Who qualifies for COVID-19 screening?
Since COVID symptoms overlap entirely with flu and common cold symptoms, there is no way to tell the difference on exam without performing a test.
For most people, staying at home and isolating from others while you are recoving is recommended. Most common symptoms are fever, cough, headache and muscle aches. It is rare, but sometimes people can develop shortness of breath and chest pain. If this happens, you should seek medical care immediately.
What kind of tests for COVID are available?
There are two types of tests avaialble to determine if you are currently infected with the virus. A third can tell you if you have had, and recovered from the virus.
1- Nasopharengeal Swab: This is a Q-tip that is inserted into your nose and advanced until the tip ends at the back of your nose. It is not a fun test! It makes your eye water and some people sneeze afterwards. This test uses an “RT-PCR” (reverse-transcriptase polymerase chain reaction). The test results can vary based on the sample type and size, the testor’s sampling technique, and where in the course of illness you are. False negative rates range from <5% – 40%. Therefore, we don’t put a lot of weight in a negative test… we re-test if symptoms are persisting. This is one of the reasons why just getting a test without symptoms is not the best idea for most people. There is no certainty in it.
2- Antibody Blood Test: The is a blood draw that gets sent out to a testing lab to look for antibodies to the coronavirus in your blood, or IgG levels. Antibodies like IgG can take days to weeks to develop, so the validity of your test will depend on when you get the test and how long your body takes to make detectable antibodies.
3- Antigen or “rapid” swab tests: This is the fastest, yet least accurate test. It detects active virus presence in your nose and it quickly performed – like the nasal flu test swabs. A positive test is very accurate, however a negative test is not. 
When should I get tested?
In a lot of cases, since testing is not readily avaialble, a diangosis can be made based on symptoms and a recent exposure of someone who is COVID postivie, or who is under invesigation or quarantine themself.
The CDC given recommendations about who should be tested, however the ultimate decision to test rests on the provider and institution that is doing the evaluation. The CDC recommends contacting your healthcare provider or your local health department first.
In general, testing priority is given to those with:
- chronic lung disease, COPD, Asthma
- serious heart conditions; coronary artery disease
- chronic kidney or liver disease; those on hemodialysis
- advanced age; > 65
- morbid or severe obesity; BMI 40 or higher
- immune system compromise; transplant, HIV/AIDS, cancer
and/or to those who:
- are employed in healthcare, or live in a household of a healthcare provider
- are of a marginalized ethnic group
- reside in longterm care facilities, hospitals or prisons
Where can I get tested?
In North Carolina, testing is available at retail pharmacies and WalMart drive throughs, if you qualify. WalMart is providing drive through testing in Elizabethtown, Fayetteville, Greenville, Sylva, Tarboro, Whiteville and Wilkesboro. Certain pharmacies like CVS, Walgreens, Eden Drug and MedicalArts are also testing.
What if I don’t qualify for a test?
If you do not qualify for a COVID test, LoginClinics provides a free virtual triage service. Text the words “COVID RAPID SCREEN” to 919-679-1880 and follow the promits. Within minutes you will be connected to a healthcare professional who can evaluate your symptoms, provide recommendations, referrals and even treatment if needed.
LoginClinics uses BlueStream Health‘s rapid response HIPAA-compliant video conference to meet you, ask questions, and assess your symptoms. During this quick triage it will be determined what your next step should be. If you need treatment, LoginClinics may be able to provide this for you. If you need a doctor excuse note, we will email you one specifiying how long you need to be in isolation and when you can return to work.
What if I have all the symptoms of the coronavirus but no one will test me?
If no one will test you, it generally means that your symptoms are mild or not life threatening and it is believed that you will recover at home in isolation, keeping family members in a separate room and wearing masks when in close proximity. Tylenol can be used for fevers, aches and pains. In addition, there should be frequent hand washing and decontamination of high contact surfaces (door handles, sink knobs, counter tops, etc). If your condition deteriorates, or you develop difficulty breathing, you should seek medical care immediately.
How long do I need to stay in isolation for?
We aren’t entirely sure how long one needs to stay in isolation for, however the CDC has some recommendations:
If you had a positive COVID test:
Resolution of fever without the use of fever-reducing medications
AND improvement in respiratory symptoms (eg, cough, shortness of breath)
AND two negative FDA approved COVID-19 tests given at least 24 hours apart.
If you did not get tested, or tested negative and are having symptoms:
At least 10 days have passed since symptoms first appeared
AND at least 72 hours have passed since recovery of symptoms (defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms).
About LoginClinics- Founded by Jaclyn Qualter, a nurse practitioner and health care mentor, in September 2019, LoginClinics provides its fee schedule on its website at www.LoginClinics.com along with FAQs on how to use the online service. More information can be found on its social media www.facebook.com/TelemedicineNC or @loginclinics on Instagram.
Author: Jaclyn Qualter, Founder, Nurse Practitioner and Healthcare Mentor