Advice on when to take a COVID-19 test

In the past, when we felt sick, whether we were stuffed up, nauseous, sneezed, coughed, nursed a headache or got a sore throat, we were pretty confident about what made us sick.

Maybe we had a cold, allergies or a sinus infection. Post-nasal drip may be to blame for a cough or sore throat. We could feel nauseous from a stomach bug and have a headache from stress.

Now, all these and other symptoms stir up confusion because they overlap with possible signs of COVID-19, leaving people anxious and puzzled about whether to take a COVID test.

Children and COVID testing

"First and foremost, people should follow any guidelines set by their school, workplace, daycare or other entity they are associated with," advises Andrea Chapman, a Sentara Healthcare infection preventionist. "If a child, especially one who is unvaccinated, feels sick or had a known exposure to COVID, we need to take these situations seriously and take action with a test."

If a child tests negative for COVID, healthcare providers may need to test for other illnesses, such as RSV and the flu, she says.

Since many kids are too young to get vaccinated, parents can reduce the risk of COVID by getting vaccinated themselves.

"If we can have a cocoon of immunity around our little ones, we can protect them better," Chapman explains.

Right now, the FDA has approved vaccines for children 12 and up. The next age group under consideration is 5 through 11 years.

Decisions about testing

Your vaccination status has a bearing on whether those 12 and up should test for COVID. You’re considered fully vaccinated two weeks after you’ve received both your Pfizer or Moderna shots or a single dose of the J&J/Janssen vaccine.

Also, experts now believe people have natural immunity for three months after recovering from COVID-19.

If you experience symptoms similar to COVID-19 but have been vaccinated and not exposed to the virus, it’s challenging to know whether to take a COVID test. However, the Centers for Disease Control and Prevention (CDC) recommends anyone with any signs or symptoms of COVID-19 get tested, regardless of vaccination status or prior infection.

To help cut through testing confusion, the CDC has developed an interactive clinical assessment tool to help determine if you need to take a COVID test.

The Coronavirus Self-Checker is designed for those ages 13 and older, and parents and caregivers of children ages 2 to 12. The tool asks a series of questions that you can answer for yourself or someone else to decide whether to test or seek medical care based on symptoms and exposure.

Testing for COVID after exposure

Determining whether you need to test if you HAVE been exposed to someone with COVID-19 is more cut and dry.

Exposure is defined as being within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period, according to the CDC.

In this case, your course of action depends on whether you are vaccinated, unvaccinated or have been sick with COVID-19. It also depends on whether you feel sick.

• Vaccinated - If you’re asymptomatic, test three to five days after being exposed to the virus. However, if you feel sick, take a test right away. People who are fully vaccinated do NOT need to quarantine (stay at home) after contact with someone who had COVID-19 unless they have symptoms.
• Unvaccinated - Start to quarantine and take a test right away. If the test is negative, you will still need to quarantine and then test again five to seven days after your last exposure. The safest thing to do is to quarantine for 14 days, with day zero being the day of last close contact/exposure to the COVID-positive person. On day 15, you can resume normal activities if you’re not experiencing any symptoms.
• Recently had COVID - People who have tested positive for COVID-19 within the past three months and recovered do not need to get tested following exposure as long as they do not develop new symptoms.

How long am I contagious?

If you test positive for COVID-19, you start being infectious two days before symptoms begin.

"For example, if you tested positive on September 3rd and symptoms started that day, you were potentially able to spread the virus on September 1st and 2nd," Chapman explains. "In general, most people are contagious for 10 days after onset of illness if they have a mild or moderate infection."

People who have suffered a more severe illness and needed help with oxygenation, were in intensive care or have compromised immune systems can be contagious longer and require an isolation period of 20 days, she says.

"For those who are immunocompromised, it’s often prudent to have some follow-up testing and be able to have negative tests to demonstrate they are no longer infectious," Chapman states. "In all cases, COVID symptoms should be improved or resolved before resuming normal activities and ending isolation at home or in a healthcare facility."