Understanding COVID-19 Testing

Look to your doctor for guidance

Widespread availability of COVID-19 testing is critical in helping to identify and control the spread of the disease — and making sure people get the treatment they need. But we understand that the subject of testing can be confusing. Are there different kinds of tests? Who should get one? Are they covered? We want to provide information that can help reduce uncertainty and stress for you during the pandemic.

This article was last updated on June 9, 2020.

First, know the symptoms

COVID-19 symptoms may appear between two and 14 days after a person is exposed to the virus, according to the U.S. Centers for Disease Control and Prevention (CDC.) The CDC says people with the following symptoms may have the disease:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

“If someone experiences symptoms and wants to get tested, they should call their health care provider for guidance,” said Dr. Claire Levesque, chief medical officer, Tufts Health Plan, Commercial Products. “It’s important to have a discussion with them because information about testing is changing so rapidly.” Members also may consider using telehealth if they’re concerned about their symptoms or have questions.

However, if someone is showing emergency warning signs for COVID-19, they should seek emergency medical care immediately. These signs include: trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, or bluish lips or face. “Call 911 or call ahead to your local emergency facility,” the CDC states. “Notify the operator that you are seeking care for someone who has or may have COVID-19.”

Your coverage

There are no costs to members for testing and in-person treatments for COVID-19. Testing is covered when ordered by your primary care provider (PCP) or other treating provider and determined to be medically necessary in accordance with CDC and Department of Public Health guidelines. This coverage applies at in-network providers, urgent care centers, emergency rooms and other facilities, and at out-of-network providers in the event a member cannot easily find an in-network provider to provide timely services.

There are three different types of COVID-19 testing:

Diagnostic or PCR test

Doctors use this test to tell if someone is actively infected. It uses a sample of mucus, usually from a person’s nose or throat. The test looks for genetic material from SARS-CoV-2, the virus that causes COVID-19. PCR stands for polymerase chain reaction, a technology that greatly magnifies the genetic material, which is detected if a person is actively infected. Results may be available in minutes if the sample is analyzed onsite or it can take one to two days if sent to an outside lab.

Antigen test

An antigen test is used to detect current COVID-19 infection as well, but it can do so much more quickly than a PCR test, according to the U.S. Food and Drug Administration (FDA). “Each category of diagnostic test has its own unique role in the fight against this virus,” the FDA said in a statement on May 9, 2020, authorizing the first use of an antigen test. “PCR tests can be incredibly accurate but running the tests and analyzing the results can take time. One of the main advantages of an antigen test is the speed of the test, which can provide results in minutes.”

However, antigen tests are not as sensitive as PCR tests and may not detect all active infections. Antigen tests have a higher chance of false negatives, so negative results may need to be confirmed with a PCR test prior to making treatment decisions.

Antibody test

An antibody test can show if you have had a past COVID-19 infection by checking your blood for antibodies. These are proteins made by the immune system when a germ enters a person’s body. The reason this test can’t check for an active infection is because antibodies generally don’t show up for days to weeks after infection.

However, it’s not certain that antibodies measured by this test will protect an individual from contracting COVID-19 again. Also, if the antibodies are protective, it’s unknown how strong that protection might be or how long it might last.

“Individuals should not consider a positive antibody test as proof that they are immune to the disease and therefor can stop taking safety precautions,” cautions Dr. Raj Hazarika, medical director, Tufts Health Plan, Commercial Products. “An antibody test can be more helpful for public health researchers who are trying to get a sense of how the disease is spreading across a population.”

In addition, the CDC writes that antibody (serologic) tests “should not be used to make decisions about returning persons to the workplace.”

Protect yourself and others

No matter the kind of test or what results it provides, you should still practice preventive measures to protect yourself and others. Guidelines from the CDC include:

Wash your hands often
Avoid close contact – stay at least six feet away from others, do not gather in groups, stay out of crowded places, and avoid mass gatherings
Cover your mouth and nose with a face cover when around others
Cover coughs and sneezes
Clean and disinfect surfaces
Monitor your health – be alert for symptoms and take your temperature if symptoms develop

You can find more information about how to prevent getting sick here.