When should I get tested?

Infection and Spread Testing and Contact Tracing

Introducing Nerdy Guest Ajay Sethi, PhD, MHS. Dr. Sethi is a leading infectious disease epidemiologist at UW-Madison’s School of Medicine and Public Health. (@AjayKSethi on Twitter!)
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Q: When should I get tested? When I’m sick? When I have specific symptoms? When I’m sick and not getting better after several days? When a family member is sick, or tests positive? What about when my kid’s babysitter’s dad tests positive??? What about if I’m just… worried?

A: First and foremost, if you want a test, you can get a test. That was not true at the beginning of the epidemic, but it is now. However, the current surge in cases in the much of the U.S. has resulted in long lines in many areas of the country, especially at places that do not give you an appointment. There are also delays in getting the results back.

But don’t let any of this stop you from getting tested because testing is super important. Testing is the only way for you to know for sure if you have COVID, get the proper medical care, and keep yourself from spreading the virus to others.

There are two reasons to get tested for COVID: 1) symptoms you are experiencing, and 2) recent exposures you have had. The test you will get is a PCR test, and it requires you to deal with a cotton swab inserted up both of your nostrils to areas you have never picked. It’s momentarily uncomfortable but not painful. The test will detect the presence of SARS-CoV-2, the virus that causes COVID.

You should absolutely get tested as soon as you experience symptoms, however mild they might be. Call your health care provider for guidance and telephone screening. You may be directed to get tested through your health system or be asked to go to a community testing site. The most common symptoms of COVID are fever, cough, and shortness of breath. Other symptoms include weakness, fatigue, nausea, vomiting, diarrhea, and changes to taste and smell. If you are experiencing something not listed here, let your doctor know because COVID symptoms are wide ranging, and we are still learning about all of them. Be prepared to tell your healthcare provider when the symptoms started and what kinds of exposures you have had to people with COVID, to indoor and outdoor gatherings or crowded environments, and to any high-risk exposure at your place of work.

If you or someone is having emergency warning signs of COVID, or any other kind of emergency for that matter, do not wait, and call 911. For COVID, the most worrying signs are having trouble breathing, persistent pain or chest pain, a new experience of confusion, an inability to waken or stay awake, or bluish lips or face.

You, your kid’s babysitter, and anyone else should get tested if either of you were in close contact with someone who tested positive for COVID within 14 days, whether or not there are symptoms at the time. The CDC estimates that up to 40% of people who have COVID are asymptomatic, and they are capable of spreading the virus to others. Some will stay asymptomatic throughout infection and some will go on to develop symptoms within 14 days.

The entire household of your kid’s babysitter would need to be tested for COVID if one of them tests positive. It’s a myth that children do not transmit COVID to other children and adults. This is what makes reopening schools so complicated, but I digress. Moreover, children are more likely than adults to have no or only mild symptoms, but they can still spread the virus to others. So, all of this means that the babysitter should not come over to watch your kid until you know that they test negative for COVID and that they have not been exposed to anyone who has COVID for 14 days.

If you or anyone tests negative after being exposed to someone with or suspected to have COVID, continue to monitor your symptoms for 14 days after the last time of having high-risk contact. Get tested again, if you begin to experience any COVID-like symptoms.

Finally, if you ever test positive for COVID, follow directions given by your healthcare provider, monitor for escalating symptoms and warning signs, and be prepared to be isolated while you recover. Let your household members know along with anyone you recently spent time with and can conveniently call, so they can get tested, too. Hopefully, a contact tracing specialist from your local public health department will reach out to you soon after you receive the positive test result. Let them know about places you’ve been and everyone you have been in close contact with in the previous two weeks. If they get tested quickly, and isolated if necessary, we can slow and maybe even stop the spread of COVID in the community.

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