Maybe you have symptoms or have been in direct contact with someone who just got a positive test result of their own. Regardless, here’s everything you need to know about getting a COVID test (including whether or not you need to be prepared for the dreaded nasal swab). 

Types of COVID tests (and how they’re different)

There are three tests that can detect COVID-19: molecular (also referred to as a polymerase chain reaction—or PCR—test), antigen, and antibody. According to the U.S. Food and Drug Administration (FDA), the molecular and antigen tests both fall under the same category of diagnostic tests; these actually tell you if you are actively infected with the coronavirus. The antibody test, however, tests for antibodies present in the immune system after infection—the FDA notes they can take days or weeks to appear—so while they do tell you if you have been infected with COVID-19 at one time, it is after you’ve already been infected and recovered.   “The antigen test is used to identify protein fragments from the virus, while the PCR test is really considered the ‘gold standard’ because it detects genetic material from the virus,” explains Dr. Joshua Lenchus, D.O., Chief Medical Officer at Broward Health Medical Center. “The antigen test results generally come back quickly—because of that, it has been referred to as a ‘rapid test’—[while] the PCR test results usually take a few hours to a few days, depending on the manufacturer.” The Minnesota Department of Health notes that there are different collection methods for samples, the most common being a nasal swab. Molecular tests can be done via nasal swab, oral swab or saliva test, while antigen tests are done via nasal swab. If you get an antibody test, you’ll get a finger prick for a blood sample.  “Each test’s manufacturer has information describing the preferred [method] for obtaining a specimen,” adds Dr. Lenchus. “So long as those instructions are followed, the test should be as accurate as it claims.” If you are nervous about getting tested—nasal swabs sound less than pleasant—some testing sites will have you take your own sample, under guidance, explains Dr. Cornelius Ferreira, M.D., Chair of Primary Care at Nuvance Health. “Nuvance Health does not administer nasal swab testing for COVID because it is a more efficient process for patients and staff when patients can self-swab,” specifies Dr. Ferreira. “We wanted to offer a more comfortable, yet still effective, method for our patients to get tested. Our clinical staff observes the self-swab, and of course, assist patients if they need help or are unable to do it on their own.”

Should you use an at-home COVID test?

You may have seen at-home COVID-19 tests and wondered if they are a reliable option. The short answer? Yes. The long answer? Yes, keeping in mind that all tests can have false negatives and false positives and that at-home tests have received Emergency Use Authorization (EUA) from the FDA. The FDA notes that there are no FDA-approved at-home COVID tests and that a EUA label does not mean a test is approved or cleared by the FDA.   “A number of factors go into the accuracy of a test result,” explains Dr. Lenchus. “One of those is the adequate and satisfactory collection of the specimen. Healthcare professionals undergo training to ensure the correct collection of the sample. The FDA has approved a few at-home tests under its EUA process. This facilitates the availability and use of tests, medications and other interventions during a public health emergency.” There are a number of tests on the market that have received a EUA from the FDA, including the Ellume COVID-19 Home Test ($30), which was the first to get the distinction, and the Everlywell COVID-19 Test Home Collection Kit ($109).

Does it matter where and when you get tested?

Different facilities do offer different tests, so if you are hoping to receive a certain one—molecular vs. antigen, for example—Dr. Lenchus recommends calling the testing site before going. The Centers for Disease Control and Prevention (CDC) recommends getting tested if you have symptoms or have had close contact with someone who has been confirmed to have COVID-19. “COVID-19 tests performed on people who feel sick or have symptoms are generally more reliable than those done on people who do not,” reveals Dr. Lenchus.

Where to get tested for COVID

The U.S. Department of Health and Human Services (HHS) notes that there are free, in-person COVID-19 testing sites offered throughout the country, even for the uninsured (due to the Families First Coronavirus Response Act). Pharmacies and retailers that have partnered with the HHS to offer these free tests include:

CVS HealthRite AidWalgreens, and Walmart. 

Health facilities across the country offer testing, also; to find a testing site near you, visit hhs.gov/coronavirus/community-based-testing-sites. Should you test positive, be prepared to quarantine for at least 10 days, per CDC recommendations. It is important to note that no matter your result—positive or negative—that you should still follow social distancing practices, wear a mask and wash your hands frequently.  “COVID-19 testing tells people whether they are COVID-19 positive or negative at one point in time,” notes Dr. Ferreira. “For people who have been exposed to COVID-19, this is important. They need to still quarantine for the recommended days and follow the CDC guidelines. Someone who has been exposed to COVID-19 should call their doctor’s office and set up a virtual visit, where they can discuss when and how to get tested and recommendations for quarantining. Also, if people are exposed, they should wait a few days before getting tested for better accuracy of test results.” Next up, read this breakdown on how accurate COVID tests actually are. 

Sources

Centers for Disease Control and Prevention (CDC), Updated 1/21/21. “Test for Current Infection (Viral Test).”Centers for Disease Control and Prevention (CDC), Updated 2/11/21. “When You Can be Around Others After You Had or Likely Had COVID-19.”Dr. Cornelius Ferreira, M.D., Chair of Primary Care at Nuvance HealthDr. Joshua Lenchus, D.O., Chief Medical Officer at Broward Health Medical CenterMinnesota Department of Health, Updated 12/2/20. “Types of COVID-19 Tests.”National Institutes of Health, Media Advisory, 12/15/20. “NIH-funded COVID-19 home test is first to receive over-the-counter authorization from FDA.”U.S. Department of Health and Human Services (HHS). “Community-Based Testing Sites for COVID-19.”U.S. Food and Drug Administration (FDA), Updated 11/6/20. “Coronavirus Disease 2019 Testing Basics.”U.S. Food and Drug Administration (FDA), News Release, 12/15/20. “Coronavirus (COVID-19) Update: FDA Authorizes Antigen Test as First Over-the-Counter Fully At-Home Diagnostic Test for COVID-19.”U.S. Food and Drug Administration (FDA), 4/6/20. “FACT SHEET FOR PATIENTS, Gnomegen COVID-19 RT-Digital PCR Detection Kit - Gnomegen LLC.” How to Get Tested for COVID 19  Nasal Swabs  Rapid Tests and More  - 25