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Coronavirus Illness 2019 (COVID-19)


Observe: This doc is meant to offer steerage on the suitable use of testing for SARS-CoV-2 in gentle of extra testing capability all through the nation and doesn’t deal with selections relating to cost for or insurance coverage protection of such testing.

Abstract of Current Modifications

As of October 21, 2020

  • Added hyperlinks to the up to date shut contact definition.
  • Up to date language to align with up to date definition and to align with sitewide adjustments

View Earlier Updates

This doc gives a abstract of concerns and present Facilities for Illness Management and Prevention (CDC) suggestions relating to SARS-CoV-2 testing technique.  The CDC suggestions for SARS-CoV-2 testing have been developed based mostly on what’s at present recognized about COVID-19 and are topic to alter as extra info turns into obtainable.

Viral Testing

Approved assays for viral testing embrace those who detect SARS-CoV-2 nucleic acid or antigen. Viral (nucleic acid or antigen) checks verify samples from the respiratory system (equivalent to nasal or oral swabs or saliva) to find out whether or not an an infection with SARS-CoV-2, the virus that causes COVID-19, is current. Viral checks are beneficial to diagnose acute an infection of each symptomatic and asymptomatic people, to information contact tracing, remedy choices, and isolation necessities Some checks are point-of-care checks, that means outcomes could also be obtainable on the testing website in lower than an hour. Different checks should be despatched to a laboratory, a course of that will take not less than 1-2 days.

For extra info on testing for SARS-CoV-2 see the Interim Tips for Accumulating, Dealing with, and Testing Scientific Specimens and Biosafety FAQs for dealing with and processing specimens from potential instances.

Antibody Testing

FDA has not approved utilizing antibody checks to diagnose SARS-CoV-2 an infection, and CDC doesn’t at present advocate utilizing antibody testing as the only foundation for analysis of acute an infection. In sure conditions, serologic assays could also be used to assist scientific evaluation of individuals who current late of their diseases when used at the side of viral detection checks.  As well as, if an individual is suspected to have a post-infectious syndrome attributable to SARS-CoV-2 an infection (e.g., Multisystem Inflammatory Syndrome in Youngsters; MIS-C), serologic assays could also be used.

Serologic assays for SARS-CoV-2 an infection, are an vital instrument for surveillance and epidemiologic research, equivalent to understanding the transmission dynamic of the virus within the common inhabitants. In contrast to direct viral detection strategies, equivalent to nucleic acid amplification or antigen detection checks that may detect acutely contaminated individuals, antibody checks assist decide whether or not the person being examined was beforehand contaminated—even when that individual by no means confirmed signs.

CDC Mitigation Protocols

CDC recommends the next measures to mitigate the unfold of the virus and to guard folks at elevated danger of extreme sickness:  social distancing, carrying a masks when social distancing is just not potential, avoiding crowds, avoiding indoor crowded areas, and washing or sanitizing arms ceaselessly.

Issues for SARS-CoV-2 Diagnostic (Molecular or Antigen) Testing

  • You probably have signs of COVID-19:
    • In case your signs are delicate:
      • Your healthcare supplier (doctor, nurse practitioner, pharmacist, and so forth.) might advise a SARS-CoV-2 check.
      • In case you check optimistic for SARS-CoV-2 an infection or don’t get examined, you need to self-isolate for not less than 10 days after symptom onset and determination of fever for not less than 24 hours, with out the usage of fever-reducing drugs, and with enchancment of different signs.
      • In case you reside with a individual at elevated danger of extreme sickness (for instance an aged relative or different people with underlying circumstances), take particular precautions within the house to guard that particular person in response to CDC tips.
    • In case your signs worsen while you’re isolating, or develop into reasonable/extreme, equivalent to shortness of breath or extreme fatigue, contact your healthcare supplier instantly or search emergency care.
    • In case you check optimistic, you don’t want to repeat a check for not less than 3 months.
    • You do not want a follow-up unfavourable check to return to work or college, so long as
      • You didn’t require hospitalization, AND
      • It has been not less than not less than 10 days after symptom onset and determination of fever for not less than 24 hours, with out the usage of fever-reducing drugs, and with enchancment of different signs.
  • You probably have been in shut contact (lower than 6 ft for a complete of quarter-hour or extra) with documented SARS-CoV-2 an infection and should not have signs.​
    • You want a check. Please seek the advice of together with your healthcare supplier or public well being official. Testing is beneficial for all shut contacts of individuals with SARS-CoV-2 an infection. Due to the potential for asymptomatic and pre-symptomatic transmission, it will be significant that contacts of people with SARS-CoV-2 an infection be shortly recognized and examined. Pending check outcomes, you need to self-quarantine/isolate at house and keep separated from family members to the extent potential and use a separate bed room and toilet, if obtainable.
      • A single unfavourable check doesn’t imply you’ll stay unfavourable at any time level after that check.
      • Even when you’ve got a unfavourable check, you need to nonetheless self-isolate for 14 days.
    • In case you can not self-isolate, or you’re a important infrastructure employee that should work, put on a masks, bodily distance, keep away from crowds and indoor crowded locations, wash your arms ceaselessly, and monitor your self for signs.
    • In case you reside with a individual at elevated danger of extreme sickness (for instance an aged individual or different people with underlying medical circumstances), take particular precautions within the house to guard that particular person in response to CDC tips.
    • Healthcare suppliers in shut contact of an individual with documented SARS-CoV-2 an infection whereas utilizing beneficial private protecting tools, don’t should be examined
  • In case you should not have COVID-19 signs and haven’t been in shut contact with somebody recognized to have SARS-CoV-2 an infection (that means being inside 6 ft of an contaminated individual for not less than quarter-hour).
    • You do not want a check except beneficial or required by your healthcare supplier or public well being official.
    • If you’re examined, you need to self-quarantine at house till your check outcomes are recognized, after which adhere to your healthcare supplier’s recommendation.
    • A unfavourable check doesn’t imply you’ll stay unfavourable at any time level after that check.
  • If you’re in a excessive SARS-CoV-2 transmission zone and attended a public or personal gathering of greater than 10 folks (with out common masks carrying and/or bodily distancing).
    • Your healthcare supplier or public well being official might advise a SARS-CoV-2 check.
    • If you’re examined, you need to self-isolate at house till your check outcomes are recognized, after which adhere to your healthcare supplier’s recommendation.
    • A unfavourable check doesn’t imply you’ll stay unfavourable at any time level after that check.
    • Even when you’ve got a unfavourable check, you need to put on a masks, bodily distance, keep away from crowds and indoor crowded locations, wash your arms ceaselessly, and monitor your self for signs.
    • Take particular precautions within the house to guard any individual(s) with elevated danger of extreme sickness in response to CDC tips.
  • In case you work in a nursing house,
    • You will have testing as a part of a nursing house’s plan to open or reopen, if not beforehand examined.
    • It is advisable to be examined if you’re symptomatic. You will need to self-isolate and never go to work till your check outcomes are recognized. In case you check optimistic, you need to self-isolate for not less than 10 days after symptom onset and determination of fever for not less than 24 hours, with out the usage of fever-reducing drugs, and with enchancment of different signs.
    • You will have testing if there may be an outbreak in your facility, and repeat testing at common intervals in case your preliminary check consequence was unfavourable till the outbreak is over.
    • You will have serial testing based mostly in your county % check positivity price.
    • Outcomes of testing shall be used to tell an infection management interventions, equivalent to resident placement selections and work exclusions.
    • Comply with any extra steerage from public well being officers and the Facilities for Medicare and Medicaid Companies (CMS).
  • In case you reside in or obtain care in a nursing house,
    • You will have testing as a part of a nursing house’s plan to open or reopen, if not beforehand examined.
    • It is advisable to be examined if you’re symptomatic. You should be remoted till your check outcomes are recognized.  In case you check optimistic, try to be remoted for not less than 10 days after symptom onset and determination of fever for not less than 24 hours, with out the usage of fever-reducing drugs, and with enchancment of different signs.
    • Additionally, you will should be examined if there may be an outbreak in your facility. This can should be repeated at common intervals in case your preliminary check consequence was unfavourable, till the outbreak is over.
    • You might also should be examined should you go away the ability regularly (e.g. for dialysis or frequent medical/different appointments).
    • Outcomes of testing shall be used to tell an infection management interventions, equivalent to resident and affected person placement selections.
    • Comply with any extra steerage from public well being officers and the Facilities for Medicare and Medicaid Companies (CMS).
  • If you’re a important infrastructure employee, healthcare employee, or first responder.
    • You could have to get examined in response to your employer’s tips.
    • Even when you’ve got a unfavourable check, you need to put on a masks once you can not bodily distance throughout your workday, keep away from crowds and indoor crowded locations, wash your arms ceaselessly, and monitor your self for signs.
  • For public well being causes, your public well being official(s) or healthcare supplier might advise particular folks, or teams of individuals, to be examined. You must observe this recommendation. You will need to understand that you may be contaminated and unfold the virus however really feel completely nicely and haven’t any signs.
    • Your healthcare supplier or public well being official might advocate that you’re examined earlier than being admitted to the hospital or earlier than a process (e.g., pregnant folks admitted for labor and supply, surgical procedure). This testing is to guard healthcare personnel and different sufferers.
    • In areas the place there are a small variety of new instances and restricted unfold, your public well being division might request a small variety of asymptomatic “wholesome folks” to be examined.
    • If there may be important unfold of the virus in your group, your public well being division might request important numbers of asymptomatic “wholesome folks” to be examined so as to assist cease the unfold of the virus.
    • Sure settings can expertise speedy unfold of SARS-CoV-2. That is significantly true for settings with folks at elevated danger of extreme sickness in shut quarters for prolonged durations of time.
      • Approaches for early identification of contaminated people embrace, preliminary testing of everybody within the setting, periodic (e.g., weekly) testing of everybody within the setting, and testing of latest or returning entrants into the setting.



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