Where to Get a Coronavirus Test or COVID-19 Antibody Test
The coronavirus pandemic is moving so quickly that we're all suffering from information whiplash. But one constant since the outbreak began is the need for coronavirus testing, and with the country inching toward re-opening, the need for wide-spread coronavirus antibody testing is equally critical.
Antibody tests can determine whether any of us who haven't had confirmed cases of the coronavirus have been infected without realizing it. There's been discussion about the possibility of herd immunity, especially if, as some have speculated, the virus has been circulating even longer than initially thought.
And, of course, there is emerging evidence that kids—once thought to have a natural immunity to the COVID-19 pandemic—might be asymptomatic, still shedding virus, and prone to severe complications long after it leaves their systems. This makes testing for the active virus or coronavirus antibodies even more critical.
With that in mind, we've dug into some of the questions we've heard from parents, to try and get clear and concise answers when it comes to testing for both active coronavirus infections and the disease's antibodies. For answers to more coronavirus-related questions, be sure to see our posts dedicated to coronavirus FAQs for parents and parents-to-be.
Where to Get a Coronavirus Test
The CDC's website is the best place to start. It lists the official Department of Health websites for each state, which connect you to information specifically relevant to your area, including infection rates, testing site details, and more. It may take two or three clicks to find testing sites on your state's DOH website, but all the info you need should be there. Almost every state has free, contactless, drive-through coronavirus testing available somewhere by now, and the state DOH websites have info on how to access that. Some states require a referral by a physician; others do not.
Of course, if you want a test because you may have the active disease, the first place to call is your doctor, who can help determine if you need a test based on your symptoms and exposure, and also instruct you on where to go to get tested. You can also check this handy COVID-19 test site locator (created by high school students participating in MIT's Research Science Institute).
Other test resources: One Medical is offering testing sites in several cities, and CVS drug stores offer free testing in eight states.
The FDA has recently authorized an active disease test that can be done using saliva. This test, which requires a patient to spit into a collection device, appears to be as accurate as the nasopharyngeal swab, and much more pleasant, though the results may take longer to process. At-home testing, dubbed Pixel by Labcorp, is also available, with nasal swabs that don't have to go so deep into the nasal passage to collect a usable sample. Ask your doctor if either of these tests might be an option, and check to ensure your insurance covers them.
Where to Get a COVID-19 Antibody Test
Rather than testing for the presence of coronoavirus or active disease, antibody tests look for the antibodies which would be present in the blood of a patient who has been sick and recovered from COVID-19—or who has been infected without experiencing symptoms. Some antibody tests, which require a quick finger prick, can return results on the same day.
Note that an antibody test will not tell you if you have a current infection; for that you need an active COVID-19 test, as laid out above. The antibody test only tells you if you have had an infection in the past.
Antibody tests are available through a variety of sources, including first and foremost your own doctor.
A coronavirus antibody test is generally less invasive than testing for the active disease.
Which antibody test is more reliable?
This is probably the most complicated question about the COVID-19 antibody test. New test development and release have been happening more quickly than FDA approval for the tests. The process of where to find tests and whether to choose lab testing vs direct-to-consumer rapid testing and whether these tests are reliable or FDA approved has been described as a Wild West. For this reason, we strongly suggest that the best advice is to consult with your own doctor.
What's the difference between antibody and coronavirus tests?
According to the CDC, antibody testing currently requires a finger prick or blood draw, which checks an individual's blood sample to look for antibodies to the novel cornoavirus. These antibodies are produced when someone has been infected, so a positive result from this test indicates the person had the virus. It usually takes 1 to 3 weeks to develop antibodies to the virus, so the antibody tests may not be able to tell if you are currently infected.
If you believe you are currently infected, you might be directed to take a test that identifies the virus in samples from your upper respiratory system, such as a nasopharyngeal swab, which essentially involves having a long Q-tip jammed up your nostril. More recently, some sites have been offering saliva tests.
What do "false negative" and "false positive" mean?
If a patient receives a negative result with an active disease test, that means the virus was not found in the sample. A sample might not contain enough disease to register, but an individual could still have low levels of the virus. If you receive a negative test result, and your symptoms continue or worsen, inform your doctor; a second test may be needed.
A false-positive test means you tested positive for the disease but are not infected. This is quite rare with the active infection test. A false positive is less concerning, because it would just mean you isolate for a few weeks to prevent spreading an infection which you don't have. You might have a cold or mild flu instead.
False positives/negatives are more likely with antibody tests, many of which were brought to market before thorough vetting. While tracking the disease to have more data about how much of the population has been infected is beneficial to the scientific community, a positive coronavirus antibody test may give people a false sense of security.
If I have coronavirus antibodies, does that mean I'm immune?
It's still unclear whether the antibodies resulting from COVID-19 infection can protect someone from reinfection with this coronavirus (i.e. immunity), or how long antibodies to the virus keep people safe. The Atlantic's James Hamblin points out that, "Usually antibodies work very reliably, but in some cases, they barely help, and in certain diseases having some antibodies is worse than having none. This is known as immune enhancement, a phenomenon that may or may not prove relevant with this coronavirus."
You may even have read that patients with the worst reactions to COVID-19 have experienced something called a "cytokine storm," in which an overproduction of immune cells launches a surge of activated immune cells into the lungs and a secondary bacterial pneumonia infection.
In summary, while having the coronavirus antibodies may confer immunity as we all hope, there is no guarantee at this point that it does. So we should just all do as the CDC recommends and wear a mask.
Face masks, hand sanitizers, and handwashing are proven to help prevent coronavirus infections.
Are children protected against the disease?
Initially, children appeared to be safer than the elderly or immuno-compromised. There were no reports of children with life-threatening coronavirus infections, though there was some suspicion children might be carriers without suffering any symptoms. As COVID-19 continues to spread, though, a new phenomenon has been identified that has affected a small number of children: pediatric multisystem inflammatory syndrome (PMIS). The good news is early detection and treatment make a huge difference in the outcome, and children who are found to have this complication can be monitored for future heart issues, similar to Kawasaki disease. It's is still extremely rare.
Symptoms of PMIS include persistent fever, rash, abdominal pain, trouble breathing, racing heart or chest pain, irritability, decreased frequency and amount of urine, and vomiting. In New York, 110 cases were confirmed as of May 13, with 60 percent of children testing positive for the active virus, and 40 percent children showing antibodies to the virus.
What is "herd immunity"?
Herd immunity implies that enough of the population is resistant to a certain disease that the disease is effectively prevented from spreading. It's a useful concept when a vaccine is available to prevent people from contracting a disease, but it's not something that can happen soon for COVID-19. In the absence of a vaccine, achieving herd immunity for the coronavirus means more than 70% of the population would have to get sick. While some might have a mild reaction to the virus, the number of individuals who develop the life-threatening complications of the disease isn't as apparent as was initially thought.
Does insurance cover coronavirus or antibody testing?
That's the million-dollar question! (Well, the $100+ question). You may find it difficult to impossible to get a quick response from your insurance company by phone or email at the moment. Some questions might be answered on the AHIP (American's Health Insurance Plans) website, where you can scroll alphabetically to see what insurance companies are currently covering.
According to a recent report on CBS, all comprehensive health insurance plans must pick up 100% of the cost of coronavirus testing, as well as any visit to the emergency room, doctor's office, or urgent care center that may have led to that testing. That includes any coronavirus test declared appropriate by the US Department of Health and Human Services. Insurers must also provide free antibody testing for COVID-19 patients under the CARES Act that President Donald Trump signed into law last month.
According to the CMS (Centers for Medicare and Medicaid Services), plans on the group health insurance market and the individual health insurance market must comply with the coverage regulations. This includes self-insured group health plans and student health insurance coverage and covers most of the insured population. However, there are exceptions. Short-term limited duration plans do not have to comply.
Covered coronavirus-related procedures and items include:
- Urgent care visits
- Emergency department visits
- Telehealth visits
- In-person office visits
- FDA-authorized coronavirus tests
- Coronavirus tests for which developers have requested emergency authorization
- State-developed and state-authorized coronavirus tests
- Coronavirus antibody testing
For more of our coronavirus coverage for families, check out our Coronavirus and Stay-at-Home Guide.