Clarify Which Patients Need a COVID-19 Viral Test

You’ll hear even more buzz about who should get a diagnostic test for SARS-CoV-2...now that exposures are up with many students in school.

CDC guidance about who needs a viral test continues to shift.

Plus testing capacity is limited in some areas. There are concerns high demand may even limit resources for labs to run other types of tests.

Consider these tips...and stay on top of state and local guidance.

Patients WITH symptoms. Continue to promptly test patients with fever, cough, new loss of taste or smell, etc.

If patients test positive, don’t retest to see if the virus has cleared...patients can remain positive for many weeks.

Educate that patients can stop isolation after 10 days if they’ve been fever-free for at least 24 hours and symptoms have improved.

Patients withOUT symptoms. Test those WITH an exposure, such as within 6 ft of someone with COVID-19 for 15 min or more.

Explain testing is needed because of the potential for asymptomatic and presymptomatic transmission...and to assist with contact tracing.

Suggest waiting at least 3 to 5 days after exposure to get tested...to limit false negatives. If the first test is negative, consider another test 7 to 10 days after exposure to confirm...depending on supply.

Recommend exposed patients quarantine for 14 days...even if tests are negative...since symptoms can take that long to develop post-exposure.

For now, don’t usually test or quarantine asymptomatic patients who had COVID-19 in the past 3 months and are re-exposed. Viral remnants from the prior infection could still lead to a positive test.

And don’t typically test asymptomatic patients withOUT a known exposure. But expect some people to be tested by public health, employers, colleges, etc...to help limit asymptomatic spread.

Use our COVID-19 Testing FAQs chart to review the types of tests...and for guidance on interpreting and reporting results.

Key References
  • www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html (9-23-20)
  • www.ama-assn.org/delivering-care/public-health/considerations-physicians-ordering-sars-cov-2-pcr-diagnostic-testing (9-23-20)
  • www.covid19treatmentguidelines.nih.gov/overview/sars-cov-2-testing/ (9-23-20)
  • www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html (9-23-20)
Prescriber's Letter. October 2020, No. 361015


Get concise, unbiased advice for effective drug therapy, plus CE/CME

Prescriber's Letter includes:

  • 12 issues every year, with brief articles about new meds and guidelines
  • 48+ CE courses, including the popular CE-in-the-Letter
  • Quick reference drug comparison charts
  • Access to the entire archive

Already a subscriber? Log in

Volume pricing available. Get a quote