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COVID-19 Tests

Last Updated January 2024 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

Despite the years since COVID-19 was identified, it remains a contagious virus. If you have or suspect you have COVID-19, you must test. It’s important to know whether you have tested positive so that you can care for your symptoms and protect those in hour household and community.

Who should get tested for COVID-19?

If you think you have COVID-19, stay home, and contact your family doctor to get advice on what you should do next. Information on COVID-19 testing options and availability continues to change.

The Centers for Disease Control and Prevention (CDC) has released guidance on who should be tested, including:

  • People who have symptomsof COVID-19. (This link is in draft mode)
  • People not fully vaccinated with COVID-19 vaccine who are prioritized for expanded community screeningfor COVID-19.
  • People not fully vaccinated with COVID-19 vaccine who have been asked or referred to get testing by their school, workplace physician, state and territorialtribal, or localhealth departments.
  • People who have had a known exposure to someone with suspected or confirmed COVID-19.
    • People who are fully vaccinatedbut do not have symptoms should get tested 5 days after exposure.
    • People who are not fully vaccinated should isolate and take precautionsand be tested immediately after being identified. If negative, they should be tested again in 5–7 days after last exposure or immediately if symptoms develop during isolation.

If in doubt whether you should test, check with your family doctor. As with any contagious condition, if you have symptoms of illness and have not tested, you should isolate at home pending test results or the passing of your symptoms. Follow the advice of your doctor.

If you believe you have COVID-19, the first step is to get a test. Testing at home has become easier. If you cannot afford to purchase an at-home test, the U.S. Department of Health and Human Services will provide residential households in the U.S. with four, free at-home tests from the U.S. Postal Service (USPS).

In general, testing availability may differ depending on where you live. There are some no-cost testing centers. Check your local health department to see what locations near you are doing testing and if there is a fee to test. This may include hospitals and pharmacies that offer drive-thru testing during high COVID-19 infection periods in your local community. This will allow you to stay in your car to prevent the possible spread of COVID-19. Depending on the location, someone may approach your car to collect a sample, or they may ask you to collect it yourself. Samples for COVID-19 viral tests are collected through nasal swabs. Depending on where you get your test, you may get your results the same day or you may have to wait a few days. Find out more about COVID-19 testing.

Health equity in COVID-19 testing

Social determinants of health may influence access to testing. For example, travel time may limit access to, and use of, testing services for those who have limited access to transportation and who live in areas with fewer public transit services and schedules.

Racial and ethnic disparities in test site distribution have been found.3 Other factors that may affect both access to, and use of, testing services include:

  • Lack of health insurance
  • Concern about the costs or co-pays
  • Occupational factors such as not being able to take time off work and lack of paid leave
  • Lack of accessible options for people with disabilities, and

Delays in testing may also delay seeking care and treatment (when sick) as well as delays in self-isolation that could reduce the spread of the virus to others.

The Centers for Disease Control and Prevention (CDC) has implemented a COVID-19 Response Health Equity Strategy to reduce the disproportionate burden of COVID-19 among people in some racial and ethnic minority groups, people with disabilities, and other population groups (e.g., essential and frontline workers, people living in rural or frontier areas) who have experienced a disproportionate burden of COVID-19. One component to move towards greater health equity is ensuring availability of resources, including access to testing for populations who have experienced longstanding, systemic health, and social inequities.

What tests are available for COVID-19?

Two types of tests for COVID-19 are currently available:

  • Diagnostic tests
  • Antibody tests

The U.S. Food and Drug Administration (FDA) made these tests available under an emergency use authorization. This means that they can be used during a public health emergency. They have not been fully reviewed and approved by the FDA.

Most COVID-19 tests are accurate. However, it is possible for them to show positive results that are wrong (called a false positive). They can also show negative results that are wrong (called a false negative). It is important to follow the testing instructions to prevent false results.

Even if your test result is negative, it’s important to keep following your family doctor’s recommendations to prevent the spread of COVID-19.

As mentioned above, at-home tests are available for purchase at pharmacies and retail stores. Some insurance plans off a small number of free tests through your local pharmacy. If you do not have health insurance and would like to order free, at-home tests, visit the USPS order tab. Most public libraries offer free access to the internet. Keep in mind that it will take time to have them delivered, so consider ordering in advance. Always check the expiration date on the testing packaging.

What are the diagnostic tests for COVID-19?

Two kinds of tests are available to diagnose a current COVID-19 infection: a molecular test and an antigen test.

The molecular test is also called a polymerase chain reaction (PCR) test. It detects genetic material of the virus that causes COVID-19 (called SARS-CoV-2). It is the most accurate diagnostic test for COVID-19.

The antigen test requires a sample collected by swabbing the inside of your nose. This test works by detecting a unique protein on or around the virus that causes COVID-19. If enough of this protein is detected, the test is positive. This means that you have an active COVID-19 infection.

Antigen tests are faster than molecular tests, but they are not as accurate. If you have a negative antigen test, your doctor may recommend a molecular test to confirm it.

What is an antibody test?

The antibody test (also called a serology test) checks your blood for antibodies to the virus that causes COVID-19. Your immune system makes antibodies to help fight harmful viruses and bacteria. They are produced a few days or weeks after you are infected. Different antibodies are produced to fight different infections.

If antibodies are detected in your blood, it could mean that you currently have COVID-19 or that you have had COVID-19 recently. But a positive antibody test could mean that you were infected with a different coronavirus in the past. This is why antibody tests are not used to diagnose a current COVID-19 infection.

A negative antibody test means that it is likely you have not had COVID-19 in the past. It could also mean that you are currently infected with COVID-19 but haven’t started producing antibodies yet.

Researchers do not know yet whether people who have been infected with COVID-19 have any immunity to the virus or for how long. Regardless of your test results, you should continue to take steps to protect yourself and others from the coronavirus.

Questions for your doctor

  • Do I need to take a COVID-19 test if I feel sick?
  • Are at-home tests just as effective as those performed at clinics?
  • Can I use a test after it has expired?
  • What if I can’t afford a test? How can I get one for free?
  • Since there’s no cure for COVID-19, why do I need to test?
  • Will the at-home test have directions for testing?

Resources

Centers for Disease Control and Prevention: COVID-19 Testing: What You Need to Know

U.S. Department of Health and Human Services: Coronavirus (COVID-19) Testing

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