TMA Explainer: COVID-19 Testing Options

You think you might have COVID-19. What testing options exist to help you verify that? Texas Medical Association (TMA) physicians have answers, as the ongoing surge in Texas COVID-19 tallied 35,572 new confirmed cases reported Wednesday, mainly due to the highly contagious omicron variant.

“This wave of Omicron COVID-19 infection is causing severe disease in many people. So we need testing results to help us make wise decisions about how to protect and care for ourselves and those around us,” said Donald Murphey, MD, chair of TMA’s Council on Science and Public Health, and a member of the TMA COVID-19 Task Force. Doctors are hopeful Texas can decrease the spike in omicron cases. However, they continue to urge vigilance to achieve that, advising everyone to get fully vaccinated with booster shots, wear masks, quarantine if necessary, and isolate if sick. Testing can help people choose which action to take.

There are two primary types of tests.

Polymerase chain reaction (PCR) tests are physicians’ “gold-standard” as the most reliable tests, but people can only access them at the doctor’s office, emergency department, or another medical setting. In addition, PCR test results take a few days for lab analysis.

“PCR testing is more definitive. If you have more severe symptoms, are fragile, or have complex medical issues, seek testing with your doctor; they likely would use a PCR test,” Dr. Murphey said.

Rapid antigen tests are also precious because you can purchase them in retail settings like drug stores and online, but they can be less consistent than PCRs in detecting the virus early and late in the infection. These rapid tests take less than an hour and can identify positive cases. Some recommendations are to test with these at least 48 hours after symptoms arise or five days after exposure to someone with coronavirus. 

While you wait to take a test – assuming you don’t feel symptoms – quarantine if you are not up to date on your vaccinations and wear a mask while around others if you are up to date. “Up to date” means you have received your COVID-19 booster dose if you are eligible. Therefore, if you are experiencing COVID-19 symptoms, you should isolate them regardless of your vaccination status.

Dr. Murphey said it is best to take these tests “if you are getting sick or you were exposed to COVID-19, especially if you are fairly healthy and have mild symptoms.”

“The test cards using a nasal swab are quick, easy, and reliable for this purpose,” he said. “If your test is positive and you have symptoms or were exposed, you are infected. If the test is negative, wait a day and repeat once or twice, especially if you suspect you have the virus. If you remain negative and your risk is low, it is unlikely you are infected.”

Neither type of test can detect which COVID variant you have, only whether you have the virus.

TMA recently detailed recommendations about quarantine and isolation of people exposed to COVID-19 if they believe they are sick and what type of mask to wear.

The federal government now requires group health insurance plans to cover the cost of over-the-counter, at-home COVID-19 tests. Some home-use tests are in short supply, however. And just last week, the Biden administration announced it allows every home in the U.S. to order four free at-home tests, one order per household, which will ship as early as late January via the U.S. Postal Service.

But buyer beware: Federal authorities are warning people about fake diagnostic tests. The Federal Trade Commission recently offered tips on avoiding phony testing products:

  • Make sure the test you’re purchasing is approved by the Food and Drug Administration (FDA), using FDA’s list of tests approved for home use;
  • Check out a seller before you buy by searching online for a website or company plus words like “scam,” “review,” or “complaint;” and
  • Pay by credit card so you can dispute the charge if you never get your tests or the product is not as advertised.

Visit the Texas Department of State Health Services web page for reputable testing sites.

The bottom line: Testing helps you and your doctor know if your symptoms are from the coronavirus and how to evaluate treatment options. “If you have COVID-19 infection and are at risk of hospitalization, you can get treated early to prevent severe disease later,” Dr. Murphey said. “Having had COVID in the last three months gives you some protection from another COVID-19 infection, so it also is good to know if you had prior infection.”

But it all starts and ends with vaccination. “Your risk of having severe COVID-19, going to the hospital, needing oxygen, needing to go to the ICU, needing a ventilator, or dying, is fantastically reduced if you get immunized,” Dr. Murphey said. “Vaccinations are the way we get through this without people dying.”

TMA is the largest state medical society in the nation, representing more than 56,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 has been to improve the health of all Texans. TMA’s Vaccines Defend What Matters initiative helps Texans make informed vaccination decisions for themselves and their families. Vaccines Defend What Matters is funded in 2022 by the TMA Foundation thanks to significant support from H-E-B, TMF Health Quality Institute, Permian Basin Youth Chavarim, and gifts from physicians and their families.

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