Testing for COVID-19

The COVID-19 test being used depends on the laboratory. The COVID-19 test developed by CDC and used at the state public health lab in Virginia, tests samples from a person’s upper respiratory tract for the presence of genetic material from SARS-CoV-2, the virus that causes COVID-19. Other laboratories might use this CDC test or a different test that they developed.

Yes, just like any other medical diagnostic test, the materials and supplies necessary to perform the test need to be manufactured. Once manufactured, the test is distributed to labs capable of performing testing. Sometimes it can take a bit of time to manufacture and distribute tests, especially if the test is in high demand.

Your healthcare provider will determine if you need to be tested for COVID-19 and might consult with your local health department if needed.

Swabs are taken from the back of the nose (and sometimes from the mouth as well) and tested for the presence of the virus that causes COVID-19.

Your healthcare provider will determine if you need to be tested for COVID-19. If the healthcare provider determines that testing is indicated, they might either collect samples to test you or provide you with information about where you can go locally for testing.

Testing is now available through the state public health lab and some private laboratories. More private labs are expected to start testing soon. If your healthcare provider tests through a private lab, they should work directly with that lab to obtain information about sample collection and shipping. Your healthcare provider does NOT need VDH approval for testing through a private lab.

Testing is available through Virginia’s state public health lab, the Division of Consolidated Laboratory Services (DCLS) for people who meet the priority testing criteria, outlined below. These criteria were last revised on 4/2/2020, in which the requirement for influenza testing was removed.

  1. Healthcare worker or first line responder with fever OR signs/symptoms of a lower respiratory illness.
  2. Potential cluster of unknown respiratory illness with priority for healthcare facility outbreaks. All suspected clusters or outbreaks should be reported to the local health department immediately.
  3. Person hospitalized with fever OR signs of lower respiratory illness. Priority will be given to patients where circumstances require a confirmed COVID-19 diagnosis for compassionate use treatment with antivirals.
  4. Person who resides or works in a congregate setting (e.g., homeless shelter, assisted living facility, group home, prison, detention center, jail, or nursing home) AND who has fever or signs/symptoms of a lower respiratory illness

VDH approval IS needed for testing at DCLS. Your healthcare provider will work with your local health department to determine if you need to be tested for COVID-19. If indicated, they will provide you with information regarding next steps for testing.

* For definitions of terms used in public health testing criteria, please see VDH Updated Guidance on Testing for COVID-19

The new criteria puts emphasis on COVID-19 testing for the following four groups:

  • Healthcare workers or first line responders who have fever OR symptoms/signs of a lower respiratory tract illness (e.g., cough, shortness of breath). This criterion is specific to healthcare workers and first responders.
  • Groups of people, such as the general public, who have an unknown respiratory illness. This is known as a “cluster” of illness. Clusters involving healthcare facilities are of increased importance and will receive higher priority for COVID-19 testing
  • Hospitalized patients with fever OR symptoms/signs of a lower respiratory tract illness. Patients whose clinical circumstance requires a positive COVID-19 test in order to obtain compassionate use antiviral medication will receive priority for testing.  This applies to the general public.
  • People who live or work in a congregate setting (such as a jail, nursing home, assisted living facility, detention center, homeless shelter, group home, etc.) AND who have fever OR symptoms/signs of a lower respiratory tract illness. This applies to people who reside or work in congregate settings.

Healthcare workers or frontline responders who are ill with symptoms of COVID-19 (fever, cough, shortness of breath), or are well and want to discuss testing, should contact their healthcare provider.

At this time, most local health departments are not doing testing for COVID-19. Your healthcare provider will determine if you need to be tested for COVID-19 and might consult with your local health department if needed. If you do not have a healthcare provider, your local health department may be able to help connect you with a healthcare provider or free clinic in your area.

Some local areas have briefly offered drive-through testing for people with symptoms of COVID-19. Due to limited testing supplies, drive-through service is not currently available. State and federal partners are working hard to increase testing availability and will share additional information with the public when more details are known. Testing of sick people for COVID-19 can still be performed through consultation with your healthcare provider.

While there have been news articles about in-home COVID-19 test kits, the Virginia Department of Health is not currently promoting in-home testing. Please contact your healthcare provider if you are symptomatic.

No, no one will come to your home to test you for COVID-19. Your health care provider will determine if you need to be tested for COVID-19. If the healthcare provider determines that testing is indicated, they might either collect samples to test you or provide you with information about where you can go locally for testing.

Your healthcare provider will determine if you need to be tested for COVID-19 and might consult with your local health department if needed. If your healthcare provider has determined that you do not need to be tested for COVID-19, you should follow your healthcare provider’s guidance regarding any necessary treatment or self-care.

Yes, this is possible. Using the CDC test, a negative result means that the virus that causes COVID-19 was not found in the person’s sample. In the early stages of infection, it is possible the virus will not be detected. A negative test result for a sample collected while a person has symptoms likely means that the COVID-19 virus is not causing the current illness.

Cost through private labs is not yet available to VDH.  If you are sick, you may request information about cost directly from your health insurance company or your healthcare provider. If you meet VDH criteria and are tested through DCLS, this is provided at no cost.  If you are a healthcare provider seeking information on testing costs, please contact the lab you use for additional information.

Many insurance plans cover the cost of testing and related health care costs.  For specific information about your health insurance coverage, call your insurance company.  You can usually find their phone number on your insurance card. Most insurance covers testing cost without a co-pay.  You will also find information about insurance and coronavirus costs here.

Virginians who do not have health insurance should contact a free clinic, federally qualified health center (FQHC), or emergency department for assistance. Or visit coverVA.org to see if you qualify for Medicaid. Your local health department might also be able to connect you with free clinics or FQHCs in your area.

You will get your test results from the healthcare professional or facility that collected your specimens. Ask your healthcare provider, when they collect your specimen, what the best way to get your results is. Most clinics and health care professionals are providing results by telephone.

While VDH does receive COVID-19 test results from private labs, including both positive and negative results, the best way to know how you will get your results is to talk with your healthcare provider.

Before March 16, private companies that were manufacturing the tests in Virginia were not required to report to VDH. Instead, they were working directly with FDA to get authorization for testing.  On March 16, FDA revised this policy, allowing states to authorize tests developed and used in their state. VDH and DCLS are aware of some private laboratories in Virginia developing tests for COVID-19.  Several hospitals are also working on developing their own tests and DCLS has been communicating with these laboratories as they go through that process.

Overall, the procedures for developing and implementing a lab test are strict to ensure the highest quality of test performance and ensure that there is confidence in the test results.

There are a variety of factors that might be contributing to the delay. First, the use of the CDC COVID-19 test at public health laboratories was initially delayed because several laboratories reported issues with the CDC test that was approved under an Emergency Use Authorization (EUA) by FDA. Specifically, some laboratories found problems with one of the three assay components, resulting in inconclusive test results. This issue has since been resolved. Second, laboratory testing requires specific instrumentation to perform the test, the need to validate/verify the test, and the need for laboratory staff be trained and demonstrate competency to perform the testing to ensure the reporting of accurate results. Third, once tests are available and validated/verified and staff are trained, the laboratory goes through a process to “ramp up” the number of tests that can be performed each day. The capacity of testing also depends on other factors, such as availability of swabs and viral transport media for collecting patient samples, availability of competent staff to collect samples and run the tests in the laboratory, available personal protective equipment to keep skilled workers safe, and having access to reagents needed to perform testing.

On March 21, 2020, the U.S. Food and Drug Administration (FDA) issued the first emergency use authorization (EUA) for a rapid test.Since that time, at least one other rapid test for COVID-19 has been approved by FDA under an EUA. See the FDA’s webpage on Emergency Use Authorizations here for more information.

Please contact your healthcare provider, they will determine if you need to be tested for COVID-19 and might consult with your local health department if needed. If your healthcare provider has determined that you do not need to be tested for COVID-19, you should follow your healthcare provider’s guidance regarding any necessary treatment or self-care.

 

Page last updated: April 6, 2020