Understanding COVID-19 Testing in the United States: A Guide
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If you’ve faced difficulties obtaining a COVID-19 test in the U.S., you’re not alone. As the pandemic unfolds, access to testing has been a significant issue, though efforts are increasing to provide more tests.
Experts emphasize the importance of widespread testing to mitigate the spread of the virus. Public health authorities utilize testing to identify outbreaks, determine which populations are most vulnerable, and gauge the overall spread of the virus. Knowing one’s infection status allows for necessary self-isolation.
"We aim to inform individuals about their infection status so they can remain at home," stated Dr. Karen Carroll, a clinical microbiologist at Johns Hopkins University, during a March 13 press briefing. "Accelerating this process is vital to curtail transmission."
> According to the COVID Tracking Project, as of March 19, the U.S. had conducted approximately 100,000 tests, significantly fewer than South Korea's tally of 274,000 tests.
Testing shortages have hindered the U.S. response. The CDC began distributing testing kits to select health labs on February 6, but initial kits had issues, causing delays. New kits have since been dispatched to all states, yet shortages persist in many regions.
"The availability is inconsistent," remarked Dr. Carmen Wiley, president of the American Association for Clinical Chemistry, in an interview with Elemental.
As of March 17, about 33,000 tests were processed by the CDC and state labs, which does not reflect the country's overall testing capacity. Commercial and university labs are beginning to offer their testing services. By March 19, the COVID Tracking Project estimated roughly 100,000 tests had been conducted nationwide, still lagging behind South Korea.
What Actions Are Being Taken to Address the Testing Shortage?
On February 29, the FDA implemented a policy to expedite the testing process, allowing various U.S. labs to create and validate their own coronavirus tests. In response, companies like Roche and Thermo Fisher pledged to manufacture millions of tests to help alleviate shortages. Commercial labs, including LabCorp and Quest Diagnostics, are also contributing by providing tests. Many universities are quickly enhancing their testing capabilities.
Should I Get Tested?
Initially, the CDC advised testing for individuals exhibiting symptoms such as fever, cough, or shortness of breath who also had clear exposure to the virus. However, as of March 4, the guidelines expanded to suggest testing for anyone showing symptoms of COVID-19, provided they have a doctor's order.
For those with mild symptoms who are otherwise healthy, healthcare providers may recommend rest at home. Testing is prioritized for older adults and individuals with underlying health conditions, even if symptoms are mild.
Seek immediate medical attention if you experience severe symptoms like difficulty breathing or persistent chest pain. Currently, individuals without symptoms who believe they have been exposed may find it challenging to secure a test due to limited availability.
"We cannot afford to test everyone who thinks they may have been exposed, as this will deplete our supply," Dr. Carroll explained. Testing efficacy in asymptomatic individuals remains uncertain, underscoring the importance of practicing social distancing.
I Suspect I Was Exposed to COVID-19. How Soon Can I Test Positive?
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, noted that symptoms could manifest anywhere from two to 14 days post-exposure, typically around five days. Determining the optimal time to test is still under investigation. Immediate testing post-exposure is likely to yield negative results, as the virus requires time to replicate within the body. "When symptoms arise, you're generally positive," Fauci stated.
Where Can I Get Tested?
The CDC suggests contacting your primary care physician first, who will conduct a preliminary assessment to decide if testing is warranted. Currently, a doctor's authorization is necessary for testing, although they cannot perform the tests themselves.
If you lack a primary care provider, reach out to your state health department for testing information. Drive-through testing facilities, allowing individuals to be swabbed while remaining in their vehicles, are emerging across the country. This model has proven effective in countries like South Korea.
> For those with mild or no symptoms, results may take three to four days.
How Does the COVID-19 Test Work?
At most testing sites, a healthcare professional will collect a sample from your nasal cavity. This sample will then be sent to a laboratory for analysis. The tests utilized by the CDC and various diagnostic companies employ a method called polymerase chain reaction (PCR) to detect the virus's genetic material. PCR amplifies small amounts of genetic material from a nasal sample to a volume suitable for analysis. The detection of viral genetic material confirms infection.
How Soon Will I Receive My Test Results?
Result timelines vary, ranging from 24 hours to up to four days, influenced by several factors, including your age, risk status, and symptom severity. Healthcare professionals are currently prioritizing testing for the most vulnerable populations. Those with severe symptoms might receive results within 24 hours, while individuals with milder symptoms may wait three to four days. The testing location’s capabilities also impact result timelines.
What Is the Accuracy of the Test?
PCR testing is considered reliable, but inaccuracies can occur. False negatives may arise from improper sample collection or degradation during transport. A false positive, where a test incorrectly indicates an infection, can happen through sample contamination or mislabeling. However, such inaccuracies are rare and not a major concern.
What Will the Test Cost?
Thanks to a coronavirus relief package signed into law by President Trump on March 18, testing is free for all Americans. Additionally, some insurance providers are waiving fees associated with COVID-19 treatment. More information on insurance policies is available.
I Suspected I Had COVID-19 Symptoms But Wasn't Tested. How Can I Confirm?
Researchers are currently developing antibody tests to identify specific antibodies produced by the immune system in response to the virus. These tests aim to indicate how many individuals have been exposed to the virus and its prevalence, but they are still under development and not yet widely accessible.