A sign displays drive-thru testing services at a pharmacy in Cary. Mark Darrough / Carolina Public Press

None of the information provided is medical advice, and individuals should consult their providers with medical questions.

What are the testing options?

Two kinds of tests are available for current infections with the COVID-19 virus: Rapid tests and PCR (polymerase chain reaction) tests.

PCRs are molecular tests administered by a nasal swab. The results typically take 24-72 hours. PCR tests are highly accurate, according to the Cleveland Clinic.

Rapid tests, or antigen tests, also use a nasal swab, but results are available in about 15 minutes, according to Yale Medicine. They can be self-administered. Medical experts recommend taking two rapid tests, hours apart. Some experts have suggested swabbing both the throat and nose for at-home tests, but the U.S. Food and Drug Administration does not advise it, and directions for the tests are limited to nasal swabbing.

Who should get tested and when?

Anyone with symptoms should get tested. The national Centers for Disease Control and Prevention’s list of potential symptoms includes:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

People who do not have symptoms but have been exposed to someone with the infection should also get tested. Any unvaccinated person with a known COVID-19 exposure should immediately get a test, according to the CDC, while a vaccinated person with a known COVID-19 exposure is encouraged to test five to seven days after close contact with an infected person.

The CDC also recommends “using a self-test before joining indoor gatherings with others who are not in your household.”

Will the tests detect omicron variant?

Early studies show the tests likely detect infection with the omicron variant but only if a person’s viral load is high. The FDA warned that at-home tests may have reduced sensitivity, but research is ongoing. PCR tests are very accurate at detecting omicron.

Will I know which variant I have if I test positive?

It is unlikely. Rapid test and PCR test results indicate whether a person is infected. Labs and the CDC test samples using genomic sequencing to determine what variants are present, but individuals do not receive those results.

The recommendations for isolation and masking are the same for any infected individual, regardless of variant.

How much do tests cost?

Free PCR testing is available throughout North Carolina. Find a free community location through the N.C. Department of Health and Human Services. Through a partnership with LabCorp, the department also offers tests by mail in limited quantities.

In addition, some rapid tests may be purchased at local pharmacies and other retailers. As of Jan. 15, private health insurers are required to reimburse the purchase of up to eight tests per insured person per month, according to a White House announcement.

The federal government is providing 50 million free at-home tests through Medicare-certified health clinics and community health centers. The government is also purchasing 500 million tests for free distribution through a website where individuals can request kits by mail.

Where in North Carolina can I find a PCR testing location?

The N.C. Department of Health and Human Services offers a free online test site finder.

North Carolinians may also request an at-home PCR test kit through a partnership between the state and Labcorp. After a request through the site, recipients are sent a self-collection test kit via FedEx Priority Overnight shipping. After collecting a sample, recipients return the kit with a prepaid FedEx label. Results are available online.

If I get a negative test but I have symptoms, what should I do?

The CDC recommends that individuals who test negative but have symptoms isolate and retest a few days later. It is possible to be infected but not yet test positive, and some studies indicate that people are highly contagious in the first few days after contracting the virus.

What do I do if I test positive?

The CDC changed guidance for positive tests, prompting some employers to reduce paid sick leave. Individuals are no longer asked to isolate for 10 days but may instead isolate for five days and wear a mask for five additional days.

People with positive tests should also ask their medical provider about possible pharmaceutical interventions such as monoclonal antibodies.

Do I need to test again at the end of isolation?

The CDC guidelines do not require additional testing at the conclusion of the isolation period, but some health care officials, including the American Medical Association, disagree with this guidance.

“A negative test should be required for ending isolation after one tests positive for COVID-19,” AMA President Dr. Gerald E. Harmon said. “Reemerging without knowing one’s status unnecessarily risks further transmission of the virus.”

If I had a positive at-home rapid test, do I need a PCR?

State guidance does not recommend a PCR following a positive rapid test, but a spokesperson for NCDHHS said individuals should consult their medical providers concerning what treatments might be available, depending on their symptoms.

Long COVID can be a recognized disability under federal law, according to the Office for Civil Rights of the U.S. Department of Health and Human Services and the Civil Rights Division of the U.S. Department of Justice. Some disability rights advocates have suggested that individuals who test positive on a rapid test also get a PCR as documentation for any future disability claims.

Can children get tests?

Yes. Children may be tested with the same tests as adults, according to the American Academy of Pediatrics.

Do I need a test to fly?

International flights require individuals 2 and older to show proof of a negative PCR test within 24 hours of flying or documentation of having recovered from COVID-19 in the past 90 days, according to the CDC.

Domestic flights do not require testing or vaccination.

What is wastewater testing?

NCDHHS takes samples from wastewater treatment plants across the state to look for evidence of the COVID-19 virus. This testing helps state experts analyze viral spread at the community level.

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Laura Lee is the former news editor at Carolina Public Press.