Which coronavirus test should I take?

It will be quite a while until most people in this region are vaccinated against COVID-19. Knowing whether you have the coronavirus — and which test to get if you think you’ve been exposed — continues to be important.

Last year, even months into the pandemic, testing could be extremely hard to come by. Drive-through test sites, urgent care centers, and hospitals across the region recorded lines out the door with long wait times, especially around the holidays.

Now, as the first anniversary of spring 2020’s lockdowns approaches, fewer Americans than ever are getting tested. And a February 2021 STAT-Harris Poll found that 25% of Americans found gaining access to testing was still a challenge.

Yet there are more options than ever for finding out whether you’ve been infected by the virus: at-home tests; in-person rapid tests at designated locations; or the “gold standard” polymerase chain reaction (PCR) test, available at urgent care centers and hospitals if you’re willing to wait a few days for results.

According to the Food and Drug Administration, there are three categories of tests: molecular tests, antigen tests, and antibody tests.

Both molecular tests — which include the PCR test, and antigen tests, commonly referred to as rapid tests — diagnose active coronavirus infections. They’re typically taken with a nasal swab, although some PCR tests are taken with a saliva sample.

Antibody tests, which are taken through a finger-drawn blood sample, show whether you’ve been infected by coronavirus in the past; they cannot detect an active infection.

Some alternatives include combination tests that look for the flu and the coronavirus at the same time. Saliva tests allow you to spit into a tube rather than get your nose or throat swabbed — these may be more comfortable for some people.

Which test should you take? Ultimately, that comes down to what you want to know by getting the test and how quickly you need the results. The two most common tests are the rapid antigen and PCR tests.

With rapid tests, as the name implies, you can expect results in just a few hours. If your rapid test comes back positive, the FDA advises that you isolate and schedule a PCR test to confirm the result.

Some testing scenarios

For a look at some testing scenarios, WHYY News consulted RapidTests.org, a volunteer group of more than 50 leading infectious-disease physicians, epidemiologists, and scientists from research universities across the world.

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I have symptoms of COVID-19. I am isolating, but I don’t want to isolate unnecessarily.

In this situation, a PCR test is recommended, to figure out if the symptoms are due to COVID or something else. In the meantime, continue to isolate and consult a physician if the symptoms persist.

I just found out a close contact tested positive for COVID-19, but I feel totally fine.

If you were maskless around someone who has tested positive, you may have been exposed to the virus. If you’re able to isolate while waiting for results and want to know if you’ve been infected, a PCR test will return the clearest results in a few days.

If you’re unable to isolate and want to know if you are highly contagious today, a rapid test is advised so you can get results as quickly as possible.

I work in a small business. We wear masks and try to stay distant, but we are in a small space, sharing the air all day. I don’t want to accidentally infect my co-workers.

Here, the question is whether you are currently contagious with the virus. A rapid test is recommended here, to get results as quickly as possible and start following current public health guidelines for close contacts.

I’ve been invited to my neighbor’s backyard for a party; I know there will be food, so people will have to remove their masks. I don’t want to infect my neighbors.

Large gatherings are discouraged in Pennsylvania, New Jersey, and Delaware. If you’re in Pennsylvania, for all locations with maximum occupancies under 2,000 people, attendance is capped at 15% occupancy.

If your gathering is in accordance with state guidelines, a rapid test is the best course here to find out if you’re contagious.

I received a vaccine. I know that it might not protect me from getting infected and transmitting the virus to others. I want to do my part to control the pandemic.

Dr. Anthony Fauci, the well-known face of the National Institute of Allergy and Infectious Diseases,  says two people who receive the vaccine can gather together with “extremely low” risk of transmitting the virus.

“You can start getting together as individual people, even though the risk is not zero,” he told CNN last week.

In this case, the question is whether you are currently infected with the virus, so a rapid test is advised. If the test comes back positive, stay home. If negative, you can go about your normal activity, but continue to follow all public health measures.

I’m a kid. I go to school. I want to know if I’m contagious today and don’t want to get my friends and teacher sick. And I don’t want my friends to get me and my family sick.

A rapid test is best in this situation, since results are required in a timely manner. If positive, stay home. If negative, you are probably not highly contagious.

I believe I was contagious for COVID a few months ago, but am not contagious now. How do I find out if I had COVID?

An antibody test is recommended in this case. The Centers for Disease Control and Prevention says that adults with “mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset.”

If you’re now past the infectious window, the only way to find out is by testing for the presence of antibodies that were created by your body to kill the virus. A positive antibody test does not necessarily require isolating or quarantining. Although the present antibodies may provide protection against future coronavirus infections, the CDC says it doesn’t know “how much protection the antibodies may provide or how long this protection may last.”

What if I want to take a flight somewhere?

According to the CDC, you should not travel if you are sick (COVID or otherwise), diagnosed with COVID-19 (even if you don’t have symptoms), or have been around someone with suspected or diagnosed COVID-19 in the past 14 days (even if they did not have symptoms). For foreign travel, all air passengers entering the United States, including U.S. citizens, are required to have a negative COVID-19 test result (or documentation of recovery from COVID-19) before they board a flight to the United States.

You are required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and stations.

Philadelphia International Airport suggests checking the testing requirements of your destination before scheduling your flight. If you require a COVID test, one can be provided for you at the Jefferson Health COVID-19 Testing Clinic located in the pre-security area of Terminal E (to the left of the Terminal E security checkpoint). The site has multiple testing options, including an antigen test and a PCR test. A Rapid PCR test will be available in the future.

What if my scenario is not listed above?

For any other questions about coronavirus testing, refer to the Pennsylvania Department of Health website, or New Jersey’s or Delaware’s, or visit RapidTests.org for more information on the differences between the tests.

To find a testing location, use the following links for:

• Pennsylvania
  • Bucks County
  • Chester County
  • Delaware County
  • Montgomery County
  • Philadelphia
• Delaware
• New Jersey

To stay up to date with the latest pandemic updates, visit https://whyy.org/coronavirus/.