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COVID-19 testing basics

Good Samaritan Hospital - September 02, 2020

If you’re struggling to parse through all of the information about the different COVID-19 tests, you’re not alone. Finding a credible, centralized source of information has been difficult for many, and this virus is still so new that what you thought was the most up-to-date information can change from one day to the next.

There are, however, plenty of facts we do know about testing for COVID-19. To start, tests are crucial to helping everyone better understand the virus, contain its spread, and make more informed personal choices day-to-day.

But should you get tested? If so, which test is right for you? Here is some information to keep in mind as you navigate the uncertainties of living in a pandemic.

What are the different types of COVID-19 tests?

In general, testing for COVID-19 falls into two categories — viral testing and antibody testing. Which test you get generally depends on your answer to one key question: Do you think you may be infected now, or do you suspect you might have been in the past?

If the first question describes you, your provider may suggest a viral COVID-19 test.

Viral testing

Viral testing determines whether a person has an active infection. This means that their immune system is currently working to fight off the virus that causes COVID-19. Most tests require a deep swab into your nose (although some labs have started offering less sensitive saliva tests).

Now, more than ever, these viral tests play a critical role in public health, explained Heather Signorelli, D.O., chief laboratory officer at HCA Healthcare. “It’s really important to have as much testing for active infection as we can, so that we’re identifying individuals who are infected,” she explained.

Fortunately, testing has come quite a way since the virus first emerged in late 2019. That progress has helped scientists create a wider range of viral testing options, including polymerase chain reaction (PCR) tests, which detect the molecular presence of the virus, and antigen tests, which identify viral proteins.

Each kind of viral test comes with caveats: PCR test results are generally more accurate, but they also take more time, since they require lab processing. Antigen tests are fast, but they may not be as accurate in ruling out a possible infection.

“The PCR test is a gold standard because it’s the most sensitive test, but antigen testing is still a really good test,” Dr. Signorelli said. “We’re going to need to have a mix of those two in order to combat this pandemic.”

Antibody testing

Antibody testing requires heading to a clinic or a lab for a blood test. When the immune system beats an illness, it creates antibodies. Because the test is able to detect the presence of antibodies in the body, it can indicate whether someone has already had (and overcome) an infection — even if it was weeks ago.

While the results of antibody testing can help researchers see who may have already had or been exposed to the virus, it has some downsides — especially if people change their behaviors, like going back to work or school, based on the results. For one thing, a positive antibody test may not mean you’re safe from getting sick again.

“We’re seeing employers or individuals trying to test a whole bunch of people with antibody testing, but that’s not reliable,” Dr. Signorelli said. “If you have a positive antibody test, we don’t know how long those antibodies stick around for — or how protective they are. It doesn’t mean you don’t have to wear a mask or worry about getting reinfected.”

Still, don’t let that discourage you from getting an antibody test if you’d like to know whether you’ve already had COVID-19. Just be careful not to mistake those results for immunity to a future infection.

How to get tested for COVID-19

By Order of the Santa Clara County Health Officer, your healthcare provider, including Good Samaritan Hospital, is required to provide you with COVID-19 testing* if you meet any of the following criteria:

  1. Have any symptom(s) of COVID-19
  2. Have been exposed to a person who has tested positive for COVID-19;
  3. Have been referred by the County of Santa Clara Public Health Department to your healthcare provider for COVID-19 testing; or
  4. Are an “essential worker” as defined by California regulations (28 C.C.R. § 1300.67.01).
    1. This includes people who may be at greater risk of COVID-19 exposure, such as: healthcare workers; care providers for the elderly or disabled; people working in shelters, jails, or other settings with large residential populations; first responders; grocery and food service workers; agricultural and food supply workers; public transit workers; childcare, school, and higher education teachers and staff; and all others who are included in the regulation.

Your provider may ask you if you fall into one of the above categories, but your provider cannot require proof. Your healthcare provider cannot tell you to go to another provider (including a County-run testing site). Your provider should provide the results of your COVID-19 test within 3 calendar days.

If you are in categories (1), (2), or (3) above, your healthcare provider must provide the COVID-19 test when you show up in person as a patient to the healthcare facility.

If you are an essential worker and not in categories (1), (2), or (3) above, your healthcare provider must provide the COVID-19 test within 3 business days. Healthcare providers can ask essential workers to wait up to 14 calendar days between tests.

You may report any concerns or violations directly to your healthcare provider or to the County at https://www.scccovidconcerns.org.

* Charges may vary. Contact your health plan to learn more.

What to do after you get your results

When you get your results, discuss the precautions you should take with your provider. If you test positive, for example, you’ll need to focus on your recovery and on not spreading the virus to others. The Centers for Disease Control and Prevention recommends avoiding contact with others until:

  1. It’s been at least 10 days since your symptoms started.
  2. You’ve gone at least 24 hours without a fever (without using fever medicine).
  3. You feel better.

It’s important to isolate until you meet all three criteria. You may also get a phone call from a contact tracer, who will ask questions related to your recent history and contact with others. Cooperate as best you can with their questions — your answers can help public health leaders track, and ultimately slow, the spread of the disease.

Most importantly, work with your provider and follow their advice around COVID-19 testing. By staying informed and cautious, you can do your part to help keep yourself and others safe.

If you still have questions about whether to get tested or which test to get, contact us for more information.