Understanding COVID-19 Testing Options

posted by Jordan Reed on Friday, April 17, 2020

As our community continues its efforts to control the spread of the COVID-19 pandemic, understanding the related testing procedures illustrates the importance of pursuing measures to reduce a widespread outbreak which would stress local and regional resources.

Testing for SARS-CoV-2, the virus which causes COVID-19, requires that a swab is inserted into the nose to the back of the throat. If virus is present, it will be collected in the swab, which is then placed in a vial containing liquid, or in a chemical used to perform the test. The liquid containing virus is then tested in one of two ways.

• Laboratory testing: State public health laboratories, research institutions, and large national reference laboratories have the ability to conduct a test for SARS-CoV-2 called Reverse Transcription-Polymerase Chain Reaction (RT-PCR). This test uses specialized equipment to look for the presence of viral genetic material in the sample. Presence of viral genetic material would indicate a positive test meaning someone has COVID-19, while no genetic material in the sample would be a negative test, meaning they do not have an infection. Locally, this test is performed at either the State Hygienic Lab at the University of Iowa or at Avera in Sioux Falls, SD.
• Rapid testing: Smaller analyzers, typically the size of a counter top kitchen appliance, are able to perform rapid molecular testing. In this test, one sample is put onto the small analyzer and undergoes a process where a chemical breaks down the virus releasing its genetic material. The genetic material is then copied and read by the analyzer. If enough genetic material is present in the sample, the test is positive. If no genetic material is detected, the test is negative. Spencer Hospital, along with 12 other healthcare facilities in Iowa, recently received the Abbott ID Now, a rapid molecular testing platform for SARS-CoV-2, from the State Hygienic Lab. This will allow Spencer Hospital to test patients and receive results in 13 minutes or less from the time the sample is received.

In addition to the tests above, recent media attention has   focused on what is called serological testing. In this test, a blood draw would be performed and examined for the presence of antibodies, which are specialized proteins your body makes in response to a specific infection, like COVID-19. In other words, this test would determine if someone has ever had an infection caused by a virus, rather than detecting the virus itself. Serological testing is under development and will be important in studying COVID-19 and developing vaccines and other treatments.

Initial testing for SARS-CoV-2 in the US was limited by a delayed national response, quality control issues, manufacturing difficulty, bureaucracy, and limited collection and testing material supply. In order to avoid completely depleting state and national testing capability, organizations like the Centers for Disease Control and State Health Departments developed criteria for testing which limited tests to those at high risk of infection, developing serious illness, or infecting others. Since those initial criteria were developed, local and state testing capabilities have improved, resulting in expanded testing criteria.

While local and state testing capabilities are improved, it is important for everyone to understand that testing supplies continue to be limited. As a result, the volume of tests needed that would allow children to return to school, business to open, and friends to meet again, simply are not available. The ability to quickly and effectively test a larger portion of the population will be a vital component in lifting current restrictions in place to slow the spread of the SARS-CoV-2 virus and prevent a COVID-19 outbreak. Until that time, it continues to be vitally important to continue to follow public health guidance, such as social distancing, in order to protect our family, friends, neighbors, and community.