*Average Read Time: 5 minutes
It was a ways into the pandemic before I had to get tested for the first time. As someone suspected of having been “patient zero”, I actually got an anti-body test before I ever got tested for COVID. I was one of the first people I knew to get an anti-body test. Which initially came back negative. I then got a second anti-body test a few weeks later, that came back positive. The unfortunate truth is most anti-body tests are not very accurate. I suppose had I sought a third anti-body test as a “tie breaker” I may have felt a bit more confident either way, but I got busy with Mask-Four-Mask and moved on with my life.
So when I finally sought testing, I actually really had no idea what was what and what kind of test I should be getting for highest accuracy. Many people I know have expressed similar bewilderment so I thought it might be valuable to put together the necessary info in one short, sweet, helpful blog post.
1. Molecular Test (aka RNA or PCR test)
These diagnostic tests are considered the most sensitive for detecting an active infection, and the results are highly accurate. You might take one if you or your doctor think you have COVID.
In most cases, a health care provider will collect mucus from your nose or throat using a specialized swab. (Some molecular tests now use saliva, which people may find more comfortable.) Molecular tests are often called PCR tests, short for polymerase chain reaction, the lab technique used to detect the virus's genetic material. Turnaround time varies from minutes to days or longer, depending on whether the sample is analyzed onsite or sent to an outside lab.
Tests using a nasopharyngeal swab—the one that goes deep into your nose to the back of your throat—are still considered the gold standard. But in recent months, at home test kits have become available. These test kits allow people to collect their own sample (mucus or spit) and ship it overnight to a lab for analysis. These test kits are easy to use and perhaps less intimidating than long-swab testing used in health care settings.
I've personally opted for the at home Labcorp Pixel Test every time I’ve been COVID tested since fall of 2020. It’s easy, simple, fast, and most insurance providers (including mine – I have Cigna) cover the cost of the test completely. However, if you do not have insurance, the cost is excessive at $119.
2. Antigen Test (aka rapid test)
This type of diagnostic test is often called a "rapid test" because the turnaround time is much quicker than an RNA/PCR test. It's also cheaper to produce. As a result, antigen tests are being used to screen large numbers of people, quickly, and are being used in settings like airports.
From a patient's point of view, antigen testing works in much the same way as molecular testing. Your health care provider will swab the back of your nose or throat to collect a sample for testing. But instead of waiting days for your results, an antigen test can produce a result in an hour or less. If you test positive, it's probably correct: Antigen tests are highly accurate. The problem is, these tests are more likely to miss active infection. Meaning they have a high propensity for false negatives. So if you have COVID symptoms but test negative, your doctor may order a molecular test just to rule out a false negative.
My issue with these tests is that so many people often walk around with COVID and are asymptomatic. So if they’re just getting a rapid test for the sake of proving let's say, to their employer, that they’re safe after traveling without any time spent in quarantine, the likelihood that they might have COVID is still possible and potentially likely and this test will not catch these cases. Meaning your co-worker who went to Mexico for a four day weekend could come back and within 24-72 hours get a rapid test – test negative – but actually be carrying and therefore, unknowingly putting you and everyone else in your work place at risk for infection.
3. Antibody Test (aka serology test or blood test)
This test looks for antibodies to the coronavirus. Antibodies are proteins your immune system produces to fight off a foreign invader like a virus. A COVID-19 antibody test cannot diagnose active coronavirus infection. All it tells you is whether you've been infected at some point in the past, even if that occurred months ago. Antibodies do not become detectable until at least several days after an infection has started.
There are no FDA-authorized, at-home antibody tests. You'll have to see a health care professional, who will take a blood sample via a finger prick or a blood draw from a vein in your arm. The vast majority of these tests are performed at a central lab, which can take a couple of days to process. But the FDA just approved the first antibody point-of-care coronavirus test, making it possible for doctor's offices, hospitals, urgent care centers, and emergency rooms to get an answer within 15 minutes using blood from a person's fingertip.
Antibody testing isn't recommended until at least 14 days after the start of symptoms, says the Mayo Clinic. If you test too early—while your immune system is still mounting its defense—it may not provide an accurate result. Sometimes antibody testing is done along with viral testing when someone seeks care late in the course of their illness. It may also help confirm a diagnosis of Multisystem Inflammatory Syndrome in Children, a condition linked to COVID.
If you have antibodies to SAR-CoV-2, does that mean you have immunity against future COVID infections? Researchers still don't know for sure, but recent studies suggest that past bouts may provide some level of protection.
Of course, the best way to remain COVID free is still the same. Adhere to social distancing guidelines, wear a sufficient mask with a filter or double mask, and quarantine as needed. But if you must get tested, I hope this has cleared up a little confusion.
Stay safe, stay stylish, stay humble.
Founder & CEO, Love Saves Apparel PBC