Should You Be Tested for COVID-19?

More tests for COVID-19 are now available, but not everyone needs to be tested, especially if they don’t have symptoms.

As SARS-CoV-2 infections continue to spread, many people are probably wondering if they should be tested for COVID-19.

“To learn if you have a current infection, viral tests are used. Most people have mild illness and can recover at home without medical care. Contact your healthcare provider if your symptoms are getting worse or if you have questions about your health.​​”

CDC on Testing for COVID-19

While it might sound like a good idea, especially if there are many COVID-19 cases in your area, getting tested for SARS-CoV-2 isn’t as easy as you might think it should be…

Should You Be Tested for COVID-19?

What’s the biggest problem with getting tested for SARS-CoV-2?

Since this is a new infection, a new test had to be developed to detect it.

And believe it or not, that test is still not widely available.

“The California Department of Public Health announced today that new CDC test kits used to detect Coronavirus Disease 2019 (COVID-19) now available in California can be used to do diagnostic testing in the community. California will immediately receive an additional shipment of kits to test up to 1,200 people.”

COVID-19 Testing Kits Arrive at State Public Health Laboratories

While more and more communities now have COVID-19 test kits, getting tested often still means a long wait for the test and an even longer wait for the results.

The CDC is now shipping its laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to qualified state and local public health laboratories.
The CDC is now shipping its laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to qualified state and local public health laboratories.

But what happens if you think that you have COVID-19?

Can you get tested?

While there were originally strict criteria for who could get a test, including folks with COVID-19 symptoms, those who had contact with a known case, and anyone with recent travel to a hot spot, it has gotten to where almost anyone can get a test.

Not everyone needs a test though…

“Can someone test negative and later test positive on a viral test for COVID-19?

Yes, it is possible. You may test negative if the sample was collected early in your infection and test positive later during this illness. You could also be exposed to COVID-19 after the test and get infected then. Even if you test negative, you still should take steps to protect yourself and others.”

COVID-19 Frequently Asked Questions

Should you get tested if you were exposed to someone with COVID-19?

While it might seem like a good idea, understand that if you test negative, it doesn’t mean that you won’t develop symptoms and test positive later on in your incubation period (up to 14 days).

Are you going to get tested every day?

So no, you probably don’t need to be tested simply because you were exposed. You should self-quarantine yourself though and can consider testing if you later develop symptoms.

And you likely don’t need to get tested if you weren’t a close contact (within 6 feet of an infected person for at least 15 minutes) of someone with COVID-19. Besides the fact that testing is still limited and should likely be reserved for those with symptoms, a negative test one day simply means that you are negative that day. Again, you could develop symptoms the next day or even later that day…

What Tests Are Used to Diagnose Covid-19?

If you are going to get tested for COVID-19, do make sure you get the right test though.

“A viral test tells you if you have a current infection.”

CDC on Testing for COVID-19

You want to get a viral test (preferably the PCR test, as it is more reliable than the antigen test), and not the antibody test (blood test), which detects past infections.

Remember though, since there is no specific treatment for COVID-19, the only thing a positive test does is reinforce your need for self-isolation.

“For COVID-19, the period of quarantine is 14 days from the last date of exposure, because 14 days is the longest incubation period seen for similar coronaviruses.”

COVID-19 Frequently Asked Questions and Answers

Testing can help identify folks who really need to be quarantined, keeping them from getting others sick, and it can help with contact tracing.

While that can be useful, it is also important to understand that the COVID-19 tests can have false-negative results. So if you think you have symptoms of COVID-19, stay in quarantine even if you have a negative test.

What to Know About COVID-19 Testing

More tests for COVID-19 are now available, but not everyone needs to be tested, especially if they don’t have symptoms.

More on COVID-19 Testing

What is the COVID-19 Mortality Rate?

Do we know how deadly COVID-19 really is?

Knowing the COVID-19 mortality rate would help folks get a better understanding of just how concerned they should be about this new disease that is quickly spreading around the world.

New modeling from the CDC puts the COVID-19 case fatality rate at 0.1 to 1%.

Unfortunately, the widely different numbers we are hearing might contribute to some of the confusion people already have about the SARS-CoV-2 virus.

What is the COVID-19 Mortality Rate?

In general, the mortality rate for a disease is “the measure of the frequency of occurrence of death in a defined population during a specified interval.”

Defined population?

That’s not how many people have the disease. That’s literally how many people there are in the place you are talking about.

Instead of mortality rate, right now, what we really want to be talking about is the case fatality rate.

“The case-fatality rate is the proportion of persons with a particular condition (cases) who die from that condition. It is a measure of the severity of the condition.”

Mortality Frequency Measures

Still, differences in defining the “population” or cases has lead to differences in reports of case fatality rates from the CDC and WHO.

“There is now a total of 90,893 reported cases of COVID-19 globally, and 3110 deaths.”

WHO Director-General’s opening remarks at the media briefing on COVID-19 – 3 March 2020

The WHO reports a case fatality rate of 3.4% for COVID-19, which they get by simply dividing the 3,110 deaths by the 90,893 reported cases.

“This crude CFR is high: for comparison, the CFR for seasonal influenza is 0.1%. However, as I will show below, this number is not a one-size-fits all, and is influenced by many factors. Please do not look at 3.4% as an indicator of your risk of dying from COVID-19!”

SARS-CoV-2 coronavirus case fatality ratio

The CDC, on the other hand, is using a method that factors in the idea that there are likely many more mild cases that haven’t been officially reported. That gets them a much lower case fatality rate rate of 0.1 to 1%.

Only more testing will get us a more accurate case fatality rate for COVID-19.
Only more testing will get us a more accurate case fatality rate for COVID-19.

Then there is the large study on COVID-19 case fatality rates that did include suspected and asymptomatic cases, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. They found an overall case-fatality rate (CFR) of 2.3%.

“Epidemiologists think and quibble in terms of numerators and denominators—which patients were included when fractional estimates were calculated, which weren’t, were those decisions valid—and the results change a lot as a result.”

COVID-19 Isn’t As Deadly As We Think

What do these numbers mean to you?

They might be easier to understand if you compare the case fatality rate of COVID-19 to some other diseases.

DiseaseCase Fatality Rate
Rabies99.9%
H5N1 bird flu60%
Ebola50%
MERS34%
H7N9 bird flu25%
SARS15%
Yellow fever15%
Tetanus13%
Diphtheria5-10%
1918 flu pandemic1-3%
COVID-19*0.1-3%
2009 flu pandemic0.1%
Seasonal flu0.1%
Measles0.1%
A high case fatality rate doesn’t tell the whole story. It is also important to understand how likely it is for a disease to spread and get a lot of people sick. And a reminder that many vaccine preventable diseases are quite deadly!

Fortunately, COVID-19 is near the bottom of the list, and as we get more and more data, it seems like the official case fatality rate will continue to drop.

Still, since it is spreading at pandemic levels, that means a lot of people will get sick and could die, especially those in high risk groups.

Older people and people with severe chronic health conditions are likely at higher risk COVID-19 infections.
Older people and people with severe chronic health conditions are likely at higher risk for COVID-19 infections.

*How many? It’s too early to tell, as we really don’t know what the real COVID-19 case fatality rate is yet.

“Practice everyday preventive behaviors! Stay home when sick. Cover coughs and sneezes. Frequently wash hands with soap and water. Clean frequently touched surfaces.”

Preventing COVID-19 Spread in Communities

That makes it important to take steps to try and slow down the spread of SARS-CoV-2, especially to people who are at high risk.

More on the COVID-19 Fatality Rate

Mixed Messages About COVID-19

Don’t let mixed messages about COVID-19 leave you confused or get in your way of preparing your family for this new pandemic.

Do you feel like you are getting mixed messages about COVID-19?

Don’t stockpile things, but be prepared.

Don’t wear a mask, but avoid other people so you don’t get sick.

It’s just like a bad flu, but states are declaring states of emergency and countries are restricting travel.

Mixed Messages About COVID-19

Are you confused yet?

Are you wondering why we continue to see new cases?

Have you forgotten that we were warned that SARS-CoV-2 would likely become a pandemic?

“With the inexorable spread of 2019-nCoV, we are again upset about the way officials and reporters are talking about containment. We think it is crucial to try to prepare the public for the very high likelihood that containment WILL FAIL, if what we mean by “containment” is that we might be able to stop a pandemic.”

Risk Communication about Containment – 2019 Novel Coronavirus

Shouldn’t we have been able to stop it if we had warning?

Although ideally we would have contained SARS-CoV-2 before we started to see community spread, the more realistic goal has been slowing down its spread.

Containment measures can help to flatten the curve in a pandemic, buying everyone some more time to get ready.

Slowing down its spread will help prevent everyone from getting sick all at once so that doctors and hospitals don’t get overwhelmed.

Wait, is everyone going to get sick?

That’s probably another thing about COVID-19 that has you confused.

And the answer is almost certainly no.

There likely won’t be constant exponential growth and like many other respiratory diseases, this one will hopefully end at some point.

We shouldn’t expect exponential growth of COVID-19, which means that everyone isn’t going to get it over the next few months.

It is also very important to understand that most of the people who do get sick will have a mild illness.

So if we can’t stop it and most cases are mild, then why are we declaring emergencies, closing schools, and canceling some large community events?

“That this disease has caused severe illness, including illness resulting in death is concerning, especially since it has also shown sustained person-to-person spread in several places.”

Coronavirus Disease 2019 (COVID-19) Situation Summary

It is because we are still learning about this new virus and we already know that it can cause severe, even life-threatening disease, in some people.

Why are we trying to slow down the COVID-19 pandemic?

So what should you do?

“Call your doctor: If you think you have been exposed to COVID-19 and develop a fever and symptoms of respiratory illness, such as cough or difficulty breathing, call your healthcare provider immediately.”

Prevent the spread of COVID-19 if you are sick

Be prepared.

There is a lot of good information out there from the CDC, WHO, and your local and state health department to help you get prepared for COVID-19.

Most importantly, be smart and do all of the common sense things that we always talk about that can help keep you from getting sick, like washing your hands and not touching your eyes, nose, or mouth, etc.

And if you are in a high risk group, or have frequent contact with someone in a high risk group, you should likely be a little extra careful to help reduce your chances of getting COVID-19. That’s when you might take the extra steps of avoiding crowds and limiting contact with others, etc.

“Stay home: People who are mildly ill with COVID-19 are able to isolate at home during their illness. You should restrict activities outside your home, except for getting medical care.”

Prevent the spread of COVID-19 if you are sick

What’s next?

As testing becomes more widely available in the coming days and weeks, you can almost certainly expect to hear about more and more cases in more and more parts of the United States.

Don’t be surprised.

Be prepared.

More on Mixed Messages About COVID-19

Getting Tested for COVID-19

Do you want or need to get tested for COVID-19? Do you know which test to get?

We have been hearing it over and over for some time now – anyone who wants a test can get a test.

The CDC is now shipping its laboratory test kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to qualified state and local public health laboratories.

As testing has become more widely available, that is somewhat true.

There are still some problems with COVID-19 testing though.

Chief among them is making sure you get the right test!

Getting Tested for COVID-19

First things, first.

Do you really need a test?

Many people who are not hospitalized might not need to be tested for COVID-19.

“Most people will have mild illness and can recover at home without medical care and may not need to be tested.”

Testing for COVID-19

The main reason that testing can be important though is that it can help limit your exposing others to SARS-CoV-2 once you have been exposed or suspect you are infected. And it can also help trace the people you have already been in contact with before you knew that you should be in quarantine.

Which COVID-19 Test Do You Need

If you think you are sick and want to get tested, do make sure you get the right test though, a viral test for current infection.

You do not want the antibody test (blood test), even though it may give rapid results, if you think you are sick now. The antibody test only checks for past or recent infections.

“CDC does not currently recommend using antibody testing as the sole basis for diagnosis of acute infection, and antibody tests are not authorized by FDA for such diagnostic purposes.”

Overview of Testing for SARS-CoV-2

Once you have narrowed down your test to the viral test for current infection, you might still have a choice to make, as there are several types, including:

  • Molecular Diagnostic Tests for SARS-CoV-2 – uses nucleic acid amplification techniques (PCR) to detect the RNA of the virus. These tests don’t necessarily take long to run, but since samples typically have to be sent out to a lab, that slows down the time to get results, sometimes up to 7 business days.
  • Antigen Diagnostic Tests for SARS-CoV-2 – detects fragments of proteins that the virus makes. Can give rapid results, in 15 minutes, but are more prone to false negatives than molecular tests.

Ready to get tested now?

There is still the problem of where to get tested…

Ideally, you might want to go to some kind of mobile, drive-through testing site, so that you don’t have to expose anyone else as you get tested. Unfortunately, those kinds of testing centers are not widely available.

Another ideal choice would be your own pediatrician. Are they doing COVID-19 testing?

With the Sofia2 analyzer, pediatricians can get rapid test results in just 15 minutes.

Lastly, you might just have to see if you county or state health department has a list of places doing testing.

What to Do After Your COVID-19 Test

What happens after your test is done?

  1. You are waiting for test results. Stay in isolation until you know the results!
  2. You are positive for COVID-19. You should stay home, in isolation, unless you need medical attention, only ending your isolation until you have gone 3 days without fever AND your respiratory symptoms have improved AND it has been 10 days since your symptoms first appeared. You should also tell all close contacts (anyone who was within 6 feet of an infected person for at least 15 minutes starting from 48 hours before the person began feeling sick until the time the patient was isolated) that you tested positive so that they can self-quarantine for 14 days.
  3. You are negative for COVID-19 and don’t have symptoms after a recent exposure. Since the incubation period for SARS-CoV-2 is 7 to 14 days, a negative test before the end of the incubation period doesn’t mean that you won’t eventually develop COVID-19. You should likely remain in self-quarantine.
  4. Your COVID-19 antigen test was negative and you do have symptoms. Since this might be a false negative, depending on your health care provider’s suspicion that you could actually have COVID-19, they might now do a molecular diagnostic test for SARS-CoV-2. Or they might just recommend that you remain in self-quarantine.
  5. Your COVID-19 molecular diagnostic test was negative and you do have symptoms. Although more accurate than the antigen test, there is still the possibility that this could be a false negative. Whether or not you remain in self-quarantine depends on your health care providers suspicion that you could have COVID-19. Did you have a known, close exposure to someone with SARS-CoV-2, for example?

Are you ready to get tested?

More on Getting Tested for COVID-19