Symptoms aren't the only reason for a test.

By Korin Miller
September 02, 2020
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You hear it all the time: Proper testing is essential to controlling the spread of COVID-19. But recommendations for (and availability of) coronavirus tests has changed pretty drastically since the virus first started circulating in the US (initially, you were only able to get tested if you had symptoms or with approval from your doctor).

But now that COVID-19 tests are a bit easier to come by, many people have started wondering: Under what circumstances should you get tested for coronavirus? Here's what you need to know, according to experts and official recommendations.

First: What does a COVID-19 test involve?

Before you get a COVID-19 test, it's best to know what your options are. There are currently two types of tests available for coronavirus, according to the Centers for Disease Control and Prevention (CDC). Those include:

  • A viral test, often a polymerase chain reaction (PCR) test that is designed to tell you if you have a current infection. PCR tests use a sample taken from a swab placed inside your nose or throat.
  • An antibody test that might tell you if you had a past infection through a blood sample.

Given that antibody tests aren’t widely used, in most cases, when people talk about getting tested for COVID-19, they’re referring to the viral or PCR test. The CDC also says antibody tests shouldn't be used at all to diagnose a current infection, given that it can take up to three weeks after infection for for antibodies to show up.

What’s the official guidance on COVID-19 testing?

The CDC currently has this listed online as part of its official guidance on who should be tested for a current coronavirus infection:

  • People who have symptoms of COVID-19
  • People who have had close contact (within six feet of an infected person for at least 15 minutes) with someone with confirmed COVID-19
  • People who have been asked or referred to get testing by their healthcare provider, or local or state health department.

But the CDC also says this: “Not everyone needs to be tested. If you do get tested, you should self-quarantine/isolate at home pending test results and follow the advice of your health care provider or a public health professional.”

The CDC recently changed testing recommendations to say that testing may not be necessary after people have been exposed to someone with COVID-19. But, after the medical community and general public quickly reacted negatively to the change, the CDC walked back the recommendation to what it says above.

The CDC does not currently have recommendations on who should get an antibody test (they refer you to state and local guidance), but does offer up advice online on what the results could mean. For example, a positive antibody test could mean you've had a COVID-19 infection in the past, or you've had an infection from another type of coronavirus. A negative antibody test also doesn't you're off the hook for COVID-19—it could actually indicate a current infection.

When do doctors recommend getting tested (or not getting tested) for COVID-19?

“Most public health officials and infectious disease doctors will say that, if you feel you have a reason to be tested, you should be tested,” William Schaffner, MD, an infectious diseases specialist and professor at the Vanderbilt University School of Medicine, tells Health. “Testing availability is out there—it just may take some time for the test result to come back. That’s the glitch.”

“A person should get tested when they have symptoms consistent with COVID-19 or have been a significant contact with a case as directed by public health authorities,” Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security, tells Health. That’s true even if you have mild symptoms, he says.

If you recently came into contact with someone who is showing symptoms of the virus but hasn’t been tested yet, Dr. Adalja recommends calling your doctor about next steps.

But ultimately, if you’re worried you might be infected, there's no reason not to get tested. “I can’t think of any reason why somebody shouldn’t get tested,” Dr. Schaffner says. “That’s why there was such push-back from public health and infectious disease clinicians to the CDC directive that has already been walked back.”

However, Dr. Adalja says repeat testing to prove that someone has been “cured” of the virus after an infection shouldn’t be used because it’s not really reliable. “People can be positive on a PCR test long after the are no longer contagious,” he says. As for antibody testing, there’s not necessarily a reason not to do it, but just know that the results may not be 100% accurate.

The bottom line here: If believe you have a reason to get tested for COVID-19 and you want to get tested, you should be able to.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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