Overview of Testing for SARS-CoV-2 (COVID-19)


Observe: This doc is meant to offer steering on the suitable use of testing for SARS-CoV-2 (COVID-19) and doesn’t handle choices relating to cost for or insurance coverage protection of such testing.

Revisions made on August 24, 2020

  • Diagnostic testing classes have been edited to deal with testing issues and actions to be taken by people present process testing

Revisions made on July 17, 2020

  • Apart from uncommon conditions, a test-based technique is not advisable to find out when a person with a COVID-19 an infection is not infectious (i.e., to discontinue Transmission-Primarily based Precautions or dwelling isolation)

Revisions made on July 2, 2020

  • Added screening to attainable testing varieties
  • Eliminated examples – please seek advice from setting particular steering

This doc gives a abstract of issues and present Facilities for Illness Management and Prevention (CDC) suggestions relating to COVID-19 testing methods.  The CDC suggestions for COVID-19 testing have been developed based mostly on what’s presently recognized about COVID-19 and are topic to alter as further info turns into out there.

Viral Testing

Licensed assays for viral testing embody those who detect COVID-19 nucleic acid or antigen. Viral (nucleic acid or antigen) exams examine samples from the respiratory system (reminiscent of nasal or oral swabs) or saliva to find out whether or not COVID-19 is current.  Viral exams are advisable to diagnose an infection.  Some exams are point-of-care exams, usually utilized in emergency rooms, physician’s places of work, and outpatient clinics.  These exams can produce outcomes on the testing website in lower than an hour.  Different exams should be carried out in a laboratory.  If there’s not a Level-of-Care (POC) gadget or laboratory on the assortment level, samples should be despatched (ship or shipped) to a laboratory for evaluation, a course of that may take at the least 1-2 days.

For extra info on testing for COVID-19 see the Interim Tips for Gathering, Dealing with, and Testing Medical Specimens and Biosafety FAQs for dealing with and processing specimens from attainable instances.

Antibody Testing

The Meals and Drug Administration has not approved antibody testing to diagnose COVID-19, and the CDC doesn’t presently advocate utilizing antibody testing for analysis of any an infection.  In sure conditions, antibody exams could also be used at the side of viral detection exams to assist medical evaluation of individuals who current late of their diseases.  As well as, if an individual is suspected of getting a post-infectious syndrome attributable to COVID-19 (e.g., Multisystem Inflammatory Syndrome in Kids; MIS-C), antibody exams could also be used to find out prior an infection.  Antibody exams for COVID-19 can play an vital position in surveillance and epidemiologic research, which might present insights into the transmission dynamic of the virus among the many basic inhabitants.  In contrast to direct viral detection strategies that may detect presently contaminated individuals, antibody exams assist decide whether or not the person being examined was beforehand contaminated, even when that individual by no means confirmed signs.

CDC Mitigation Protocols

CDC recommends the next measures to mitigate the unfold of the virus and to guard susceptible populations:  social distancing, sporting a masks when social distancing is just not attainable, avoiding crowds, avoiding indoor crowded areas, and washing or sanitizing palms regularly.  Go to cdc.gov/coronavirus for extra info.

Issues for COVID-19 Diagnostic (Molecular or Antigen) Testing

  • You probably have signs of COVID-19:
    • In case your signs are gentle:
      • Your well being care supplier (doctor, nurse practitioner, pharmacist, and many others.) could advise a COVID-19 check.
      • If you happen to check constructive for COVID-19 or don’t get examined, it is best to self-isolate for at the least 10 days after symptom onset and at the least 24 hours after the decision of any fever (with out the usage of fever-reducing drugs).
      • You need to strictly adhere to CDC mitigation protocols in circumstances during which you can’t self-isolate, particularly in case you are interacting with a susceptible particular person (for instance an aged individual or a person with an underlying well being situation). You need to adhere to CDC pointers to guard susceptible people with whom you reside.
      • If you happen to reside with a susceptible particular person, they need to be examined.
    • In case your signs are extreme or change into extreme, it is best to contact your well being care supplier instantly or search emergency care.
    • If you happen to take a check and check constructive, you don’t want to repeat a check. Except your sickness required hospitalization, you possibly can return to regular actions (e.g., work or college) after the passage of 10 days from the onset of signs and 24 hours from when any fever has subsided by itself (with out assistance from any fever-reducing drugs).
  • You probably have been in shut contact (inside 6 toes) of an individual with a COVID-19 an infection for at the least 15 minutes however would not have signs:
    • You don’t essentially want a check until you’re a susceptible particular person or your well being care supplier or State or native public well being officers advocate you’re taking one.
      • A unfavourable check doesn’t imply you’ll not develop an an infection from the shut contact or contract an an infection at a later time.
    • You need to monitor your self for signs. If you happen to develop signs, it is best to consider your self below the issues set forth above.
    • You need to strictly adhere to CDC mitigation protocols, particularly in case you are interacting with a susceptible particular person. You need to adhere to CDC pointers to guard susceptible people with whom you reside.
  • If you happen to would not have COVID-19 signs and haven’t been in shut contact with somebody recognized to have a COVID-19 an infection:
    • You don’t want a check.
      • A unfavourable check doesn’t imply you’ll not contract an an infection at a later time.
    • If you resolve to be examined, it is best to self-isolate at dwelling till your check outcomes are recognized, after which adhere to your well being care supplier’s recommendation. This doesn’t apply to routine screening or surveillance testing at work, college, or related conditions.
  • In case you are in a excessive COVID-19 transmission space and have attended a public or personal gathering of greater than 10 individuals (with out widespread masks sporting or bodily distancing):
    • You don’t essentially want a check until you’re a susceptible particular person or your well being care supplier or State or native public well being officers advocate you’re taking one.
      • A unfavourable check doesn’t imply you’ll not develop an an infection from the gathering or contract an an infection at a later time.
    • You need to monitor your self for signs. If you happen to develop signs, it is best to consider your self below the issues set forth above.
    • You need to strictly adhere to CDC mitigation protocols, particularly in case you are interacting with a susceptible particular person. You need to adhere to CDC pointers to guard susceptible people with whom you reside.
    • In case you are examined, it is best to self-isolate at dwelling till your check outcomes are recognized, after which adhere to your well being care supplier’s recommendation.
  • If you happen to work in a nursing dwelling or a long-term care facility:
    • You’ll need to be examined, until you will have already been examined as a part of your facility’s operational plans.
    • You’ll want to be examined in case you are symptomatic. You will need to not go to work till your check outcomes are recognized.  If you happen to check constructive, until your sickness required hospitalization, you possibly can return to work after the passage of 10 days from the onset of signs and 24 hours from when any fever has subsided by itself (with out assistance from any fever-reducing drugs).
      • You’ll need testing if there’s an outbreak in your facility (i.e., a brand new COVID-19 an infection in any employees or any nursing home-onset of COVID-19 in a resident), and you will have to be examined at common intervals till the outbreak has been mitigated.
    • The upper the incidence fee within the county during which you reside or work, the extra regularly you will have to be examined.
    • Outcomes of testing can be used to tell an infection management interventions at your facility, together with choices relating to resident placement and work exclusions.
    • Observe any further steering from State and native public well being officers and the Facilities for Medicare and Medicaid Providers (CMS).
  • If you happen to reside in or obtain care in a nursing dwelling or a long-term care facility:
    • You’ll need to be examined, until you will have already been examined as a part of your facility’s operational plans.
    • You’ll want to be examined in case you are symptomatic. You will need to self-isolate till your check outcomes are recognized.  If you happen to check constructive, until your sickness required hospitalization, you possibly can return to regular actions after the passage of 10 days from the onset of signs and 24 hours from when any fever has subsided by itself (with out assistance from any fever-reducing drugs).
    • You’ll need testing if there’s an outbreak in your facility and you will have to be examined at common intervals till the outbreak has been mitigated.
    • You’ll need to be examined extra regularly in the event you go away the power frequently (e.g. for dialysis or frequent medical/different appointments).
    • Outcomes of testing can be used to tell an infection management interventions at your facility, together with choices relating to resident and affected person placement.
    • Observe any further steering from State and native public well being officers and the CMS.
  • In case you are a crucial infrastructure employee, well being care employee, or first responder:
    • It’s possible you’ll must get a check, in keeping with your employer’s pointers.
    • Even when you’ve got a unfavourable check, it is best to, always, take particular care to watch your self for signs and strictly adhere to CDC mitigation protocols.
  • State and native public well being officers could advise particular individuals, or teams of individuals, to be examined. You need to comply with this recommendation.
  • You will need to notice you can be contaminated and unfold the virus however really feel properly and haven’t any signs.
    • In areas the place there are restricted variety of new instances, State or native public well being officers could request to check a small variety of asymptomatic “wholesome individuals,” notably from susceptible populations.
    • If there’s important unfold of the virus in your neighborhood, State or native public well being officers could request to check extra asymptomatic “wholesome individuals,” notably from susceptible populations.
    • For instance, sure settings can expertise fast unfold of COVID-19. That is notably true for settings with susceptible populations in shut quarters for prolonged intervals of time (e.g., hospitals, nursing houses, and long-term care services).
      • As mentioned above, these chargeable for managing an infection in such settings ought to undertake measures to facilitate the early identification of contaminated people, together with preliminary testing of everybody within the setting, periodic (e.g., weekly) testing of everybody within the setting, and testing of recent or returning entrants into the setting.



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