When to Test and How
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/ Categories: WELLNESS, 2021

When to Test and How

Healthcare systems are attempting to walk a fine line. We want everyone who needs a COVID-19 test to get one. Testing helps people determine whether they need to isolate from others and whether it’s safe to resume our lives after a suspected exposure. At the same time, nervousness and anxiety are inspiring people to get a PCR test when they may not need one. This causes unnecessarily long waits at testing centers. Here’s the latest.

Get a PCR test if:

  • You have symptoms of COVID-19, even after vaccination.
  • You have been informed that you are a close contact (within 6 feet for a total of at least 15 minutes) of someone with a confirmed case of COVID, even after vaccination.

Note that if you have tested positive in the past 90 days, you may test positive again, even after you have recovered without having been reinfected. Because reinfection within 90 days is so rare, getting tested within this timeframe may not be worthwhile.

A new web-based tool available from the Centers for Disease Control and Prevention helps people decide whether or not they need a PCR test for COVID-19. We’ve linked to it at svhealthcare.org/COVID-Resource-Center.

You may also need a negative COVID test if you are returning to college or boarding school or if you are traveling via plane, for instance. Some workplaces or family gatherings also require a negative test.

If you took part in activities that put you at higher risk—like travel or attending a big gathering in a crowded indoor setting—but have not been alerted to any potential exposure or you would like assurance that you’re not infected before attending an event, an at-home antigen test is likely sufficient to provide the reassurance you need.  

Following these recommendations will ensure everyone gets the tests they need while preserving local testing capacity for those who need it most.

Karen Bond is the director of Laboratory Services at Southwestern Vermont Medical Center, part of Southwestern Vermont Health Care, in Bennington.

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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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