Information about COVID-19 Testing

Pharmacists are medication experts and the most accessible healthcare providers. They also administer vaccines and conduct health and wellness screenings. Pharmacists can also provide information and answer questions about the different types of COVID-19 tests available today.

Federal guidelines say when to get tested
The Centers for Disease Control and Prevention (CDC) recommends testing for people who have symptoms of COVID-19, people who have had close contact with someone with confirmed COVID-19, and anyone who has been asked by a healthcare provider or local or state health department to get tested.

The agency advises people who are tested to self-quarantine or isolate at home until the test results are available and to follow the advice of their healthcare provider or public health professional.

Testing too soon after exposure may produce a wrong result
Infection with SARS-CoV-2 requires a person being exposed to the virus from an infected person, taking in the virus, and then having the virus multiply in their body.

Because COVID-19 diagnostic tests vary in their ability to find the virus in an infected person, samples collected very early during the course of infection may not contain enough virus material to be detected. Clinicial studies indicate that tests can begin to detect the virus about 3–7 days after exposure.
According to CDC, RNA levels of the COVID-19 virus in the upper respiratory system decline after their symptoms begin. The agency states that people who have recovered from COVID-19 may have detectable amounts of viral RNA in their upper respiratory tract for up to three months after the onset of illness but are unlikely to be infectious.

There are a lot of COVID-19 diagnostic tests on the market
The Food and Drug Administration (FDA) has cleared more than 200 in vitro COVID-19 diagnostic test products for use under Emergency Use Authorization (EUA) provisions. Initial tests required laboratory processing but as the pandemic has progressed, manufacturers have increasingly offered products for that provide results at the site of testing.

There are two distinct types of COVID-19 diagnostic tests
FDA classifies COVID-19 diagnostics as molecular tests, which detect SARS-CoV-2 RNA, and antigen tests, which detect viral proteins. Both types of test are used to diagnose active infection in symptomatic and asymptomatic people.

According to FDA, antigen tests can quickly deliver results, but negative results in a symptomatic patient may need to be confirmed by more a more sensitive molecular diagnostic test.

According to FDA, molecular diagnostics typically detect acute SARS-CoV-2 infection accurately and test results usually don’t need to be confirmed by another test.

Antibody tests don’t diagnose active infection
FDA’s website lists more than 50 authorized tests to detect SARS-CoV-2 antibodies in patient blood samples. A positive result indicates a past infection but cannot be used to diagnose or confirm a current infection with the virus.

Tests are available to detect virus in different specimen types
Most COVID-19 tests require a sample from the upper throat, middle throat, or nose; some tests use a saliva sample. Collection of upper and middle throat samples require special training and is performed by a healthcare provider or other person.

Patients may be able to collect their own specimen for tests that require a nasal swab or a saliva sample. Although some COVID-19 test kits are designed for patients to collect samples at home, most kits require that specimens be sent to a laboratory for processing. FDA on Nov. 17, 2020 cleared the first COVID-19 diagnostic test (available by prescription) that allows patients to collect a nasal specimen and process it at home.

Pharmacists can collect patient specimens for COVID-19 testing
Federal guidance issued in accordance with the Public Readiness and Emergency Preparedness (PREP) Act authorizes licensed pharmacists — and, in some states, pharmacy technicians and pharmacy interns — to order and administer COVID-19 tests as part of the nation’s response to the pandemic. Pharmacists have been on the front lines of testing since early in the pandemic.

Insurers must cover COVID-19 testing, but with caveats
Federal law requires insurance companies to cover COVID-19 testing to patients at no cost to them, but regulations appear to permit insurers to limit coverage on the basis of medical necessity. Specific questions about coverage for individual patients should be directed to their insurer.

Federal resources, such as the Health Resources and Services Administration’s COVID-19 Claims Reimbursement Portal, are available to cover costs incurred when testing uninsured patients.

COVID-19 tests are available in many settings
The Department of Health and Human Services maintains a list, organized by state, of health centers and pharmacies in the community where patients can be tested for SARS-CoV-2 infection. The list includes links to state public health departments. State and local health departments may have additional options for testing, including drive-up clinics.

Medical offices, urgent care facilities, and hospital outpatient clinics may also offer testing services in your community.