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June 30, 2020

Why it can still be so hard to get a coronavirus test

Daily Briefing

    Many public health officials have urged Americans to get tested for the new coronavirus if they've taken part in activities that heightened their risk of exposure, such as recent nationwide protests. But getting a coronavirus test can be difficult and potentially costly for some people—particularly if they're not experiencing symptoms of Covid-19, the disease caused by the virus.

    The difficulty of getting a coronavirus test

    America's capacity to test people for the new coronavirus has significantly increased over the past few months, and some cities—including Boston, Seattle, and San Francisco—earlier this month said they are offering tests at no cost to anyone who says they participated in a recent protest, Kaiser Health News reports.

    However, it might not be as easy for people to access coronavirus tests in other areas. For instance, in some areas, people can access a coronavirus test only if they're prescribed by a doctor or only if they're considered an essential worker.

    Cost also could be an obstacle to obtaining a test for the new coronavirus.

    Currently, uninsured individuals can access no-cost coronavirus testing through Medicaid programs in 21 states, and health care providers can seek reimbursements for testing uninsured patients through a federal program established earlier this year. Medicare also covers the cost of coronavirus testing for beneficiaries.

    However, individuals enrolled in private health coverage may face some costs for coronavirus testing. Federal law currently requires private health plans to fully cover the cost of coronavirus tests that clinicians deem as "medically necessary." As such, some insurers may refuse to cover charges for tests that haven't been prescribed by a health care providers.

    "This is a very live and active debate right now," Sabrina Corlette, a health policy researcher at Georgetown University, said. "That requirement may only apply if you've been referred for a test by a health care professional after presenting with symptoms of the disease."

    When should you get a coronavirus test?

    Given the potential difficulties people might face when trying to access a coronavirus test, it's important that they know how to determine whether they should get tested—and that they're being tested in a way that provides them with useful information, KHN reports.

    According to KHN, people who have symptoms of Covid-19—such as fever, cough, sore throat, and trouble breathing—should immediately seek testing for the new coronavirus.

    If you're not experiencing symptoms of Covid-19 but think you might have been exposed to the virus, you should determine your risk and consider the timing of when you think you might have been exposed to the virus before seeking testing.

    According to William Miller, professor of epidemiology at Ohio State University, people can determine how great their risk of contracting the new coronavirus was by considering three questions:

    • Do they live in an area where the number of newly reported coronavirus cases is increasing each day;
    • Did they participate in an activity in which it was difficult to physically distance themselves from others; and
    • Were there people near them who were coughing, singing, or shouting and not wearing a mask.

    "If your answers to those questions are yes, the risk is greater—and so is the benefit of being tested," Miller said.

    "Any large gathering creates risk for transmission," Anne Rimoin, professor of epidemiology at UCLA's Fielding School of Public Health, said. "It's just common sense that when you have events where people are shouting or singing or chanting and in close proximity to each other, that is the perfect storm."

    People also should consider how long it's been since they potentially were exposed to the new coronavirus, experts say, as it might take some time for the virus to reach a viral load high enough for tests to detect the pathogen in a human sample. However, there's not yet scientific consensus on how long a person should wait to be tested after potential exposure. According to KHN, some experts say a person should wait at least three to four days after potential exposure to get tested, while others say people should wait at least a week.

    What to do if you can't get tested?

    In general, health experts recommend that if you believe you may have been exposed to the new coronavirus, you should limit interactions with people for 14 days after the potential exposure, regardless of whether you're able to get tested—or what the results of a coronavirus test say if you are tested.

    Given that the virus can take up to 14 days to incubate, people shouldn't feel falsely reassured by a negative test, Ravi Kavasery, a medical director at AltaMed Health Services, said.

    In addition, it's important to remember that any coronavirus test result you receive "is relevant only for the day you take it," KHN reports. That means if you test negative but then participate in another activity that may have put you at risk of exposure, you may again need to seek testing and self-isolate (Farmer, "Shots," Nashville Public Radio/NPR, 6/19; Wolfson/Galewitz, Kaiser Health News, 6/22).

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