When in Doubt, Test

As the pandemic continues to develop, we are recommending testing more than ever. Here are the reasons why:

Testing is more available than ever. Within a 30-minute drive of home, almost everyone can get a test every day of the week. Note that advanced registration is required for most tests. Visit svhealthcare.org/COVID-19/testing for details.

The expense of testing has been largely removed. Testing at many sites is free. At other sites, it is covered by insurance. Almost no one should have to pay out-of-pocket for a COVID-19 test.

Testing is more comfortable now. Nasopharyngeal tests take a sample from deep inside the nose and throat. Some people call it “the brain tickler.” It burns a little and makes your eyes water. The anterior nares test is becoming more common. It takes the sample from just inside your nostril and is way easier for patients to take.

Many people are positive without knowing it. COVID-19 causes no symptoms, mild symptoms, or unusual symptoms in many people. Those people can still spread COVID-19 to others who may develop severe symptoms. So, if someone has unusual symptoms, we recommend testing.

Positive results help people isolate. Results are usually available in 12 - 36 hours. When someone knows they are positive, they do a much better job of staying away from others than when they don’t. When we test people and get them their results quickly, they are far less likely to spread COVID to others. And that’s the goal: to keep cases low.

The vaccine isn’t quite here yet, and its effect will not be immediate. While it would be nice to be able to forget about testing, doing so could mean racking up lots more cases and deaths between now and when we reach herd immunity.

So who should get tested?

• We know that anyone who is a close contact of a positive case should be tested. These include people who share a household or worksite with a positive person and those who have attended an event with that person. Close contacts should be tested immediately and again after 7 days. 
• If you have attended a gathering of any kind in the last two weeks, you should get tested. (If you are planning to attend a gathering, please don’t.)
• Anyone who travelled out of state and returned home, including students, or who has had a visitor from out of state, including families of students, should be tested.
• Maybe surprisingly, if you have had unexplained symptoms lately, even mild symptoms or those not usually associated with COVID, you should get tested, as well. More and more, we are seeing patients with unusual symptoms—sinus symptoms and stomach or gastrointestinal symptoms, for instance—test positive.

Until most people in our community are vaccinated, mitigation—including limiting trips outside of your household, wearing a mask, distancing from others, and washing your hands—is our best defense against COVID. Testing is important, too, because it will help us limit the virus’s ability to spread beyond a case or two. So, when in doubt, test.

Marie George, MD, FIDSA, is Southwestern Vermont Medical Center's infectious disease specialist.