Q&A on testing: Who needs it and how to get it
Q: How many people have been tested?
A: As of Tuesday, more than 27,600 tests have been conducted in California, according to the state Department of Public Health.
That includes tests by public health labs and commercial and private labs. About 15,555 results have been received and approximately 12,100 are pending. The test involves taking a sample with a swab to the throat or nose.
Nationally, 328,800 tests have been conducted, according to the COVID Tracking
Project, a database compiled by journalists at the Atlantic.
It is unclear how many people have been tested counties in report each county how many in California. people have Some been tested, while other counties report only how many positive cases they have. Now that private companies and some university labs are doing testing, they don’t always report the results right away to county health departments. On Tuesday, health officials in six
Bay Area counties banded together to issue an order requiring all private and university labs to turn over more results data as they work to stitch together a more complete picture of the virus’ impact on the region.
Q: Is testing going to increase?
A: Yes — but it’s hard to say when, and how much.
Twenty-two public health labs in California are now authorized to do testing. Two of the largest U.S. commercial labs, Quest and LabCorp, also are processing tests, and have a combined capacity to run 45,000 tests each day nationally. Testing capacity nationally is expected to reach 100,000 people per day by this week, according to the think tank American Enterprise Institute, which is tracking testing capacity. However, that may not necessarily mean that 100,000 people will get tested each day, because there continues to be a shortage in the actual tests and components needed to make them.
Many diagnostics companies are working quickly to develop their own tests, but they are being shipped out to hospitals and other health care providers in varying numbers, making it difficult to determine exactly how many tests are available at any given time. Abbott, for instance, received authorization from the Food and Drug Administration this month for its COVID-19 test and immediately shipped 150,000 tests out to a number of states. It expects to make 1 million tests per week by the end of March.
Q: What is the holdup in doing more testing?
A: Initially, there was a massive backlog because every test had to go through the Centers for Disease Control and Prevention labs in Atlanta. In some cases, people weren’t getting results for two weeks. The CDC began sending testing kits to state labs in mid-February, but those first kits were faulty and had to be recalled. Usable testing kits didn’t make it to state labs until the end of February.
But all of the kits were still coming from the CDC, which hasn’t been producing enough to meet demand. The FDA has tried to speed up approval of nonCDC tests to allow commercial and academic labs to begin testing, but that process took time, and it wasn’t until the last couple weeks that private companies started introducing their own tests.
Meanwhile, shortages continue for some key components in the test kits — primarily swabs and vials. It is unclear why this is the case in the U.S., while South Korea has been able to make tests widely available and report results within hours. One explanation is that South Korean health officials appeared to act earlier in the outbreak. In late January, just a week after that country reported its first confirmed case, government officials urged medical companies to develop test kits for mass production, while the U.S. did not act as quickly to do so.
Q: Who should get tested?
A: This answer has shifted with time — and continues to be dynamic, public health experts said. Technically, anyone can be tested now at a doctor’s discretion. But there are not nearly enough tests to do that.
Initially, the CDC would test only people who had recently traveled to China or who had been in close contact with someone who had already been diagnosed with COVID-19. But at the end of February, a Solano County woman with no known risk factors tested positive, four days after her doctors said they had requested a test and been refused. Her case became the fist known “community-acquired” infection in the United States, and not long after, the CDC agreed to expand testing.
Now, health care providers are prioritizing testing for health care workers, people who work with older adults who are at risk of serious illness and first responders. They are also prioritizing people who are very ill and already hospitalized or at the emergency room. Some health care systems are beginning to expand testing beyond that to include people who show symptoms of fever, shortness of breath and dry cough, particularly if they are 60 or older or have chronic health conditions.
Q: Should I be getting tested?
A: The answer is probably no.
People over 60 or who have underlying health problems like heart disease or diabetes should call their doctor if they have a fever and cough. Their doctor will probably advise them to keep an eye on their symptoms and check in if they get worse.
As more testing becomes available, this group of people will likely be prioritized for testing.
Health care workers and people who work with seniors should also call their doctors if they have symptoms. They, too, may be prioritized for testing.
But most people do not need, and should not ask for, testing for coronavirus. About 80% of people who are infected will experience only mild symptoms and won’t require medical care.
Plus, there is no treatment for COVID-19, so even if a test comes back positive, the course of care won’t change.
People who have a fever and respiratory symptoms should stay home and keep their distance from others as much as possible. They should not demand a coronavirus test, unless they have reason to think they may be at risk of serious illness or they work with vulnerable communities.
Q: Should I get an in-home test?
A: Probably not, at least not now. Several medical startups in recent weeks began rolling out, or were preparing to roll out, test kits that could be delivered to your doorstep by a courier. Patients could take a saliva or throat swab, follow the instructions on putting the sample in a vial, and place the kit outside their doorstep, and a courier would take it to a lab. The FDA late last week warned consumers it had not authorized hometest kits, and the companies suspended sales. But the FDA has acknowledged the potential value of home testing and is working with test developers, so in-home tests may later become available once they are evaluated for accuracy and efficacy.
Q: Can I get same-day results?
A: For the most part, no.
At the new Hayward fire station test site, which opened Monday, results come back in as little as six to nine hours, or the next day, because the lab that processes the tests is in nearby
Menlo Park and runs them almost immediately. People who were tested Monday are receiving their results Tuesday, according to a spokesman for the city of Hayward. Stanford Medicine provides results within 24 hours because the institution developed its own test that it processes at its own lab, cutting down on processing time.
The vast majority of test sites send the samples to a lab offsite, like Quest or LabCorp, and results generally take two to seven days because it takes time to ship the samples, and time for the labs to receive enough samples to run a batch of tests.
The FDA on Friday authorized a test that reports results in 45 minutes, made by the Sunnyvale diagnostics company Cepheid, but it will be used primarily in hospitals and emergency rooms for very ill patients — not at urgent care or drive-through testing sites. Cepheid plans to start shipping the tests and make them available by March 30. A hospital must have a specific Cepheid diagnostic machine, called the GeneXpert System, to process the test and return results in 45 minutes. Cepheid said there are GeneXpert Systems in Bay Area hospitals, but declined to say which ones.