Should you be tested for COVID-19?
Only if you are in a priority group
With the number of confirmed cases of COVID-19 in the United States topping 4.5 million, more and more people are looking to be tested, even as the recommendations for who should get tested have changed.
Here’s the current guideline: If a person is exhibiting symptoms of COVID-19, they should be tested.
When the pandemic of the coronavirus that causes COVID-19 first began in the U.S. in February, that also was the guideline. But as testing capacity increased, the guideline changed and asymptomatic people were encouraged to seek testing.
The dramatic rise in cases changed the guidelines again, as testing facilities became backlogged. Doctors at UPMC and Allegheny Health Network — along with Dr. Debra Bogen, director of the Allegheny County Health Department — have all returned to the recommendation that testing be prioritized for those who are experiencing symptoms.
Symptoms consistent with the virus include fever, cough, shortness of breath, loss of taste or smell, fatigue, muscle aches and gastrointestinal upset.
“We are recognizing that COVID presents in many
ways,” said Dr. Amy Crawford-Faucher, the vice chair of the department of family medicine at Allegheny Health Network. “That is also why we require a medical evaluation prior to ordering the test.”
A person who does not have symptoms — but knows they have been in close contact with someone who has tested positive — falls into the second category of people who have priority in testing.
The federal Centers for Disease Control and Prevention considers close contact to be any contact that happens within 6 feet of another person for more than 15 minutes.
In both of these instances — whether a person is symptomatic or suspects having contact with someone who tested positive — the person should contact their primary care physician before seeking testing. Many testing facilities require a doctor’s order and an appointment.
Another group that falls into a higher priority are people who do not have symptoms but have recently returned from somewhere that has been considered “high risk travel.”
High risk travel locations for Pennsylvania residents include 20 states and can be found on the state health department’s website.
Unless symptoms are severe, it is not recommended that people go to a hospital’s emergency department for testing. If someone thinks they have been exposed but are asymptomatic, they should self-isolate at home for two weeks.
Once a test is taken, the patient will be advised to self-isolate and likely will not hear anything from their doctor until their results are in.
If the test is positive, they will be advised by either their primary care doctor or someone from the testing facility to self-isolate at home and limit contact with other people. If they have symptoms that become severe at any time, they should seek medical help.
A physician may recommend a trip to the emergency room if the symptoms include high fever or shortness of breath. Patients should call ahead to make the staff aware that a COVID-19-positive patient is on the way.
Across Pennsylvania, many sites will not administer a test unless symptoms are present.
Dr. Raymond Pontzer, an infectious disease specialist at UPMC St. Margaret hospital, said UPMC is not testing asymptomatic individuals due to the testing capacity issues.
The same recommendations apply for children.
On July 17, the CDC shifted from a test-based strategy to a symptom-based strategy to determine when someone can end their self -isolation. Initially, a person had to have two negative COVID-19 tests more than 24 hours apart to discontinue a quarantine.
According to the newest guidelines, three things need to happen for a positive, immunocompromised patient with mild to moderate symptoms to end their quarantine:
● It must be at least 10 days since the first symptoms appeared, and improvement must be made.
● It must be at least 24 hours after the patient has had a fever without the use of fever-reducing medications.
● If the person is asymptomatic throughout, then self-isolation can stop 10 days after the date of the positive test.
The new guidelines, combined with the backlog in national testing, mean that a patient’s quarantine could be over before they get the test result. Because of this, medical professionals highly recommend that anyone who has been tested remain quarantined while they await their results.
Guidelines are subject to change based on how information about the virus evolves, and the most up to date guidelines for Pennsylvania residents can be found on the CDC website or the Pennsylvania Department of Health website.