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The Difference Between COVID-19 Screening and Testing

March 19, 2020
Published in: COVID-19, Infectious Disease

Nurse speaking with a senior patient

We have seen confusion in the community about screening and testing for COVID-19. Lets take a look at the difference and learn why some people may be tested while others are not.

What is screening?

Screening for COVID-19 is a series of questions asked to determine a person's risk for COVID-19. They include questions about symptoms being experience, travel history in recent weeks, and exposure to someone who has been confirmed to have COVID-19. Right now, all entrants to Augusta Health (patients and support persons) are screened.

After screening and consulting with Virginia Department of Health and CDC guidelines and directives, the decision is made on whether or not a person should be tested.

Can I be tested?

As mentioned in Governor Northam's update on March 18, 2020—there are two main reasons someone would be tested for the coronavirus: having symptoms or exposure to an infected person. These are not Augusta Health established criteria for testing; they are the same criteria used by all hospitals within Virginia.

The main symptoms of COVID-19, the disease caused by the coronavirus SARS-CoV-2, are fever, dry cough and shortness of breath. These look a lot like the flu and the common cold, so it takes a physician to determine if testing for the virus is necessary. Those at higher risk—such as people over the age of 60 or with an underlying medical condition—might be considered for testing when others without those high risk factors may not.

Those who don't meet testing criteria are encouraged to stay home and continue to follow the recommended CDC preventions such as covering coughs and sneezes; not sharing household items such as glasses, dishes and bed linens; cleaning high touch surfaces like doorknobs and counters often; and washing hands frequently. People in this category should also monitor symptoms and call their healthcare provider if symptoms worsen. Once symptom-fever-free for 72 hours, social contact can be resumed.

Why are some tested for COVID-19 and others—perhaps in the same family—are not?

We spoke with David Fosnocht, MD in the Augusta Health Emergency Department for clarification.

In an ideal situation, we would like to be able to test all patients for COVID-19. Because the supplies of test kits are severely limited, and because that supply changes on a daily basis, we need to manage and triage these resources very carefully.

When the testing process for COVID-19 began, we were testing only through Virginia Department of Health, who has very strict criteria. We continue to use the Virginia Department of Health testing lab, and on Friday, March 13, we also started using the Quest commercial lab for COVID-19 testing. However, using commercial labs has not necessarily increased the supply of tests. The Quest COVID-19 testing facility is located in California, which translates to a four to five-day turnaround time for pending results. On Monday, March 16, we learned that Quest is building out their testing facility in Chantilly, Virginia, for COVID-19 testing, but do not know when that facility will be operational.

For deciding who gets tested, we have an algorithm to use to determine those in highest need of the test based on severity of symptoms, number of high-risk factors and availability of test kits. When multiple members of the same family have the same symptoms, healthcare providers generally test the sickest member of the family, recognizing that if one family member has the infection, the rest of the family members most likely have the same infection. We use the same practice with other upper respiratory infections such as the flu. This not only conserves tests, it saves the family money.

Visit our Coronavirus page for the latest information.