ConsumerLab.com Answers  

COVID-19 Virus and Antibody Tests Compared and Where to Get Them

Question:
How can I get tested for the coronavirus? Can I get a home-test for COVID-19? Which are the best tests? Are any tests free?
Coronavirus (COVID-19) Tests: How and Where to Get -- COVID-19 Test Tube and Swab
Answer:
These are great questions, as many people want to know if they are currently infected or have already been infected with coronavirus that causes COVID-19 and have developed antibodies due to immune response. There has been much confusion and about tests for coronavirus and the FDA has reported that some test developers have falsely claimed their tests are FDA approved or authorized and that many commercial tests are performing poorly, so it is important to sort out the facts.

Before we get into specifics, let's start with a quick overview of the types of tests for coronavirus.

Types of COVID-19 Tests

There are basically two types of tests for the coronavirus that causes COVID-19:

Virus test
This test detects the virus (SARS-CoV-2) to determine if you have an active infection and are infectious, i.e., you can spread the virus. Although you can be infectious before showing any symptoms, the virus is best detected during the first week of symptoms (which is about two weeks after becoming infected from exposure) (Sethuraman, JAMA 2020).

The virus test is best done by collecting a sample of mucous from a swab (typically from the nasopharynx or nostril) or saliva. This sample then needs to be analyzed in a laboratory or with a special rapid, portable machine using a technique that amplifies the genetic material (RNA) from the virus. This can take as little as a few minutes or several hours. The FDA has begun allowing some at-home sampling kits to be sold by which you can collect your own sample and drop it off or mail it to a lab, which will report the results back to you.

Antibody test
The other detects antibodies to the virus and requires blood — either a drop or a vial — to determine if you have been infected in the past and have developed some level of immunity. This test (also called a serology test) can be run in a laboratory or on a test strip. However, the accuracy of test strips has been found to vary, so you need to be careful if using a home-based test. None have been allowed by the FDA. As it takes time to develop antibodies that can be detected, antibody tests are most accurate when performed at least 20 days after the first disease symptoms. Tests focus on levels of the antibody IgG, which persists without much decline for several weeks, but may include levels of IgM which fall off more rapidly (Sethuraman, JAMA 2020). [Note: Avoid taking large doses -- 10,000 mcg or more -- of biotin for several days before an antibody test, as biotin may skew results.]

Who is checking these tests?
To speed the availability of tests, rather than put these through its normal approval process, the FDA has provided a special emergency use allowance (EUA) for tests that, although imperfect, may be useful at this time. So there are actually no FDA "approved" SARS-CoV-2 virus tests, but a list of "FDA allowed" tests. The FDA allowances are based on data submitted by the test manufacturers, but the has FDA announced that government laboratories, including those at the National Institutes of Health (NIH) are now conducting independent tests of these tests and the FDA expects to make the results public (which we will post when available — so watch for announcements in our newsletter.)

Several other organizations around the world have been testing the test and/or certifying virus and antibody tests. The European Union's has been certifying tests, conferring on them its CE (Conformité Européenne) mark, and the Chinese National Medical Products Administration (NMPA) has been doing the same. Researchers in California, Denmark, and elsewhere have been testing the antibody tests. 

Where to Get COVID-19 Tests

Virus Test
To date, the FDA has permitted the use of over 60 virus tests. The vast majority must be performed on a sample collected in a medical setting, such as in a doctor's office, a diagnostic laboratory, or a drive-through facility, but the FDA has also begun authorizing at-home sample collection tests for the virus.  

Local testing (often free)
Although you can ask your doctor for a virus test, you may be able to arrange to get a virus test for free from your state or local government. You can also go to a diagnostic laboratory or testing center, including some pharmacies. The test may be covered by your insurance or the government based on an assessment of your risk level. Here are some examples of testing programs around the country. 
  • Project Baseline works with community based screening programs in locations in several states to offer free virus testing. You must fill out an online questionnaire and be accepted. You will then be given an appointment at local testing center where a sample will be collected with a self-nasal swab or a nasopharyngeal swab. The project is sponsored by the parent company of Google through its health unit, Verily, and a Google email account is needed to complete questionnaire online. 


  • Rite Aid Pharmacies in some locations are participating in Project Baseline.


  • CVS (including MinuteClinic and HealthHUB) offers drive-up, rapid testing in which you can receive results within 30 minutes. Patients must pre-register online and qualify, and testing is on a drive-through basis, no walk ups. (CVS uses the Abbott ID NOW system, a small, portable device that yields results in 13 minutes or less. Unfortunately, this system has been reported to yield a high percentage of false negative results due to lower sensitivity than other systems. That is, a negative result may need to be confirmed using another test (Basu, bioRxiv 2020 preprint). (For more details, see Finding the Best COVID-19 Test, below).


  • Walgreens offers drive-up testing in which you perform your own nasal swab. You sample is sent to a laboratory and you will receive results within 24 hours.
At-home sample collection
  • Pixel from LabCorp allows users to collect their own nasal swab samples and mail it to LabCorp for testing. This product costs $119. It was initially only available to healthcare workers and first responders but is now available for consumer purchase. No prescription is necessary, although you need to complete a simple online questionnaire and meet eligibility criteria demonstrating need for the test. You may be covered by your insurance for the cost. Due to state restrictions, it is not be available in Maryland, New Jersey, New York and Rhode Island.


  • Everlywell COVID-19 Test Home Collection Kit ($109) will be available for individual purchase by the end of May. After completing an online eligibility questionnaire users are sent the kit to collect their own nasal swab samples. Samples are then sent directly to an accredited laboratory. The company promises online results within 3-5 days from purchase and results are reviewed by a physician. It is not be available in Maryland, New Jersey, New York and Rhode Island.


  • Rutgers Clinical Genomics Laboratory allows users to collect their own saliva sample using a special collection device and return it for testing at Rutgers. This test requires a prescription.
Antibody Test
As with virus tests, many laboratories have received FDA approval to conduct antibody tests, some of which are very accurate. Although the FDA has not approved or allowed rapid, home tests for antibodies, many such tests are available in other parts of the world and some have been sold in the U.S.

Through a local healthcare provider
Your healthcare provider can arrange for you to get an antibody test if they believe is it appropriate. Blood would be drawn either by your provider or at nearby diagnostic laboratory. Similarly, many walk-in, urgent care centers can arrange for you to have the test, for a fee, which may be covered by your insurance. The samples are typically sent to a commercial laboratory, so results can take a few days.

Consumer-initiated testing
QuestDirect allows consumers to request a COVID-19 IgG antibody test and pay for it online ($119 plus a $10.30 physician oversight fee). An appointment is made for a blood draw at one of Quest Diagnostics 2,200 patient service centers and test results are available online one to two days later. Interested consumers must not have experienced symptoms of COVID-19 for at least 10 days. Quest has stated that the testing will initially rely on antibody tests run on the Abbott Architect and EUROIMMUN systems (see how these compare in the Finding the Best COVID-19 Test section below).

Rapid, home tests
The FDA has not yet approved or allowed of the use of any rapid, home antibody tests but several have been approved by the European Union, which provides its CE mark (Conformité Européenne) and/or by the Chinese National Medical Products Association (NMPA). In addition, research groups have been evaluating these tests. Some of these tests have been marketed in the U.S. without FDA approval or allowance. 

Finding the Best COVID-19 Test

There are now more than 60 virus tests and 11 antibody tests for COVID-19 allowed by the FDA. ConsumerLab has reviewed the data on their performance and assessed which appear to be the best. We've added this information for ConsumerLab members. Sign in as a member or become a member now to learn how specific brands of virus and antibody tests compare, which currently appear to be the best, and where to get them.

Learn More About Coronavirus (COVID-19)



What are natural remedies for coronavirus (COVID-19)? Do supplements like zinc, vitamin C, or herbals work? >>

Does heat kill coronavirus (COVID-19)? Can it disinfect face masks and packages? >>

How can I make a mask that is as good as a surgical mask or an N-95 mask? >>

Should I wear a face shield to protect from coronavirus (COVID-19)? >>

Do UV light sanitizing wands and boxes kill coronavirus (COVID-19)? >>

Can I get the new coronavirus (2019-nCoV) from supplements from China? >>

I read that famotidine (Pepcid) may help treat COVID-19. Is this true? Are there risks with taking famotidine? >>

How are you staying healthy during the coronavirus pandemic? >>

See other recent and popular questions >>
COMMENTS

william 20046   May 27, 2020
Excellent description of testing issues!

Folks mostly do not understand prevalence, sensitivity, specificity, and sero-conversion.

bill g, mph

ConsumerLab.com   May 27, 2020
Thanks. We're staying on top of this area, continually updating.

Jennifer19937   May 18, 2020
I've seen no mention anywhere of whether biotin supplementation will interfere with some of the antibody tests. I assume it's possible since Troponin, thyroid hormones, Hep A, B, and C antibody tests can be falsely negative if a patient is consuming biotin.

ConsumerLab.com   May 21, 2020
Large doses of biotin may interfere with COVID-19 antibody tests. We've added a note about this in the answer above. For information about biotin interference with other types of tests, see the Biotin section of the B Vitamin Supplements Reviewhttps://www.consumerlab.com/reviews/Review_Best_B_Vitamins_and_Complexes_Energy_B6_B12_Biotin_Niacin_Folic_Acid/bvitamins/#kummer.

Mark19912   May 14, 2020
Hoping there will be a review of the Quest antibody test.

ConsumerLab.com   May 14, 2020
As noted above, QuestDirect has stated that it is using the Abbott Architect and EUROIMMUN systems. The results for each are shown above in the "Finding the Best COVID-19 Test" section.

J.Claire19904   May 13, 2020
This is very interesting: the base rate fallacy, I admit I had never heard of it, but then I avoid statistics if I can. Does this mean even a antibody test 100% both sensitive and specific will have false positives?
https://www.nytimes.com/2020/05/13/opinion/antibody-test-accuracy.html?referringSource=articleShare

"Just Because You Test Positive for Antibodies Doesn't Mean You Have Them"

In a population whose infection rate is 5 percent, a test that is 90 percent accurate could deliver a false positive nearly 70 percent of the time.


ConsumerLab.com   May 14, 2020
A test that is 100% sensitive and specific should not create false negatives or false positives (if done correctly), regardless of the prevalence of disease in the community. But it is true that when the prevalence of a disease is low (i.e., few people have it), a test that not 100% specific could falsely identify more people as positive who are actually negative than who are actually positive.

Doug19899   May 13, 2020
Although this may not be your area of expertise, I'm looking for reasons why and why not to get a voluntary test. I'd like to know if I've been exposed, but if I was then what could happen to me? What could I be forced to do?

There is a story that anybody positive for COVID cannot join the military. I recall a reluctance in the population to be tested for HIV many years ago.


ConsumerLab.com   May 21, 2020
These are good questions with both medical and ethical implications and beyond the scope of this article. However, regarding your question about preclusion from military service, this appears to only be true if one has been hospitalized with COVID-19, not just for having tested positive for the virus or antibodies, as noted an article in Stars and Stripes on May 8: https://www.stripes.com/news/us/contracting-coronavirus-won-t-disqualify-you-from-serving-in-the-military-but-a-hospital-stay-for-it-might-1.628995

Lazar19887   May 13, 2020
You mentioned that some anti-body tests were approved by EU. Which ones? Are they available for purchase in U.S. for home use?

ConsumerLab.com   May 21, 2020
We have added a link to a list of tests that conform to the European standards and have the CE mark. Those tests may or may not be available in the U.S., although some have received both FDA allowance and the CE mark. See the full section, Finding the Best COVID-19 Test.

Jimmy19886   May 13, 2020
I had the virus for 5 weeks, even though I had 3 negative tests. I took my first test at the 2 1/2 week mark, nasal rapid test swab and it was negative. I continued to have symptoms and then 1 1/2 weeks later I took a 2nd swab test that got sent to the lab, negative again. At the 5 week mark, I got a blood test with Quest and it came back negative that I never had the virus or antibodies.

I know I had the virus as the symptoms were it to a T. How can we rely on any of these tests?

Gwendolyn20049   May 27, 2020
All of the usual viruses (influenza, etc) are still out there. According to one source, around 50% of the people who were absolutely SURE they had had COVID-19, did not have any antibodies. A PCR test for Covid-19 would not diagnose other viral infections.

Eve20054   May 27, 2020
I had a similar experience. I then realized that I take a lot of supplements including Vit B Complex and other supplements which contain biotin which CAN cause the COVID tests and antibody test to not work correctly. Do you take supplements for nails and hair or others that may contain high levels of biotin?

Jim19881   May 13, 2020
Is it possible to get the virus sickness twice?

ConsumerLab.com   May 13, 2020
A big question, but there is no definitive answer as of yet.

Sandy19925   May 17, 2020
Hi: Looks like you can get reinfected according to this NPR article about sailors. "The U.S. Navy says 13 sailors from the USS Theodore Roosevelt who had apparently recovered from the coronavirus and had received negative test results have now tested positive for a second time.

In a statement released earlier on Saturday when five sailors were found to have retested positive, the Navy said the sailors had "met rigorous recovery criteria, exceeding CDC guidelines," including testing negative for the virus at least twice, but have now retested positive. The statement said the sailors had been monitoring their health and adhered to social-distancing protocols while on board the Roosevelt, which has been docked in Guam following an outbreak infecting hundreds of crew members.

"These five Sailors developed influenza-like illness symptoms and did the right thing reporting to medical for evaluation," the statement said.

The Navy has since confirmed to NPR that an additional eight sailors have retested positive for coronavirus, bringing the total to 13." https://www.npr.org/sections/coronavirus-live-updates/2020/05/16/857379338/5-uss-roosevelt-sailors-test-positive-for-covid-19-again

Marthe19872   May 11, 2020
I read your article about covid tests. I know someone who had symptoms and had 2 negative tests. She had trouble breathing and went to the hospital on Sat. Had a negative test and they sent her home. She went back to the hospital Sunday and died there.

Someone my daughter knows had a negative test and then tested positive and died. Makes me worry that these tests aren't accurate. What do you think?

ConsumerLab.com   May 11, 2020
Very sorry to hear that. It could have been the type of tests used, the timing of them (too early or too late), or, as you note, the accuracy of the specific tests.

j19851   May 10, 2020
I would like to see your comments as to whether the antibodies actually offer protection from reinfection or not. Many are reporting/speculating that with rapid mutation and reported reinfections that we still are not sure about protection .

ConsumerLab.com   May 11, 2020
We, like you, also await definitive evidence on this question.

Brian19849   May 10, 2020
Which antibody tests have received approval vs. EUA? There is a list for EUA companies but I have not found the list for approvals.

ConsumerLab.com   May 21, 2020
At this time, the FDA has not approved or authorized tests for COVID-19 virus or antibodies, it has only issued Emergency Use Authorizations (EUA) for such tests.

Judith19837   May 10, 2020
I've heard that the nasal swab is very painful. Is the saliva swab just as good?

ConsumerLab.com   May 11, 2020
A nasopharyngeal swab, in which a long swab is inserted far back through your nose, can be very uncomfortable. A nasal swab would not go far back and would cause little discomfort. Research is showing saliva to provide a sample that may be just as useful, although most tests at this time are based on nasopharyngeal or nasal samples.

Brian19868   May 11, 2020
A nasal swab should not be painful when using proper technique. One generally needs a tissue and may sneeze and/or laugh from the experience.


Share your thoughts and comments about this topic in the space below. Please abide by the following rules:
  • If you make a statement of fact, such as whether a type of treatment does or does not work, state your basis -- such as personal experience or a published study.
  • If you make a positive or negative comment about a product, note whether or not you have a financial interest in the product or in a competing product.
  • Please be respectful in your tone.
  • Please do not submit any type of HTML markup or scripting as it will not be accepted, nor will comments that exceed 2,500 characters.
For your privacy, only your first name (from your account) followed by a random number will appear with your comment. Your last name and email address will not be displayed.
Comment:

Share your thoughts and comments about this topic in the space below. Please abide by the following rules:
  • If you make a statement of fact, such as whether a type of treatment does or does not work, state your basis -- such as personal experience or a published study.
  • If you make a positive or negative comment about a product, note whether or not you have a financial interest in the product or in a competing product.
  • Please be respectful in your tone.
  • Please do not submit any type of HTML markup or scripting as it will not be accepted, nor will comments that exceed 2,500 characters.
For your privacy, only your first name (from your account) followed by a random number will appear with your comment. Your last name and email address will not be displayed.
Comment:

You can modify your comment below. Please be aware the comment will have to approve the changes before they will be shown:
Comment:

Your edit has been submitted and is being reviewed by ConsumerLab.com prior to publication.
This CL Answer initially posted on 5/9/2020. Last updated 5/26/2020.
ConsumerLab.com members may submit questions to CLAnswers@ConsumerLab.com. We read all questions and try to answer those of popular interest.

 

   BECOME A MEMBER
JOIN NOW

SPECIAL
Coronavirus Information Center
Coronavirus Information Center
Answers to Critical Questions About COVID-19.


Product Reviews

ENCYCLOPEDIA
In addition to our product reviews our encyclopedia covers the following:

Herbs & Supplements

Conditions

Drug Interactions

Alternative Therapies

MEMBER TESTIMONIALS


Follow us on...
facebook twitter
 
 
Join |  Sign In
   
Join Us on Facebook! Join Us on Instagram! Join Us on Twitter! Join Us on YouTube! Join Us on YouTube!
Product Reviews
Brands Tested
Health Conditions
Encyclopedia
CL Answers
Clinical Updates
News
Recalls & Warnings
Recommended Intakes
Where to Buy Products
Testing Program
How Products Were Tested
Quality Certification Program
Join CL Today
Testimonials
Join Free Newsletter
Group Subscriptions
Gift Membership
About Us
The CL Seal
CL Survey
Privacy Policy
Sitemap
Contact Us/Help

©2020 ConsumerLab.com, LLC. All rights reserved. A single copy of a report may be printed for personal use by the subscriber. It is otherwise unlawful to print, download, store or distribute content from this site without permission.
ConsumerLab.com name and flask logo are both registered trademarks of ConsumerLab.com, LLC. This site is intended for informational purposes only and not to provide medical advice.