Testing for COVID-19

There are different tests available for COVID-19: tests for current infection (viral tests) and tests for past infection (antibody tests.) The COVID-19 test being used depends on which test the clinician ordered and the laboratory doing the test.

Tests for current infection:

The viral 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 (nose, throat) 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. Viral tests are used to diagnose current infection with COVID-19.

Tests for past infection:

There are also tests that detect antibodies to the virus that causes COVID-19.  These tests indicate that a person’s immune system responded to COVID-19. The antibody test is NOT intended as a diagnostic test. An antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies. We do not know yet if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last.

For more information about differences between the different types of tests, please visit VDH’s Testing Webpage.

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.

To learn if you have a current infection, viral tests are used. But not everyone needs this test.

  • Most people will have mild illness and can recover at home without medical care and may not need to be tested.
  • CDC has guidance for who should be tested, but decisions about testing are made by state and local health departments or healthcare providers.
  • If you have symptoms of COVID-19 and want to get tested, call your healthcare provider first. Your healthcare provider will determine if you need to be tested for COVID-19 and might consult with your local health department if needed.
  • You can also visit the VDH COVID-19 Testing Sites page to find the nearest testing facility.
  • Although supplies of tests are increasing, it may still be difficult to find a place to get tested.

To learn if you have a previous infection, you might be interested in a serologic test. A serology test should not be used to diagnose COVID-19, but it might help identify if you have been previously infected. You can talk with your healthcare provider about whether a serology test is appropriate for you. You can find more information about serology tests on VDH’s COVID-19 Testing Site.

Viral testing uses swabs or a nasal wash to collect samples taken from the back of the nose (and sometimes from the mouth as well) which are tested for the presence of the virus that causes COVID-19.  Antibody tests check your blood for antibodies, which may show if you had a previous infection.  An antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies.

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 available through the state public health lab and some private laboratories.  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 high priority and priority testing criteria, found here (criteria revised 6/4/2020).

VDH Recommendations for prioritizing SARS-CoV-2 testing

 

Private/Commercial Lab Testing

Public Health Lab Testing

High Priority

  • Hospitalized patients*
  • Healthcare workers and first responders with COVID-19 symptoms*
  • Un- or underinsured persons with COVID-19 symptoms*
  • Residents and workers with COVID-19 symptoms* in, or newly arriving to, congregate settings (e.g., long-term care facilities, prisons, jails, or behavioral health facilities)
  • Contact and outbreak investigations
  • Residents and workers with COVID-19 symptoms* in, or newly arriving to, congregate settings (e.g., long-term care facilities, prisons,  jails, or behavioral health facilities)
  • Un- or underinsured persons with COVID-19 symptoms*

Priority

  • Persons with COVID-19 symptoms*
  • Persons without symptoms who are
    • Close contacts of cases**
    • Prioritized by clinicians based on their best clinical judgment (e.g. for medical procedures)
  • Public health monitoring, including point prevalence surveys
  • Sentinel surveillance and seroprevalence studies
  • Community testing clinics

*Description of symptoms associated with COVID-19. Atypical presentations have been described, and older adults and persons with medical comorbidities may have delayed presentation of fever and respiratory symptoms.

**A close contact is any individual within 6 feet of an infected person for at least 15 minutes starting from 2 days before the person became sick (or 2 days before specimen collection if asymptomatic) until the person was isolated.

You can find more information about testing sites and testing events in Virginia at this website. Each facility has different policies and procedures for testing; please reach out to the individual facility for information about testing availability and procedures.  Information on One-Day Testing Events is located in the table below the map on the web page referenced above.

If you test positive for antibodies (blood test), next steps will depend on the type of antibody detected. Depending on the result and your symptoms, it may be more likely that you have COVID-19 and that you may need to have an additional, diagnostic test and to isolate yourself to avoid spreading the virus to others. Other results may indicate you were infected previously. Your healthcare provider will work with you to determine how best to care for you based on the test results along with other factors of your medical history, your symptoms, possible exposures, and places where you have recently traveled. There is also the chance that this test can give a positive result that is wrong (a false positive result).

If you test negative for antibodies (blood test), that means antibodies to the virus that causes COVID-19 were not found in your sample. However, it is possible for this test to give a negative result that is incorrect (false negative) in some people with COVID-19. A negative result may occur if you were tested early in your illness and your body hasn’t had enough time to produce antibodies. This means that you could possibly still have COVID-19 even though the test is negative. If this is the case, your healthcare provider will consider the test result together with all other parts of your medical history (such as symptoms, possible exposures, and places where you have recently traveled) in deciding how to care for you. It is important that you work with your healthcare provider to help understand the next steps you should take.

You can find more information about serology tests on VDH’s COVID-19 Testing Site.

Healthcare workers or frontline responders who are ill with symptoms of COVID-19 (fever, cough, shortness of breath, chills, muscle pain, sore throat, new loss of taste/smell), 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 are offering drive-through testing for people with symptoms of COVID-19. You can find more information about testing sites in Virginia at this website. Each facility has different policies and procedures for testing; please reach out to the individual facility for information about testing availability and procedures.  Information on One-Day Testing Events is located in the table below the map on the web page referenced above.

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 sick.

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. If you test negative for COVID-19, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection when your sample was collected and that you could test positive later. Or you could be exposed later and then develop illness. In other words, a negative test result does not mean you won’t get sick later. This means you could still spread the virus.

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.

After May 31, 2020 for those patients who do not meet public health testing criteria, clinicians will need to utilize commercial laboratories. Uninsured or underinsured people in Virginia can obtain testing from the state public health lab or a commercial laboratory if they meet the testing criteria.  People without insurance are encouraged to contact a free clinic, federally qualified health center (FQHC), or urgent care center to have the specimen collected. Or, visit https://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 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.

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 to 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 molecular 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. Virginia is aiming to rapidly expand testing for COVID-19. Testing capacity at commercial and private laboratories performing SARS-CoV-2 testing continues to increase. Hospital laboratories are also performing SARS-CoV-2 testing.

Check out the following websites:

CDC COVID-19 Testing Website

CDC COVID-19 FAQs

VDH COVID-19 Website

VDH COVID-19 Testing

VDH COVID-19 Testing Sites (Information on One-Day Testing Events is located in the table below the map)

 

Page last reviewed: June 29, 2020