How to get tested for the coronavirus (COVID-19)?
3 Sep 2020
Faced with the upsurge in confirmed cases of coronavirus (COVID-19), more and more private laboratories and screening centres are now offering testing. At present, it is estimated that at least 180,000 tests are carried out every day across the UK, according to Health Secretary Matt Hancock. The Government's objective is to reach 500,000 a day by the end of October.
What are the different types of tests on offer? How do they differ? Who can be tested? How is the test carried out?
We tell you everything in our article!
Who can be tested for COVID-19?
Since 18 May, lab-based tests are available to anyone in the UK exhibiting coronavirus symptoms (fever, new continuous cough, loss of smell or taste). These tests are free and are covered by the NHS.
Testing is also available for those who don't have symptoms and for whom any of the following apply:
- Your local council has asked you to take a test
- You live in England and are told to take a test before you go into hospital, for example, for surgery
- You’re taking part in a government pilot project
- You are a care home resident or staff member (you can find more information about this separate testing service here).
When should one get tested?
If you have coronavirus symptoms, you should get a test as soon as possible. The test should be done within the first 5 days of having symptoms. To have a test done you can book a visit to a testing site or order a home test kit if you can't make it in for a test in person.
Some things to note:
- On days 1 to 4 of your symptoms: you can get tested at a testing site or at home. If you order a home test kit on day 4, you should do it by 3pm.
- On day 5 of symptoms: you will have to go to an in-person testing site, it is too late to order a home test kit.
- If you are unable to get a test within the first 5 days of your symptoms, you, those you live with, and your support bubble must stay at home and self-isolate.
PCR test, antibody test, RDT… What are the different types of coronavirus (COVID-19) test? How do they work?
Coronavirus tests make it possible to take care of infected people, to break the chain of transmission by isolating the sick, but also to control the evolution of the pandemic.
There are two types of tests:
- Viral tests (RT-PCR): they make it possible to determine whether a person is a carrier of the coronavirus at the time of the test. It is carried out by nasal swab.
- Antibody tests: are used to determine whether a person has developed an immune reaction after having been in contact with the virus. This test detects the presence of antibodies through a blood sample.
To carry out this test, a swab is inserted far enough into the nose of the patient to reach the area called the "nasopharynx" to collect secretions.
Laboratory analysis can then identify the presence of Sars-CoV-2 in the sample. It cannot be misidentified as another coronavirus.
The RT-PCR test must be carried out by a doctor or nurse. You should receive the test results by text message from 48 hours to five days from the day of the test.
Unfortunately, false negative results are possible if the sample is taken at the wrong time. This is because Sars-CoV-2 is only temporarily present in the nasopharynx area. This varies according to the clinical signs and the course of the infection.
As Blaise Kamendje, a public health doctor on assignment to the dedicated coronavirus unit within the Regional Health Agency in Centre-Val de Loire in France, explains: "If you look too early, you won't find it, and if you look too late, you risk not finding it. There is a window of opportunity which is most optimal on the 7th and 8th days after the onset of symptoms".
Antibody tests are designed to look for traces of the virus in the body. When the body is attacked by a disease-causing agent (in this case Sars CoV-2), the body produces immunoglobulins (antibodies) to defend itself. These antibodies make it possible to eliminate the virus, heal and generally develop immunity.
These tests make it possible to find out whether a person has been in contact with the disease.
The antibody test consists of a blood test in a testing centre. The blood is then spun in a centrifuge and a biologist analyses the serum (where antibodies are present). Antibody testing is not yet available through the NHS except for NHS and other essential workers.
There are different types of antibody tests:
- ELISA tests (enzyme-linked immunosorbent assay) carried out in a medical laboratory,
- Rapid diagnostic tests (RDT) performed by a doctor, nurse or pharmacist.
This test makes it possible to tell whether the patient has been in contact with the virus and has therefore developed antibodies. To date, science has not yet been able to determine whether patients with antibodies are immune to reinfection. Official cases of reinfection are, for the time being, rare.
According to Professor Arnaud Fontanet of the Pasteur Institute, the problem with these tests is that they still have a high rate of false-positives, at around 5%.
Public Health England has approved two antibody tests (by Roche and by Abbott), but they have not yet been made available to the public.
RDT tests consist in placing a drop of blood taken from the fingertip on a strip that changes colour depending on the test result.
These tests do not determine whether the person is contagious or not, but only reveal the presence of specific antibodies to the virus.
These tests are carried out by a doctor, a nurse and, more recently, a pharmacist.
Rapid tests developed by the UK Rapid Test Consortium Results have recently been approved for professional use and commercial distribution and are in production. They will allow results to be available within 20 minutes.
As patients are often wary of needles involved in the blood draws for RT-PCR testing, many teams around the world have tried to develop a testing method using saliva samples (and therefore involving little or no pain).
The Government has recently committed funding towards saliva-based testing. A new test using swab and saliva samples to detect the coronavirus will be available in NHS hospitals from September, and should be able to produce result in 60 to 90 minutes.
Where to get tested?
Patients who are hospitalised or have severe symptoms are tested in hospital.
For all others, tests can be requested through the GOV.UK portal here.
In England, the tests are carried out at regional drive-through centres or at home. With the latter, you can request an at-home test kit which will be delivered to your door and can be administered yourself. You will then be asked to complete an identity check to get the test sent out. Supplies of these tests may be limited.
Mobile testing units and satellite centres have also been set up which move around the country depending on where they are needed most.
In Scotland, testing is being conducted in drive-through sites at:
- Glasgow Airport,
- Edinburgh Airport,
- Aberdeen Airport,
- Prestwick Airport,
- Inverness - University of the Highlands and Islands campus,
- Perth – University of Highland and Islands campus,
as well as at mobile testing units. Depending on availability, people in Scotland may also book an at-home test kit if they cannot get to a drive-through centre.
In Wales, testing is carried out at drive-through testing centres at:
- Cardiff City Stadium (Cardiff),
- Rodney Parade Stadium, Newport (Gwent),
- Abercynon Railway Station (Rhondda Cynon Taf),
- Cwm, near Ebbw Vale (Blaenau Gwent),
- Builder Street, Llandudno (Conwy),
- Deeside Industrial Park, (Flintshire),
- Carmarthen Showground (Carmarthenshire),
- Liberty Stadium (Swansea),
- Margam (Neath Port Talbot),
- Royal Welsh Showground, Builth Wells (Powys),
- Newtown College (Powys),
at Community Testing Units (CTUs) operated by local health boards, and at 8 mobile swab units operated by the military.
In Northern Ireland, testing is currently conducted by appointment only in drive-through sites at:
- SSE test centre, Odyssey Car park, Belfast BT3 9QQ,
- Lycra car park (near The Rec Club), Maydown Works, 60 Clooney Road, Derry/ Londonderry, BT47 6TP,
- Craigavon MOT centre, Craigavon, BT63 5RY,
- St Angelo Airport, 62 Killadeas Road, Trory, Enniskillen BT94 2FP.
These sites are open 9:30am - 5:30pm, 7 days a week. Mobile testing units are also available in response to local need.
What to do after being tested for COVID-19?
If the result is positive:
A positive result means you had coronavirus when the test was done. If your test is positive, you must self-isolate immediately.
- If you had the test done because you had COVID symptoms, you must stay in self-isolation for at least 10 days from when your symptoms started
- If you had a test but haven't had symptoms, you should self-isolate for 10 days from the date of the test.
In England, you will be contacted by the NHS Test and Trace service and asked where you've been and with whom you've been in contact in recent days. It is important to trace close recent contacts to inform those who may be at risk and to control the rate of reproduction (R), reduce the spread of the infection and save lives.
If the result is negative:
A negative result means the test did not find coronavirus. You do not need to self-isolate as long as:
- Everyone you live with who has symptoms tests negative,
- Everyone in your support bubble who has symptoms tests negative,
- You haven't been told by the NHS Test and Trace service to self-isolate for 14 days
- You feel in good health - if you feel ill, stay home until you feel better
If the result is unclear, void, borderline or inconclusive
An unclear, void, borderline or inconclusive results means that it's impossible to say if you had coronavirus at the time of the test. In this case, you should get another test done as soon as possible.
If you had the test done because you were exhibiting symptoms, you should continue self-isolating and get another test within 5 days of the first signs of symptoms.
If you've been contacted by NHS Test and Trace because you've been in contact with someone who has COVID-19
If you've been in contact with someone who has coronavirus, you should stay at home in self-isolation for 14 days and strictly follow the barrier gestures. You can find and read the NHS guidance for this situation in more detail here.
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