6 Scenarios Where You Should Get a COVID-19 Test and What to Expect

Even as more people become fully vaccinated against COVID-19, testing is still a crucial measure in curbing the spread of the novel coronavirus.

"Testing is important for us to be able to have public health measures to prevent people from being infected in the first place," says Lisa McFarlane, PhD, director of laboratory services at Atlantic Health System in New Jersey.

Why? Because an estimated one-third of people with COVID-19 don't show any symptoms, according to a January 2021 review in ​Annals of Internal Medicine​.

"We need to be able to identify those people and have measures in place to prevent them from infecting others," McFarlane says.

That's not to say you should necessarily run out and get swabbed every single day. Rather, follow these guidelines for situations that warrant a COVID test.

If you have COVID-19 symptoms — which include fever, cough, shortness of breath or loss of taste and smell — your doctor might recommend getting tested, per the Mayo Clinic, regardless of your vaccination status, according to the CDC.

But being symptomatic is not the only reason to get a COVID-19 test. If you live in an area where tests are available, here are other scenarios when it's appropriate — even necessary — to get tested.

This might include health care or a nursing-home setting.

"If you're working in a situation where you do have high contact with sick patients, it's also imperative to be tested somewhat frequently," McFarlane says.

People who work in health care are considered a high priority because they come in contact with vulnerable populations, per the CDC.

This could mean anyone 65 and older as well as people with underlying health conditions like heart disease and diabetes, along with illnesses that weaken your immune system, like lupus.

"If they're infected, it could cause the infection to spiral out of control," McFarlane says. You should also get tested if you're a caregiver for someone at high risk, she adds.

Given that tests are only so accurate, you should also monitor for signs and symptoms, says Ravina Kullar, PharmD, a spokesperson for the Infectious Diseases Society of America. Symptoms show up an average of about five days after exposure to the virus, with most patients seeing symptoms within 12 days, per a July 2020 article in the ​Journal of the American Medical Association​ (JAMA).

This might actually be out of your hands. Many facilities are requiring COVID-19 tests before a procedure or surgery, Kullar says. Once you have a negative result, then you can go in. The Anesthesia Patient Safety Foundation recommends that all patients get tested before non-emergency surgery.

Atlantic Health System, where McFarlane works, requires patients to be tested before procedures.

"We went from testing symptomatic patients who came into institutions or doctors' offices to now broad-based testing of everybody," she explains. "And certainly from the hospital perspective we do try to protect patients and employees as well."

The coronavirus travels with extreme speed and efficiency. "If you've been in contact with someone who has actually tested positive, absolutely, absolutely, yes, you should seek out a test," McFarlane says.

If you're fully vaccinated and do not display any COVID-19 symptoms, you no longer need to be tested after exposure to someone who is sick, according to the CDC.

Similarly, if you tested positive for COVID-19 within the past three months and have recovered, you don't need to get tested after coming in contact with someone with symptoms, per the CDC, as long as you don't have any symptoms.

Fully vaccinated people can begin to return to some more populated indoor and outdoor activities, according to the CDC, but it's still important for unvaccinated people to steer clear of crowds and wear masks if crowds are unavoidable.

After being somewhere you couldn't physically distance yourself to avoid potential COVID-19 exposure, the CDC still recommends testing — regardless of whether you know of anyone else in the group who develops COVID-19.

"You likely don't know everybody in that crowd, and you don't know what their practices are," Kullar says.

And keep in mind that as many as half of all transmissions may be through people who have no symptoms, per a June 2020 model in the ​Proceedings of the National Academy of Sciences​.

Shelter in place. While you're waiting, "you should be isolating and quarantining yourself," says Matthew G. Heinz, MD, a hospitalist in Tucson, Arizona. You also shouldn't be visiting with high-risk folks, even if it's just to deliver a meal, he adds. And it definitely means avoiding crowds.

"The test is only as good as your behavior," McFarlane says. "If you've taken a test today and you still are going to high-risk environments, you do run the risk of actually being infected after. Therefore, the results would not be an indication of your current status."

The gold standard for detecting potential active infections of COVID-19 is the reverse transcription-polymerase chain reaction (PCR) test, Kullar says.

PCR tests vary slightly, but all involve nasopharyngeal swabs, which means getting a sample from the area inside your nose and the back of your throat, according to Johns Hopkins Medicine.

Some collect samples from deep inside your nose. "That's the most accurate," Kullar says. It's also the most uncomfortable because the swab makes a deep dive. Fortunately, it only lasts a couple of seconds.

The "mid-turbinal swab" doesn't penetrate as far but may not be as accurate, McFarlane says. There are also new antigen tests to diagnose COVID-19, according to the U.S. Food and Drug Administration (FDA). The tests look for proteins on the surface of the virus, but these antigen tests are not widely used.

There are now several COVID-19 tests you can take at home. Some require a prescription, but others are available over-the-counter at major retail stores like CVS, Walmart and Walgreens, and they can deliver results in just a few minutes. Some tests have you swab the inside of your nose, while others test your saliva, according to the CDC.

You can see the full list of self-tests that have been approved for use on the FDA's site.

If you need to be tested for an active COVID-19 infection (for any of the above reasons) and can't get tested by a health care provider, you should consider using a home test, per the CDC.

Just keep in mind that we don't yet know for sure how accurate the COVID at-home tests are. The FDA found that some self-tests were up to 96 percent accurate for negative results and 100 percent accurate for positive results, but more research needs to be done. Meanwhile, the PCR test you'd get from your doctor is still considered the gold standard in COVID testing.

If you get a positive test result, the CDC recommends telling your health care provider, isolating yourself from others, telling your close contacts and seeking medical care if your symptoms becomes severe or concerning.

Antibody tests are different from PCR diagnostic tests for SARS-CoV-2, per the CDC, and are not used for diagnosing COVID-19.

Antibodies are produced when your body mounts an antibody response to an infection. That means antibody tests tell you if you have had COVID-19 in the past, but not if you have a current infection, per the CDC. Antibodies can take one to three weeks to develop after you've been infected.

Some testing sites, including Johns Hopkins Medicine, require appointments. Drive-through testing or pharmacy testing sites may not.

COVID-19 tests are available for free at certain locations, per the U.S. Department of Health and Human Services (HHS). That applies to people who have insurance and those who do not. If you do have insurance, it's a good idea to call your insurance company ​before​ you get the test to find out the cost, as prices can vary widely.

The person taking the sample should be wearing multiple layers of safety gear, such as protective clothing, a mask, a face shield and gloves. You'll likely be asked to follow appropriate social distancing recommendations and wear a mask before and after the actual test.

During the test itself, swabs will be used to take samples from the back of your throat and inside your nose. No, this isn't a comfortable experience, but fortunately, the test is quite brief — it'll be over in mere seconds, per Johns Hopkins Medicine.