Clarify Which Patients Need a COVID-19 Viral Test

You'll be asked who should get a diagnostic test for SARS-CoV-2.

CDC guidance about who needs a viral test continues to shift.

Plus testing capacity is limited in some areas. There are concerns high demand may even limit resources for labs to run other types of tests.

Stay on top of your pharmacy policies and state and local guidance.

Patients WITH symptoms. Continue to recommend prompt viral testing for patients with fever, cough, new loss of taste or smell, etc.

If patients test positive, don't advise retesting to see if the virus has cleared...patients can remain positive for many weeks.

Educate that patients can stop isolation after 10 days if they've been fever-free for at least 24 hours and symptoms have improved.

Patients withOUT symptoms. Recommend testing for those WITH an exposure, such as within 6 ft of someone with COVID-19 for 15 min or more.

Explain testing is needed because of the potential for asymptomatic and presymptomatic transmission...and to assist with contact tracing.

Suggest waiting at least 3 to 5 days after exposure to get tested...to limit false negatives. If the first test is negative, consider another test 7 to 10 days after exposure to confirm...depending on supply.

Tell exposed patients to quarantine for 14 days...even if tests are negative...since symptoms can take that long to develop after exposure.

For now, don't usually advise testing or quarantine for asymptomatic patients who had COVID-19 in the past 3 months and are re-exposed. Viral remnants from the prior infection could still lead to a positive test.

And don't typically recommend a test for asymptomatic patients withOUT a known exposure. But expect some people to be tested by public health, employers, colleges, etc...to help limit asymptomatic spread.

Use our COVID-19 Testing FAQs chart to interpret and report results, and review rapid tests in our COVID-19 Point-of-Care Testing chart.

Key References

  • www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html (9-21-20)
  • www.ama-assn.org/delivering-care/public-health/considerations-physicians-ordering-sars-cov-2-pcr-diagnostic-testing (9-21-20)
  • www.covid19treatmentguidelines.nih.gov/overview/sars-cov-2-testing/ (9-21-20)
  • www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html (9-21-20)
Pharmacist's Letter. October 2020, No. 361002



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