At this point, most people have had at least one COVID-19 test, but did you know there are over 6 different types of tests, and some tests are better than others?

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COVID-19 Tests Are All the Same, Right?

At this point, most people have had at least one COVID-19 test, but did you know there are multiple types of tests, and some tests have different benefits over others? Whether you’re experiencing COVID-19 symptoms, had exposure to someone who may be infected with COVID-19, or need a test to return to work/school or for travel, there are numerous options available now for COVID-19 testing. Dr. Lyn Nuse weighs in on the different tests and when, where, and how to get the right one for you and your family.

With the hike in COVID-19 cases recently, testing is top of mind for everyone, so we can keep ourselves, and our families safe, and try to keep some semblance of normalcy. But there are many tests in market, all with different accuracy and time to results. How do you know which one is right for you?

Whether you’re experiencing possible COVID-19 symptoms (such as shortness of breath, coughing, chest pain, fever, loss of taste or smell, etc.), are concerned that you’ve been directly exposed to someone with COVID-19 or need a confirmed negative test before returning to work/school or for travel, there are several options for COVID-19 testing.

Tests when you’ve got symptoms or have a known exposure

Commonly called “diagnostic testing”, there are two main testing types you can get to let a person know if they are currently infected with COVID-19:  

Test 1

PCR testing: When it comes to COVID-19 testing, PCR (polymerase chain reaction) testing is the “gold standard.”

“It’s the most accurate, because it looks for RNA, the molecular material of the virus and is sensitive enough to need a very minor amount of it in order for the virus to be detected,” says Lyn Nuse, MD, specialty medical director of general pediatrics at Atrium Health Levine Children's. ”There are very few false positives with this test, although a person can have the virus in their nasal passages without being actively infected with the virus.”

This type of diagnostic test is taken using a nasal or throat swab, and can be administered in a clinic, hospital facility, or even in your car at a drive-thru testing site. Results are typically available within 24-72 hours after a test is administered.

Test 2

“Rapid” testing:when you want results in 15 minutes or less.  

“The tradeoff for the speed is the accuracy of the test,” says Dr. Nuse.  Results from rapid testing can be turned around in 15 minutes or less, but rapid tests are less accurate than PCR tests, and any level of accuracy depends on kind of the technology behind the test.

There are several different rapid testing products out on the market right now, “Even though there are rapid tests that are accurate,” Dr. Nuse says, “it is important to understand that not all are created equal. While PCR may detect the presence of the virus over 99% of the time, the rapid test may pick it up at 90-93% of the time. It can even be as low as 60-70% of the time depending on the type of the rapid test and the timing of when you get your test done.”

This type of test is also taken using a nasal or throat swab, and is now available in many clinics, healthcare facilities and drive-thru locations.

Additional types of rapid testing include:

  • ID Now: a rapid molecular test available in many primary care offices that can detect COVID-19 in 13 minutes or less via a nasal or throat swab. 
  • At-home antigen testing: there are several at-home tests available for purchase that can detect COVID-19 in 15 minutes or less via a self-administered nasal swab. These tests are typically not as accurate because they are less sensitive than molecular tests and user errors can occur while self-testing. However, they can be a helpful tool for those unable to access professional testing. The Food and Drug Administration (FDA) provides guidance on at-home tests that have been authorized for use. The FDA found that some of these at home testing kits could have as high as 91%-96% accuracy in identifying positive cases, while identifying 96%-100% of negative cases.
  • At-home molecular testing: while the FDA has given Emergency Use Authorization (EUA) to a molecular at-home testing kit, this kit is not currently available for purchase. The accuracy of this at-home testing kit is considerably higher than the antigen tests currently available for at home testing.

Remember, no matter what kind of COVID-19 diagnostic test you get and where and when you get it, it’s important to quarantine before getting test results back and to practice social distancing and mask wearing at all times.

What if I just need a negative test to return to work, school, or to travel?

Every individual’s situation is different, so either a PCR or rapid test could be fine if your child’s school, your employer or even your travel agency is requiring a negative COVID-19 test to participate, but make sure you double check.

“As pediatricians, we’ve been in close contact with the school systems and in North Carolina, for example, officials recommend either PCR or rapid testing before returning to school, but local school systems can choose to require PCR only” says Dr. Nuse. 

Cost for a COVID-19 Test

If you need a test because you have a known exposure to or have symptoms of COVID-19, there is no out of pocket cost for you under federal law. If you need a test for return to work/school or travel with no symptoms and no known exposure, your insurance will be billed and you may have out of pocket costs, depending on your insurance plan.

Where to get tested

The testing options below will offer PCR and some rapid testing based on availability:

  • Drive-thru community testing sites: Our community testing sites offer drive-thru COVID-19 testing via self-administered swabbing at convenient locations with no appointment needed. Testing is available for those ages 5 and older, and all children under 18 must be accompanied by a parent or guardian. For more information about our community testing sites and to find a location near you, visit us online
  • Testing by appointment at area testing centers: If you prefer to set up a specific time to get tested, you can schedule an appointment at one of our area testing centers. These locations offer COVID-19 testing via self-administered swabbing for ages 5 and older, and all children under 18 must be accompanied by a parent or guardian. Find a location near you and schedule an appointment on MyAtriumHealth or call 704-468-8888. 
  • Testing by appointment at primary care offices: Testing is available at primary care offices by appointment for all ages, including those under 5. To schedule, contact your primary care provider’s office. If you don’t have a primary care provider, visit online to find one near you or call 704-468-8888

Learn more about what to expect when you arrive for your COVID-19 test. 

 For more information on testing and care options for COVID-19, visit our resource hub online.