COVID-19 Information: Santa Clara County and Bay Area, California

Should you get tested if you think you've come into contact with someone who has COVID-19, or who you suspect has it? 

• For people generally in good health, use the CDC's online When to Test calculator.
• For people who may be medically vulnerable, or are in a community that experiences less-than-equitable health care (immigrants, refugees, low-income, Latinx or Black or some Asian communities), use the CDC's more detailed online calculator.
• To calculate for yourself, read on for the factors to consider.

In general, the current guidelines are that everyone - regardless of vaccination - should get tested if:

1. they have symptoms of COVID-19, or have been exposed to someone who has tested positive for COVID within the last 5 days;
2. their work requires that they be tested on a regular basis;
3. travelling distances (that is, immediately before international travel, domestic air travel, or using public transit to take a longer than usual trip;
4. while not required, it is a good idea to test just before visiting vulnerable relatives or friends (skip the visit if test positive).

When to get tested can be a tricky question. Testing too early, before an infection takes hold, can give a false negative test, and could end up spreading the disease.

As of Winter 2023-4, home antibody tests tend not to show up positive until sometime between days 3 - 5 when compared to gold-standard PCR testing (and a research study found that peak viral loads of the JN.1 variant followed the same pattern). That means that a negative result from a home antibody test may not be accurate if it was immediately after being exposed or after symptoms start. Current recommendations from the CDC are to repeat in 48 hours to confirm a negative test result; given those research findings, it may be wisest to test on day 4 or 5 (if day 1 is known) to be certain.

In the workplace, different timelines for testing and quarantining may apply. The CDC's When to Test calculator for organizations, and/or Department of Industrial Relations provide guidance in those circumstances.

If someone tests positive for COVID-19, what to do next depends on vaccination status and how severe the symptoms may be. See this page for current guidelines.

The end of the U.S. federal public health emergency means changes to which COVID-19 tests are available, and their cost.

At-home antigen test kits are still available from drugstores, but we need to pay full price (currently $12 - $20) per kit. If their health insurance plan partially covers these, there would be a co-pay. Also, Santa Clara County's Better Health Pharmacy offers some free at-home antigen test kits at present.

These tests are usually packaged in sets of 2. At times these can have a fairly high "false negative" rate (read on for more details). if a test is negative (no COVID), the FDA recommends testing at least twice, 48 hours apart, to be certain of that result.

PCR tests are still the most accurate for COVID-19.

Now that funding for the pandemic has expired, a PCR test needs to be ordered by a doctor or clinic when medically necessary, just like any other lab test. If not covered by health insurance, here's how to get a PCR test in Santa Clara County:

At present two different tests, PCR tests and antigen tests, to discover if someone currently has a COVID infection, so these are most relevant to us as individuals. These use either a nasal swab or saliva to test. (NOTE: be sure to follow the instructions on the specific test kit on where to swab.)

PCR (polymerase chain reaction) tests look for SARS-CoV-2 genetic material. Processing needs to take place in a laboratory, and takes at least 12 hours - usually much longer - to get results. (Which means that, in theory, immediately after testing people should isolate themselves until they know their test results to be absolutely certain that they're not currently infected.) 

When done correctly PCR tests are remarkably accurate at detecting whether SARS-CoV-2 viruses are present - that is, if that person could infect someone else. They can also identify which variant of SARS-CoV-2 is causing the infection, and that is how mutations of this virus are tracked across populations.

Antigen tests (also called rapid tests, lateral flow tests, or home tests) look for the presence of substances that trigger our bodies to produce antibodies. That is, they look for by-products of  COVID infection, not the virus itself. These tests indicate if someone is fighting off a COVID infection, but cannot tell us just how infectious someone might be, or which version of the virus they have. They can be less accurate than PCR tests, especially when too close to the initial infection, or some days after systems peak.

However, they are much faster (around 15 minutes instead of days), and testing can be done anywhere, making these much more convenient. Currently they are sold over the counter in drugstores or online.

At-home antigen tests can give false negative results (that is, they fail to detect when someone is infected). This might not be from any fault of the test itself; often that's because people test too soon. It can take 3-5 days or more after getting infected before enough antigens accumulate in the nasal passages to register positive, even though the person could possibly be shedding virus. To be certain, the FDA recommends taking multiple tests (at least 2) that are 48 hours apart.