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Coronavirus Illness 2019 (COVID-19)


Notice: This doc is meant to offer steering on the suitable use of testing for SARS-CoV-2 in gentle of further testing capability all through the nation and doesn’t handle selections concerning cost for or insurance coverage protection of such testing.

Revisions made on 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 modifications

Clarifications made on September 18, 2020

  • As a result of significance of asymptomatic and pre-symptomatic transmission, this steering additional reinforces the necessity to check asymptomatic individuals, together with shut contacts of an individual with documented SARS-CoV-2 an infection.

Revisions made on August 24, 2020

  • Diagnostic testing classes have been edited to deal with testing issues and actions to be taken by people present process testing

Revisions made on July 17, 2020

  • Aside from uncommon conditions, a test-based technique is not really helpful to find out when a person with a SARS-CoV-2 an infection is not infectious (i.e., to discontinue Transmission-Based mostly Precautions or house isolation)

Revisions made on July 2, 2020

  • Added screening to attainable testing sorts
  • Eliminated examples – please check with setting particular steering

This doc supplies a abstract of issues and present Facilities for Illness Management and Prevention (CDC) suggestions concerning SARS-CoV-2 testing technique.  The CDC suggestions for SARS-CoV-2 testing have been developed based mostly on what’s at present identified about COVID-19 and are topic to vary as further data turns into obtainable.

Viral Testing

Approved assays for viral testing embrace people who detect SARS-CoV-2 nucleic acid or antigen. Viral (nucleic acid or antigen) exams test samples from the respiratory system (akin 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 exams are really helpful to diagnose acute an infection of each symptomatic and asymptomatic people, to information contact tracing, therapy choices, and isolation necessities Some exams are point-of-care exams, which means outcomes could also be obtainable on the testing web site in lower than an hour. Different exams should be despatched to a laboratory, a course of which will take not less than 1-2 days.

For extra data on testing for SARS-CoV-2 see the Interim Tips for Amassing, Dealing with, and Testing Medical Specimens and Biosafety FAQs for dealing with and processing specimens from attainable circumstances.

Antibody Testing

FDA has not approved utilizing antibody exams 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 help medical evaluation of individuals who current late of their sicknesses when used along side viral detection exams.  As well as, if an individual is suspected to have a post-infectious syndrome brought on by SARS-CoV-2 an infection (e.g., Multisystem Inflammatory Syndrome in Kids; MIS-C), serologic assays could also be used.

Serologic assays for SARS-CoV-2 an infection, are an essential software for surveillance and epidemiologic research, akin to understanding the transmission dynamic of the virus within the basic inhabitants. Not like direct viral detection strategies, akin to nucleic acid amplification or antigen detection exams that may detect acutely contaminated individuals, antibody exams assist decide whether or not the person being examined was beforehand contaminated—even when that particular person by no means confirmed signs.

CDC Mitigation Protocols

CDC recommends the next measures to mitigate the unfold of the virus and to guard individuals at elevated threat of extreme sickness:  social distancing, sporting a masks when social distancing is just not attainable, avoiding crowds, avoiding indoor crowded areas, and washing or sanitizing palms incessantly.

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

  • In case you have signs of COVID-19:
    • In case your signs are delicate:
      • Your healthcare supplier (doctor, nurse practitioner, pharmacist, and so on.) could advise a SARS-CoV-2 check.
      • For those who check optimistic for SARS-CoV-2 an infection or don’t get examined, you must self-isolate for not less than 10 days after symptom onset and backbone of fever for not less than 24 hours, with out the usage of fever-reducing drugs, and with enchancment of different signs.
      • For those who reside with a particular person at elevated threat of extreme sickness (for instance an aged relative or different people with underlying situations), take particular precautions within the house to guard that particular person in keeping with CDC pointers.
    • In case your signs worsen while you’re isolating, or turn out to be average/extreme, akin to shortness of breath or extreme fatigue, contact your healthcare supplier instantly or search emergency care.
    • For those who check optimistic, you don’t want to repeat a check for not less than 3 months.
    • You don’t want a follow-up destructive 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 backbone 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 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 don’t have signs.​
    • You want a check. Please seek the advice of together with your healthcare supplier or public well being official. Testing is really helpful for all shut contacts of individuals with SARS-CoV-2 an infection. Due to the potential for asymptomatic and pre-symptomatic transmission, it is necessary that contacts of people with SARS-CoV-2 an infection be shortly recognized and examined. Pending check outcomes, you must self-quarantine/isolate at house and keep separated from family members to the extent attainable and use a separate bed room and loo, if obtainable.
      • A single destructive check doesn’t imply you’ll stay destructive at any time level after that check.
      • Even if in case you have a destructive check, you must nonetheless self-isolate for 14 days.
    • For those who can not self-isolate, or you’re a essential infrastructure employee that should work, put on a masks, bodily distance, keep away from crowds and indoor crowded locations, wash your palms incessantly, and monitor your self for signs.
    • For those who reside with a particular person at elevated threat of extreme sickness (for instance an aged particular person or different people with underlying medical situations), take particular precautions within the house to guard that particular person in keeping with CDC pointers.
    • Healthcare suppliers in shut contact of an individual with documented SARS-CoV-2 an infection whereas utilizing really helpful private protecting gear, don’t have to be examined
  • For those who don’t have COVID-19 signs and haven’t been in shut contact with somebody identified to have SARS-CoV-2 an infection (which means being inside 6 ft of an contaminated particular person for not less than quarter-hour).
    • You don’t want a check until really helpful or required by your healthcare supplier or public well being official.
    • If you’re examined, you must self-quarantine at house till your check outcomes are identified, after which adhere to your healthcare supplier’s recommendation.
    • A destructive check doesn’t imply you’ll stay destructive 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 individuals (with out common masks sporting and/or bodily distancing).
    • Your healthcare supplier or public well being official could advise a SARS-CoV-2 check.
    • If you’re examined, you must self-isolate at house till your check outcomes are identified, after which adhere to your healthcare supplier’s recommendation.
    • A destructive check doesn’t imply you’ll stay destructive at any time level after that check.
    • Even if in case you have a destructive check, you must put on a masks, bodily distance, keep away from crowds and indoor crowded locations, wash your palms incessantly, and monitor your self for signs.
    • Take particular precautions within the house to guard any particular person(s) with elevated threat of extreme sickness in keeping with CDC pointers.
  • For those who work in a nursing house,
    • You have to testing as a part of a nursing house’s plan to open or reopen, if not beforehand examined.
    • You must be examined in case you are symptomatic. You need to self-isolate and never go to work till your check outcomes are identified. For those who check optimistic, you must self-isolate for not less than 10 days after symptom onset and backbone of fever for not less than 24 hours, with out the usage of fever-reducing drugs, and with enchancment of different signs.
    • You have to testing if there may be an outbreak in your facility, and repeat testing at common intervals in case your preliminary check end result was destructive till the outbreak is over.
    • You have to serial testing based mostly in your county % check positivity fee.
    • Outcomes of testing will probably be used to tell an infection management interventions, akin to resident placement selections and work exclusions.
    • Observe any further steering from public well being officers and the Facilities for Medicare and Medicaid Companies (CMS).
  • For those who reside in or obtain care in a nursing house,
    • You have to testing as a part of a nursing house’s plan to open or reopen, if not beforehand examined.
    • You must be examined in case you are symptomatic. You should be remoted till your check outcomes are identified.  For those who check optimistic, you have to be remoted for not less than 10 days after symptom onset and backbone 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 have to be examined if there may be an outbreak in your facility. It will have to be repeated at common intervals in case your preliminary check end result was destructive, till the outbreak is over.
    • You might also have to be examined in the event you go away the power regularly (e.g. for dialysis or frequent medical/different appointments).
    • Outcomes of testing will probably be used to tell an infection management interventions, akin to resident and affected person placement selections.
    • Observe any further steering from public well being officers and the Facilities for Medicare and Medicaid Companies (CMS).
  • If you’re a essential infrastructure employee, healthcare employee, or first responder.
    • You might have to get examined in keeping with your employer’s pointers.
    • Even if in case you have a destructive check, you must put on a masks if you can not bodily distance throughout your workday, keep away from crowds and indoor crowded locations, wash your palms incessantly, and monitor your self for signs.
  • For public well being causes, your public well being official(s) or healthcare supplier could advise particular individuals, or teams of individuals, to be examined. It is best to observe this recommendation. You will need to notice which you could be contaminated and unfold the virus however really feel completely nicely and don’t have any signs.
    • Your healthcare supplier or public well being official could advocate that you’re examined earlier than being admitted to the hospital or earlier than a process (e.g., pregnant individuals 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 circumstances and restricted unfold, your public well being division could request a small variety of asymptomatic “wholesome individuals” to be examined.
    • If there may be vital unfold of the virus in your neighborhood, your public well being division could request vital numbers of asymptomatic “wholesome individuals” to be examined in an effort to assist cease the unfold of the virus.
    • Sure settings can expertise fast unfold of SARS-CoV-2. That is notably true for settings with individuals at elevated threat 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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