Testing
CDC UPDATE ON CRITICAL INITIATIVES AND ACTIVITIES
A. Expanding Testing and Advising Testing Practices
Extensive, rapid, and widely available COVID-19 testing is essential. CDC is working within the “All-of-Government and All-of-America Approach” to increase testing capacity and availability to improve case detection and contact tracing though all phases of the US plan to Opening Up America Again. As the supply and nature of tests expand, testing criteria have been broadened to include a wider range of people and situations.
Prioritizing Patients for Testing: Current recommendations for testing:
https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
Focusing Testing Efforts: CDC is working across the US government to support diverse efforts to increase testing in multiple settings to support diagnosis, surveillance, and outbreak control:
• Testing for Diagnosis and Clinical Management:
CDC is working with federal government partners to support hospitals, healthcare systems, clinics, and public health departments to ensure the capability to diagnose COVID-19 infections with a turnaround time needed for appropriate clinical care and public health decision-making.
CDC is:
o Working with federal government partners to provide a wide range of technical assistance resources to each state to help them develop a state-specific testing plan that meets their unique needs.
o Equipping state public health laboratories with sufficient quantities of devices, reagents, and testing supplies in the International Reagent Resource (IRR).
o Working with the White House Coronavirus Task Force to enhance the national supply of reagents and testing supplies so that the commercial market is able to supply state efforts. This supply should be sufficient to achieve a rate of less than 10% positive tests for COVID-19 among symptomatic, asymptomatic, and pre-symptomatic individuals.
• Testing for Surveillance and Outbreak Control:
Identify newly emergent cases or clusters of COVID-19 among symptomatic and asymptomatic individuals who are prioritized by public health officials and clinicians, and improve reporting of COVID-19 cases to public health systems.
CDC is:
o Utilizing established, nationwide surveillance systems to identify any areas of potential COVID-19 outbreaks, including use of CDC’s Influenza-Like Illness Network and the National Syndromic Surveillance Program.
o Enabling public health systems at state, local, territorial, and tribal levels to develop a robust system to identify COVID-19 infections, particularly among vulnerable populations such as residents of nursing homes, people of racial and ethnic minority groups (e.g., African Americans, American Indians, Alaska Natives) at higher risk of disease, and those in areas of high social vulnerability, closed settings, and congregate housing.
o Supporting existing case-based surveillance efforts for identifying infections through routine testing of persons in clinical encounters.
o Enhancing case investigation and contact tracing efforts through increased public health staff and rapid testing capability.
o Working with point-of-care diagnostic test manufacturers and state health departments to improve reporting of results from rapid, point-of-care devices
o Evaluating various serologic assays for use in surveillance and for potential use for returning to work.
Defining Usage:
CDC is working with state, local, and other partners to define the circumstances where testing of asymptomatic persons is likely to be helpful in controlling the pandemic, as well as the best application of surveillance serologic testing.
• Emerging evidence suggests that asymptomatic infections play an important role in the epidemiology of SAR-CoV-2 infections. Testing for asymptomatic infection should focus (1) on persons with an increased likelihood of infection and (2) on settings with particularly vulnerable populations.
• CDC is working to identify indications for serologic testing. Broadly, the purpose of serologic test falls into two categories: serologic surveillance of populations and serologic testing of individuals to determine if they have had a prior infection. This current CDC COVID-19 test is not currently designed for individual use (i.e., to test people who want to know if they have been previously infected with SARS-CoV-2). Serologic surveillance has the potential to provide important insights into the transmission dynamics of disease, as well as a more complete picture of total burden of COVID-19 infections in a community or among first responders and front-line health providers. More information is needed to determine how the results of serologic testing correlate with possible immunity.
• See Appendix D and https://www.cdc.gov/coronavirus/2019-ncov/lab/serology-testing.html for additional details on testing strategies, testing of asymptomatic infections, and serologic testing.[/vc_column_text][vc_column_text]Two kinds of tests are available for COVID-19: viral tests and antibody tests.
- A viral test tells you if you have a current infection.
- An antibody test tells you if you had a previous infection.
An antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies. We do not know yet if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last.
Who should be tested
To learn if you have a current infection, viral tests are used. But not everyone needs this test.
- Most people will have mild illness and can recover at home without medical care and may not need to be tested.
- CDC has guidance for who should be tested, but decisions about testing are made by state and localexternal icon health departments or healthcare providers.
- If you have symptoms of COVID-19 and want to get tested, call your healthcare provider first.
- You can also visit your state or local health department’s website to look for the latest local information on testing.
- Although supplies of tests are increasing, it may still be difficult to find a place to get tested.
Results
- If you test positive for COVID-19 by a viral test, know what protective steps to take if you are sick or caring for someone.
- If you test negative for COVID-19 by a viral test, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. The test result only means that you did not have COVID-19 at the time of testing.
If you test positive or negative for COVID-19, no matter the type of test, you still should take preventive measures to protect yourself and others.
For healthcare professionals
For information on evaluating and testing, see recommendations for reporting, testing, and specimen collection.
For public health professionals
For information on antibody surveillance, see objectives and types of surveys.
For laboratorians
For information on CDC viral and antibody testing, see information on CDC lab tests.
Viral tests check samples from your respiratory system (such as swabs of the inside of the nose) to tell you if you currently have an infection with SARS-CoV-2, the virus that causes COVID-19. Some tests are point-of-care tests, meaning results may be available at the testing site in less than an hour. Other tests must be sent to a laboratory to analyze, a process that takes 1-2 days once received by the lab.
If you test positive or negative for COVID-19, no matter the type of test, you still should take preventive measures to protect yourself and others.
How to decide if you should get a viral test
Not everyone needs to be tested for COVID-19. Here is some information that might help you make decisions about getting a viral test.
- Most people have mild illness and can recover at home without medical care. They may not need to be tested.
- At this time, there is no treatment specifically approved for people who have COVID-19.
CDC has guidance for who should be tested, but decisions about testing are made by state and local health departments or healthcare providers.
How to get a viral test
COVID-19 testing differs by location. If you have symptoms of COVID-19 and want to get tested, call your healthcare provider first. You can also visit your state or localexternal icon health department’s website to look for the latest local information on testing. Although supplies of tests are increasing, it may still be difficult to find a place to get tested.
In late April, the U.S. Food and Drug Administration (FDA) authorized a viral test that lets you collect a respiratory sample at home. However, you will still need to send your sample – a swab of the inside of your nose – to a laboratory for analysis. The home collection kitsexternal icon will be available through healthcare providers in most states in coming weeks.
What to do after a viral test
Guidance on Interpreting COVID-19 Test Results pdf icon[610 KB]external icon: A guide for interpreting test results and determining what actions to take.
To get your test result, please check with the group that performed your test, such as your healthcare provider or your health department. Check the CDC website to locate your health department information. How long it will take to get your test results back depends on the test used.
- If you test positive for COVID-19, know what protective steps to take If You Are Sick or Caring for Someone.
- If you test negative for COVID-19, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection when your sample was collected and that you could test positive later. Or you could be exposed later and then develop illness. In other words, a negative test result does not mean you won’t get sick later. This means you could still spread the virus.
For healthcare professionals
For information on evaluating and testing, see recommendations for reporting, testing, and specimen collection
Antibody tests are available through healthcare providers and laboratories.
If you test positive or negative for COVID-19, no matter the type of test, you still should take preventive measures to protect yourself and others.
How to get an antibody test
Guidance on Interpreting COVID-19 Test Results pdf icon[610 KB]external icon: A guide for interpreting test results and determining what actions to take.
Check with your healthcare provider to see if they offer antibody tests.
- If you test positive:
- A positive test result shows you have antibodies that likely resulted from an infection with SARS-CoV-2, or possibly a related coronavirus.
- It’s unclear if those antibodies can provide protection (immunity) against getting infected again. This means that we do not know at this time if antibodies make you immune to the virus.
- If you have no symptoms, you likely do not have an active infection and no additional follow-up is needed.
- If you have symptoms and meet other guidelines for testing, you would need another type of test called a nucleic acid test, or viral test. This test uses respiratory samples, such as a swab from inside your nose, to confirm COVID-19. An antibody test cannot tell if you are currently sick with COVID-19.
- It’s possible you might test positive for antibodies and you might not have or have ever had symptoms of COVID-19. This is known as having an asymptomatic infection, or an infection without symptoms.
- If you test negative:
-
- If you test negative for COVID-19 antibodies, you probably did not have a previous infection that has gotten better. However, you could have a current infection. It’s possible you could still get sick if you have been exposed to the virus recently, since antibodies don’t show up for 1 to 3 weeks after infection. This means you could still spread the virus.
- Some people may take even longer to develop antibodies, and some people may not develop antibodies.
- If you have symptoms and meet other guidelines for testing, you would need another type of test called a nucleic acid test, or viral test. This test uses respiratory samples, such as a swab from inside your nose, to confirm COVID-19. An antibody test cannot tell if you are currently sick with COVID-19.
For healthcare professionals
For information on evaluating and testing, see recommendations for reporting, testing, and specimen collection
CDC’s work in antibody testing
CDC is evaluating commercial tests
CDC is evaluating the performance of commercially manufactured antibody tests in collaboration with other government agencies. FDA has authorized emergency use of several antibody tests.
For more information:
CDC is conducting serologic surveillance
CDC is looking at data from antibody tests to estimate the total number of people who have been infected with SARS-CoV-2 in the United States. CDC is also using antibody testing to learn more about how the body’s immune system responds to the virus and to explore how the virus spreads among people exposed to it. The information CDC is looking at comes from many groups, including blood donors and household contacts of people who had symptoms and were diagnosed with COVID-19.
CDC is supporting state, local, tribal and territorial laboratory capacity.
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