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Throughout the course of the past 19 months, testing has been a key way for public health officials to track the spread of the novel coronavirus in a community and throughout the state.
In recent months, Iowans have more options when it comes to testing for an infection. In addition to the available testing option through health care providers, many pharmacies and online retailers now offer dozens of products from which to choose.
How can Iowans know which coronavirus test is the right option for them?
Dr. Dan Diekema, an infectious disease specialist at the University of Iowa Hospitals and Clinics, answered some frequently asked questions regarding testing for COVID-19:
What are the different types of COVID-19 test?
COVID-19 tests can determine whether an individual has a current infection or was infected in the past.
A viral test is a diagnostic test to determine whether there is an active infection. There are two categories — antigen tests and molecular or PCR tests.
There’s also an antibody test, also known as a serology test. These tests search for antibodies the body creates to fight a virus.
Antibody tests can’t diagnosis an active infection, but instead determine whether someone has had an immune response to the virus and produced antibodies.
This type of testing is used by public health officials to determine what portion of the population has antibodies against the virus, either through vaccination or previous infection. Diekema said health care providers also will conduct a serology test on patients to determine if they are having a delayed response to COVID-19.
What’s the difference between a PCR and an antigen test?
Both antigen and PCR tests are used to detect an active COVID-19 infection.
Antigen tests, which detect a protein that is part of the coronavirus, are commonly used for rapid diagnostic tests that produce results quickly — often in less than an hour. Some products available can provide results within 15 minutes — much faster than a typical PCR test.
However, rapid tests are less accurate than a PCR test, which stands for polymerase chain reaction. The PCR test, which detects genetic material of the virus, is the standard diagnostic test for the coronavirus.
These tests must be analyzed in a lab, meaning they take longer to produce results than a rapid test. But a PCR test is more sensitive and can detect the virus for a longer period of time than the antigen test, Diekema said.
“If you're having symptoms that could be COVID-19, a negative antigen test is not enough to reassure you that we don't have COVID-19,” Diekema said.
Where can I get a COVID-19 test?
There are several options in Iowa to obtain a test.
Test Iowa: The state-run Test Iowa program offers free, take-home PCR test kits.
Iowans can collect their own saliva and mail it directly to the State Hygienic Lab for analysis. They also can drop it off at various locations around the state, including directly to the State Hygienic Lab locations in Coralville or Ankeny.
The process for these mail-in kits can take several days. The time for an individual to receive a requested kit through mail and for that kit to be returned to the lab can take up to a week, according to Test Iowa’s website.
Once the laboratory receives the test, results should be emailed to individuals within 24 hours, the site states.
Pharmacies: Retail pharmacies across the state — including Hy-Vee, CVS and Walgreens — offer a number of testing options.
Hy-Vee has rapid antigen, PCR and rapid antibody tests, according to the retailer’s site. Rapid antibody tests cost $25 and prices vary for the rapid antigen tests. PCR tests are free.
Some locations offer drive-through testing, which must be scheduled online. Visit hy-vee.com/my-pharmacy/services/covid-19-testing for more information and to book an appointment.
CVS, which offers rapid antigen and PCR tests, also has drive-through testing available throughout the state. These tests are covered by insurance or through federal programs for uninsured individuals. For more information and to find a testing location, visit cvs.com/minuteclinic/covid-19-testing.
Walgreens offers PCR, rapid molecular and rapid antigen tests. Some locations also have free drive-through COVID-19 testing for anyone aged three and older, according to its site. Find an appointment or more information by visiting walgreens.com/findcare/covid19/testing.
Health care providers: Hospitals and clinics across the state provide COVID-19 testing to patients for a cost. That cost may vary.
Some facilities also may require an appointment. Contact that provider or your primary care provider for more information.
Self-testing: Iowans can purchase at-home tests online or at various retailers, including Walgreens, CVS and Walmart. Check their websites to see if a store or pharmacy near you sells a rapid at-home testing kit.
On Thursday, President Joe Biden announced his administration is working with Kroger, Walmart and Amazon.com to sell rapid coronavirus tests at cost, making them more affordable. He added he would invoke the 1950 Defense Product Act to increase manufacturing of those tests.
Who should get a COVID-19 test?
People who have symptoms of COVID-19 should get a test, including individuals who are fully vaccinated. They also should get tested if they have had a close contact — or were within six feet for a total of 15 minutes or more — with someone who has COVID-19.
If fully vaccinated, its recommended individuals seek out a test three to five days after their last known exposure, Diekema said. If it’s positive, they should isolate. If they must leave their home, they should wear a mask in public and in indoor settings for 14 days, or until they receive a negative test.
For those who are unvaccinated, they either should stay in quarantine for 14 days or get a PCR test at seven days after the last known exposure. If the results are negative, then those individuals can come out of quarantine.
Diekema noted they should continue to wear masks and social distance in public settings.
“For those who are not vaccinated, they still need to think about it as a 14-day window during which they could develop symptoms and need to be very careful,” Diekema said.
How do I know which test is best for me?
It depends on whether individuals have symptoms of COVID-19. If you develop symptoms, Diekema said the best course is to arrange for a test with your health care provider.
He also recommended Iowans keep a rapid test on hand at home, in case they do develop symptoms. Otherwise, individuals may be going out in public while they’re infectious to purchase an at-home test.
“If you feel like you're the type of person who's going to want to do a rapid antigen test at home if you were to develop symptoms, you should probably have one or two of them at home just to have available,” Diekema said.
Should I get tested for COVID-19 regularly?
If you live in a county with high rates of coronavirus transmission but your county public health department is not doing contact tracing, then you should consider testing yourself for COVID-19 on a regular basis, Diekema said. That’s particularly true if you’re in frequent contact with other members of the community, such as through work.
If you live in a county that’s conducting contact tracing locally, you only need to get a test if you’ve been identified as a contact of a positive case, Diekema said.
You also should seek testing if you develop symptoms.
The Washington Post contributed to this article.
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