Med+Stop: COVID-19 Testing

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A guiding principle, for the proper use of any medical “test” is to apply the following question…

Are the results of this test likely to change how I treat this patient??

If the answer is no, then you should not order the test, it is a waste of resources.

When those resources are scarce and precious, it is an inexcusable waste.

COVID-19 testing resources are scarce for everyone and precious for those that really need them.

If you have a cough and fever known to be caused by a COVID-19 infection and you are not sick enough to be hospitalized the current treatment plan includes:

  • Stay home/avoid close contact with others, especially vulnerable people.
  • Self quarantine until you have no fever, without fever reducing drugs AND your symptoms are improving for 3 days; AND at least 7 days from the start of your illness.
  • The usual viral illness treatment: good hydration, nutrition and acetaminophen for pain/fever.
  • Seek medical advice if, for example, if you are short of breath, light headed or getting worse.
    • Ideally, you should call your own doctor for the most appropriate evaluation plan.
    • Call a local Urgent Care for advice if you have no doctor available.
  • Go to a local hospital ER if you think you are sick enough to need hospitalization.

On the other hand if you have a cough and fever NOT cause by a COVID-19 infection and you are not sick enough to need hospitalization the current treatment plan is the exact same.

COVID-19 testing will not change the treatment plan for the majority of patients with cough and fever.

Therefore, the current recommendations for when to test for COVID-19 are:

Hospitalized patients, long-term care facilities patients, high risk for severe complication patients and healthcare workers with signs and symptoms compatible with COVID-19.

For all others, COVID-19 testing is only warranted if there is a known significant COVID-19 exposure and at least moderate symptoms that warrant an acute care medical evaluation. 
However, that evaluation may, for example, reveal an alternate diagnosis such as Influenza, Bacterial Pneumonia or Strep Throat, which do not require COVID-19 testing to treat properly.

The cardinal symptoms of a COVID-19 infection are cough and fever.  This is often accompanied by shortness of breath, aches and pains, significant fatigue and headaches.  These symptoms are very similar to and not distinguishable from many other common respiratory viral infections.

Mildly ill patients do not need acute medical care or any testing.  If in doubt call a medical advice line.

Moderately ill patients may be tested, if there is a known or suspected COVID-19 exposure and no alternate diagnosis. 

Seriously ill patients need to be evaluated, in an appropriate setting, for potential hospitalization.