Coronavirus information changes quickly, so please take note of this story’s publication date. You can find current recommendations and national outbreak data on the CDC website. Or, if you want local coronavirus updates and stats, check out the department of health website for your state or your city. Enjoy reading and stay safe. Let’s flatten that curve.
Guidance on the coronavirus seems to change by the hour. If you’re not sure when to inquire about testing — or how to go about doing it, or where you’d need to go — you’re hardly the only one. With help from experts, we put together an overview of the testing process.
The coronavirus is actually a family of viruses that can cause a range of respiratory symptoms. The illness caused by this coronavirus, called COVID-19, is thought to primarily spread via “respiratory droplets,” most often when an infected person sneezes or coughs.
“Coronavirus doesn’t typically cause what we call upper respiratory disease, where you get a runny nose, for example,” says Dr. Robert Murphy, director of the Center for Communicable Diseases and a professor of infectious diseases at the Northwestern University Feinberg School of Medicine. “It’s a lower respiratory disease that affects the lungs. That’s a big difference from the common cold, but unfortunately, it is similar to how the flu presents.”
Anyone with a cough and a fever should stay home from work and wear a mask if they have to go out, Murphy says. The most common symptoms of COVID-19 are fever, tiredness and a dry cough. Some patients may have aches and pains, nasal congestion, a runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually, according to Dr. Krutika Kuppalli, an infectious diseases physician and vice chair of the Infectious Diseases Society of America Global Health Committee.
Who’s supposed to get tested?
Doctors are permitted to test any patient they feel might be infected; the WHO advises anyone who has a fever, cough and/or difficulty breathing to seek medical attention, whether or not they have a reason to believe they’ve been exposed to the coronavirus.
But to guide testing decisions, the CDC advises healthcare providers to prioritize a few groups of symptomatic people:
- hospitalized patients
- members of higher-risk groups, meaning those who are older and/or have compromised immune systems or underlying health conditions
- anyone (healthcare workers included) who’s had close contact with a suspected or confirmed COVID-19 patient within two weeks of developing symptoms. This is called a “contact person.”
- anyone who’s been to an affected area within two weeks of developing symptoms. Affected areas are defined as “geographic regions where sustained community transmission has been identified.”
Ultimately, Kuppalli says, “the decision to perform testing will be individualized to the patient, their risk factors and symptoms.”
How many Americans are getting tested?
Testing is finally ramping up. Until now, it’s been extremely hard for (regular) people to get tested, especially in parts of the country hit hardest by the outbreak. Fast, widely available testing is necessary to mitigate the spread of the disease, experts say. Epidemiologists also need a lot more testing data to determine, with any confidence, how many people are actually infected with COVID-19.
What should you do if you think you might have COVID-19?
Call your primary care provider, or schedule a telehealth visit, and explain that you’re concerned about potential exposure — but don’t show up at a doctor’s office unannounced.
The healthcare provider you speak to will screen you (to learn about your current symptoms, health status, recent travel history and other exposure risk factors) and tell you what to do next, whether that’s lying low at home and monitoring your health, seeing a doctor in person for testing or heading to a testing site.
“We really want to try and limit the overburdening and crowding of any one particular area, which is why it’s important to present to the appropriate place,” says Kuppalli. “If you’re really sick, then it’s important to go to the ER. But if you have mild symptoms, see if you can be evaluated [by your PCP].”
States have different (and often evolving) protocols in place; some have established hotlines for COVID-19 testing information. Keep abreast of media reports and check local health department websites for COVID-19 updates.
Where do you go to get tested?
While most patients are being tested at primary care offices, urgent care centers and emergency rooms, drive-through testing sites are also cropping up across the country (with more expected to open soon). At these outdoor facilities, patients get swabbed through their car windows by healthcare workers in protective gear. This method is intended to enable swift coronavirus testing while minimizing the spread of the disease in healthcare settings. Testing rules vary across different drive-through sites have varied rules for how to get tested. Check before you go.
How should you get to your testing appointment?
If you’re sick, the CDC recommends avoiding public transportation, including ride shares. But what if you don’t have a vehicle or you’re too sick to drive yourself to a medical appointment?
Dr. Michael Chang, an infectious disease physician at UTHealth in Houston, says there’s not really an ideal solution at this point. In many cities, public transportation is still open, but with reduced seating capacity to allow for separation. “You can still use public transit if it is the only option, but try to control your exposure,” he says. For patients who are too sick to drive and need medical attention, Chang recommends finding a close contact who is lower-risk for severe disease. Make sure to wear a mask and sit in the back seat to distance yourself from the driver. If necessary, calling 911 would be the other way to get transportation to a medical facility.
How does the testing process actually work?
Healthcare providers collect samples of fluid from the throat, nose or lungs with antiseptic swabs designed to detect several types of viral infection, although not coronavirus specifically, says Hruby.
The swab needs to go “through nasal passages, all the way into back of your throat. It’s a little uncomfortable, they do get back in there,” says Dr. Luis Ostrosky, a professor of infectious diseases at McGovern Medical School at UTHealth.
The test can make you cough, Ostrosky notes, so anyone who does the swabbing needs to be properly protected. “Providers need to be wearing gowns, gloves, respiratory protection and a face shield. Currently the CDC is recommending wearing N95 respirators.”
The swabs will then be sealed in a plastic container and sent off to a lab for testing. The current turnaround time is one to three days, Hruby says, although it varies by state and lab. Some medical centers should have on-site testing capabilities soon, leading to shorter wait-times for results.
What should you do while you wait for your results?
Self-quarantine is the general recommendation for anyone with COVID-19 symptoms, whether or not they get tested. “Don’t go about your business if you have been tested and are waiting for results,” says Chang.
If you test negative, can you stop quarantining yourself?
If you have respiratory symptoms, you should still tread carefully until you feel better.
“Just because it isn’t [the coronavirus] doesn’t mean it is okay to go and spread [a different respiratory infection] around especially since we are trying to minimize the overall burden to the healthcare system,” says Chang. “Even if testing is negative, but you’re symptomatic, self-quarantine should be considered.”
What happens if the test comes back positive?
Don’t panic. We don’t have much data on it yet, but it appears that most people with the virus have mild cases and can recover without medical treatment. A “mild” case means one that doesn’t require hospitalization. Health complications appear to be considerably more likely for higher for people who are older, immunocompromised, and/or have certain underlying conditions, including heart disease, diabetes, or COPD and other lung diseases.
You may be sent home for self-isolation if the evaluating physician deems you healthy enough, Kuppalli says. (“Isolation” is for infected patients; “self-quarantine” is seclusion for healthy people who may have been exposed to the virus.) If you’re very sick, hospitalization may be required instead.
When can you stop self-isolating?
All patients with symptoms should follow CDC’s most recent recommendations for how long to remain in isolation. Currently, people should should self-isolate until 72 hours have passed since recovery. You can consider yourself “recovered” once you meet both of the following criteria: 1) Your respiratory symptoms and fever are gone, without the use of fever-reducing meds. 2) It’s been at least seven days since your symptoms first appeared.
The CDC also lists a second way to determine when isolation is over, but it’s not a feasible option until (or maybe unless) we have an abundance of tests and no limits on our capacity to process them. By this measure, isolation should last until you get two negative test results, at least 24 hours apart.
Policies regarding testing costs are changing, frequently. Here’s more info.
The coronavirus is officially a pandemic, according to the WHO. Don’g go rogue: If you’re coronavirus-free, take the recommended precautions to keep yourself and others healthy: Wash your hands frequently and thoroughly (and wash your phone just as often); stop touching your face; keep your distance from sick people; stay home if you’re sick; take social-distancing rules seriously.
“This really could pop up anywhere, and people should follow the things we’ve been recommending,” Kuppalli says.