What to do when you think you need a COVID-19 test

Do's and don'ts when you have symptoms or have been exposed to the coronavirus

Dr. Brian Tjarks wears full-body personal protective gear at a drive-thru coronavirus testing site.

So you wake up in the morning and you’re not feeling well. Invariably these days, you will wonder whether it’s COVID-19 that is making you ill.

Or, you receive word that someone you’ve been in close contact with recently has the virus.

In either case, you ask yourself: What should I do now?

There are two different answers to these all-too-common COVID-19 questions:

First, if you have symptoms that match up with those most often associated with COVID-19, you should contact your provider.

“Try to arrange to be seen or get a test depending on what (your provider’s) preference is,” said Dr. Jeremy Cauwels, senior vice president of clinic quality at Sanford Health and medical officer for Sanford Health Plan. “That would apply to anyone who has symptoms of COVID.”

Do seek a COVID-19 test

At Sanford Health, there are three common ways to seek a test:

  • Log in. The quickest way to investigate COVID-19 testing is to log in to your My Sanford Chart to request an e-visit. It’s easy from there. Follow the prompts and submit your request. A Sanford provider will respond to you within four hours.
  • Call your clinic. Call to ask your primary care provider’s office whether they recommend a test. For the benefit of patients and health care providers working at these sites, please call rather than going to your clinic.
  • Call a nurse. If you’re new to Sanford Health, or you don’t have a primary care provider, call My Sanford Nurse to learn about your next steps for care.

Do reserve rapid tests for emergencies

In some cases, individuals with mild symptoms, or none at all, are seeking rapid-testing options at hospital emergency rooms. These are situations health care providers want to avoid.

“We reserve the rapid tests for people who are currently in the hospital and people we think will likely need to be in the hospital,” said Dr. Doug Griffin, vice president and medical officer of Sanford Fargo.

In those cases, accurate and efficient diagnosis can be crucial.

“We want to know if somebody is COVID-positive or not because they need a certain type of isolation if they are COVID-positive,” Dr. Griffin said. “If somebody has symptoms and it’s not COVID, they do not need the type of isolation that we give for COVID patients.”

Do quarantine if you’re a close contact

If you think you’ve been exposed to COVID-19 but are not experiencing symptoms, the CDC and Sanford do not recommend testing initially. Instead, Dr. Cauwels advises self-quarantine. That is, work or attend school from home. Wear a mask when you need to leave your home. Limit your interaction with other people.

The CDC recommends testing after seven days under these conditions, though a negative test should not end the quarantine.

“Try to isolate yourself for 14 days,” Dr. Cauwels said. “Unfortunately, that’s currently not an adjustable sentence. What many people have done is go out and get a test on day three or day five, for instance, and think if you’ve tested negative it’s OK to go out in the real world. But our recommendation is that you can’t test out of quarantine.”

Don’t leave quarantine early

As doctors continue to learn about the disease, the quarantine time may be adjusted. For now, though, it’s 14 days. On Sept. 18, the CDC updated its guidelines, emphasizing the importance of self-quarantine and testing for those who have been in contact with people who have the virus.

The CDC’s reasoning: People can spread the virus before they show symptoms or without showing symptoms at all.

“The CDC has re-emphasized the fact that many people do not have symptoms with COVID,” Dr. Cauwels said. “That’s why they recommend the 14-day quarantine. They’re trying to keep people who have been exposed separate enough from other people so they do not spread the virus. That’s the goal and that’s why the CDC re-confirmed that work.”

Don’t ignore other illnesses

Nurses can order a test within the Sanford system when patients have the appropriate symptoms. These tests can involve the Sanford drive-thru or your clinic.

“The easiest thing to do is to call your doctor and ask, ‘Do I need to come in for this, or go through the drive-thru for this?’” Dr. Cauwels said. “If you’re healthy and do not have a lot of medical problems, it’s very reasonable to call My Sanford Nurse and talk your way through it. If you have lots of medical problems, it’s better to call your doctor’s office and make sure they know that you’re sick in some way.”

Doctors are finding that some who are sick with non-COVID-19 illnesses are deciding that because they’ve tested negative for the virus, they’re not in need of medical attention at all. That can be a dangerous assumption.

“A doctor may look at them and think, ‘Well, it’s not COVID but you still need care,’” Dr. Cauwels said. “For those folks who carry along the burden of other illnesses, it’s important that their doctor knows about them being ill.”

Do wear a mask, social distance, wash hands

Tests have become more available since the virus became part of our lives. Those needing tests can get them at drugstore chains and sometimes at school.

“These tests are typically easier to give to people,” Dr. Cauwels said. “But they may not be perfectly accurate. And that’s fine — it’s still an excellent screening tool and useful in that regard. But I still think it’s important that you make sure you keep your doctors involved and your health care team involved.”

While testing has become an increasingly effective way of tracking the virus, it’s not the ultimate answer, Dr. Cauwels said. Preventive measures remain the best way to stay healthy.

“The screening process isn’t nearly as important as wearing a mask, keeping your social distance and keeping your hands clean,” Dr. Cauwels said. “What we’re seeing very clearly is that big events — things like weddings and other events — are what cause the transmission of this disease. When people ask about the best ways to keep yourself healthy, it’s still about wearing a mask, keeping your distance and washing your hands.”

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Posted In Coronavirus, Emergency Medicine, Family Medicine, Frequently Asked Questions, Internal Medicine

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