COVID-19 Testing: What You Need to Know

Editor's note:

Updated on 5/16/2020 to reflect changes in New York City guidelines.

By
Columbia Health
May 11, 2020

There are many different coronavirus tests out there. They fall into two main groups – diagnostic tests and antibody tests. This information is intended to help you understand these tests and determine whether either may be right for you.

Jump to:

A nasal swab being administered to an individual

Novel Coronavirus Diagnostic Test 

Diagnostic or PCR tests are used to determine whether you currently have the virus.

Quick facts about diagnostic testing in New York City

  • New York State is increasing efforts to provide tests to diagnose those who may currently have the novel coronavirus. 
  • The New York City Department of Health recommends diagnostic testing for:
    • All people who are symptomatic:
      • Any person with new-onset signs or symptoms consistent with COVID-19.
    • Close contacts of a person confirmed with COVID-19:
      • Any person, with or without symptoms, who had close contact within the previous 14 days to a person confirmed with COVID-19, especially household contacts and intimate partners.
    • Congregate residential setting staff:
      • Any person, with or without symptoms, who works in a residential facilities designed especially for elderly persons requiring supportive services, such as a nursing home, shelter or adult care facility.
  • As testing supplies continue to increase, criteria for and availability of testing may change. 

Are you eligible to get a diagnostic test?  

Currently in New York City, the diagnostic test must be ordered by a health care provider.

To learn if you meet criteria for testing, please consult with your health care provider, fill out the online assessment through the New York State Department of Health (NYSDOH), or call the New York State COVID-19 Hotline at 1-888-364-3065 and they will fill out the screening assessment with you over the phone.  

Those who meet testing criteria through the NYSDOH testing assessment will receive a call from a scheduler to make a testing appointment at a local testing site, including walk-in and drive-through testing locations throughout the state.  

Do you need to pay? 

At this time, the diagnostic test is free to all eligible New Yorkers if you have been recommended to get tested after calling the New York State COVID-19 hotline at 1-888-364-3065 or completing the NYSDOH online assessment.  

If you get tested but NOT with the NYSDOH testing program, and you have health insurance, insurance plans and providers MUST cover the cost of the diagnostic test and related office visit (no matter whether the visit was telehealth, in-person, urgent care, or emergency room). This means you should not be charged any co-pays or coinsurance for these services.    

If you get tested, but NOT with the NYSDOH testing program, and do not have health insurance, you may be charged for the tests and related services. However, if your healthcare provider can verify that you do not have health insurance through an individual, employer-sponsored, Medicare or Medicaid plan, you may not be charged if they are able to submit for reimbursement for the charges from the CARES Act Provider Relief Fund. If you do pay for services and your health care provider is later reimbursed for those charges through the program, your health care provider must reimburse you for what you were charged. 

What can you expect when you arrive at the testing location?  

If you have been advised to get a diagnostic test, please proceed to the testing location. Please wear a face covering while you travel to the location and maintain physical distancing measures. 

The way a sample is collected will depend on what sample collection method(s) are in use at that location. The health care professional will be wearing protective equipment including a mask, face shield, gown and gloves. 

Sample collection methods include: 

  • Nasal-pharyngeal swab: a health care professional will insert a swab (like a long-stemmed Qtip ®) into one of your nostrils and roll it around, making sure they leave the swab inserted for several seconds to absorb secretions. They will then remove the swab. If they did not collect enough fluid from one nostril, they may repeat the process on your other nostril.  
  • Saliva sample and self-administered swab: a health care professional will provide you with a clean glass/plastic vial for your saliva sample and a small swab (regular Qtip ® sized) to collect your nasal samples. They will provide instructions for how to correctly spit into the vial and to use the swab to collect fluid from your nostrils. The health care professional will observe the collection process and gather your samples upon completion.  

When will you get diagnostic test results? What can you do with the information afterwards? 

The speed at which individuals receive results from their tests vary. Please ask the health care provider when you can expect your results. Test results may be sent to individuals via phone, text message, or can be accessed by individuals through an online patient portal. 

If you test positive, this means you currently have a COVID-19 infection: Stay home, separate yourself from others in your home, and continue to monitor your symptoms. Some people may have a positive test while they have symptoms, and others will not have any symptoms, but they are considered infectious to others. Some people may continue to have a positive test even after they are feeling better, though it is unclear if they remain infectious to others. If you have an emergency warning sign (including bluish lips/face, trouble breathing, persistent chest pain/pressure, disorientation), call 911. The Centers for Disease Control and Prevention (CDC) provides additional guidance.

If you test negative, this means you do NOT have a COVID-19 infection at the time the test was taken: This could change tomorrow or next week. Please continue to practice essential prevention measures as recommended by public health officials: shelter in place, wear a face covering when physical distancing is unsustainable, wash your hands frequently, sanitize frequently touched surfaces, avoid touching your face with unwashed hands, and cough/sneeze into your elbow or cover it with a tissue and throw it away immediately. 

Novel Coronavirus Antibody Test 

Antibody or serologic tests determine evidence of the body’s immune response to the SARS-CoV-2 infection. They are not used to diagnose a current infection and are currently used to look at a population (rather than individual) level for patterns of prior infection (seroprevalence), for understanding of the immune response to the virus, or for identification of COVID-19 convalescent plasma donors. Antibody tests detect antibodies that are produced in response to germs in the body, including viruses and bacteria. Antibodies usually take about 3 to 4 weeks to develop in the body after an infection. 

Quick facts about antibody testing in New York City

  • New York State is conducting antibody testing to determine the rate of novel coronavirus infection as a way to inform health policy. It is not used to diagnose if someone has a current active infection. 
  • While antibody testing is increasingly available at private testing facilities and commercial labs, none of the available tests have been approved by the Federal Drug Administration (FDA). Some of these tests may not be very accurate in detecting antibodies. At this time, this test is not a clear indicator of immunity to the novel coronavirus so may not inform whether it is safe for you to go back to work or engage in other activities without risk. 

Are you eligible to get an antibody test?  

New York State and New York City are conducting outreach to specific groups for antibody testing to evaluate the city population’s exposure to coronavirus.  

Private testing facilities and commercial labs are providing antibody tests at this time but are not directly associated with the New York State Department of Health’s efforts. The state is prioritizing antibody testing for essential workers only. 

Thus, public health officials do not recommend universal antibody testing for the novel coronavirus at this time.  

Do you need to pay? 

Antibody tests are being prioritized by New York State for essential workers. Individuals who are given the antibody test under the direction of government health officials do not have to pay for the test.  

Insurance plans and providers MUST cover the cost of the antibody test and related office visit (no matter if the visit was telehealth, in-person, urgent care, or emergency room). This means you should not be charged any co-pays or coinsurance for these services.  

If you get tested, but not with the NYSDOH testing program, and do not have health insurance   you may be charged for the test and related services. However, if your healthcare provider can verify that you do not have health insurance through an individual, employer-sponsored, Medicare or Medicaid plan, you may not be charged if they are able to submit for reimbursement for the charges from the CARES Act Provider Relief Fund.  

If you do pay for services and your health care provider is later reimbursed for those charges through the program, your health care provider must reimburse you for what you were charged.   

As described previously, public health officials do not recommend antibody testing for all individuals at this time.  

What can you expect when you arrive at the testing location?  

If you have been advised to get an antibody test, please proceed to the testing location. Please wear a face covering while you travel to the location and maintain physical distancing measures. 

A health care professional will collect a sample from you. They will sterilize one of your fingertips and prick your finger to collect small drops of blood on a piece of paper called a dried-blood spot card. Once the card dries, it will be sent to the lab for testing. Alternatively, they may take a traditional blood sample from your arm. 

When will you get antibody test results? What can you do with the information afterwards? 

Regardless of results, please continue to practice essential prevention measures as recommended by public health officials: shelter in place, wear a face covering when physical distancing is unsustainable, hand wash frequently, sanitize frequently touched surfaces, avoid touching your face with unwashed hands, and cough/sneeze into your elbow or cover it with a tissue and throw it away immediately. To know if you are currently infected, you must get a diagnostic test. 

Antibody tests at this time do not tell us if you are protected from future infections or are unable to transmit virus to other people.


Sources:
Centers for Disease Control

Food and Drug Administration

New York City Department of Health

New York State Department of Health