurer directly.
Check with your local health department about free testing.
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