What to Know About COVID-19 Tests

By M. Ali
From PHN Issue 52, Spring 2023

COVID-19 is an illness caused by a coronavirus called SARS-CoV-2. It spreads when a person with the virus (symptomatic or asymptomatic) releases droplets and particles from their mouth or nose. This can occur when they breathe, cough, or sneeze in close contact with another person. It can also occur in poorly ventilated or crowded indoor settings, such as correctional and detention facilities. The best way to prevent COVID19 infection and reinfection is to practice basic hygiene like washing your hands with soap and water, wear a well-fitting mask, stay up to date with vaccines, and avoid contact with individuals who may have the virus. While the use of masks to prevent the spread of this virus has been politicized and debated, randomized controlled trials have found that community-level mask wearing does reduce COVID-19 infections and may be an especially effective resource in crowded facilities.

Unfortunately, COVID-19 cases continue to rise in U.S. correctional and detention facilities. The Centers for Disease Control and Prevention (CDC) released data in November 2022 estimating that since March 2020 there have been 885,486 confirmed cases behind bars. Confirmed cases mean COVID-19 testing is being implemented; however, the Bureau of Justice Statistics found that testing protocols are different depending on the state and the type of facility.

Testing for COVID-19 is extremely important, if you have access to it. States that tested incarcerated individuals more than once tended to have more people who tested positive for COVID-19, and states that performed fewer tests tended to have fewer people who tested positive for COVID-19. This doesn’t mean there are fewer people getting COVID-19 in those states, just that many of them are not diagnosed or treated. If you do test positive, it can allow you to pursue options like Paxlovid (an antiviral medication) to shorten the duration of symptoms and protect your health.

There are currently two types of COVID-19 tests available: Reverse transcriptase polymerase chain reaction (RT-PCR) and rapid antigen. RTPCR tests detect viral genomes and are considered the gold standard for COVID-19 diagnosis. However, the amount of time required from the collection of the sample to the return of the results is often too long for effective quarantine procedures. Comparatively, rapid antigen tests detect the presence of a specific viral protein. While this type of test gives a result within a matter of minutes, the accuracy of antigen tests is different depending on the manufacturer and the method of sample collection.

When getting a COVID-19 test, a long swab is used to collect respiratory material from the inside of your nose. Depending on if it’s an RTPCR or rapid antigen test, the material is then placed in a sealed tube and squeezed onto a testing strip for results in minutes or sent to a laboratory to detect viral proteins. A positive test means you likely have the SARS-CoV-2 virus, and a negative test means you are unlikely to have it. But it is possible the virus was not detected by the test (especially if it was a rapid antigen test). While new variants of COVID-19 have emerged as the virus mutates, as of now the rapid antigen tests are accurate at detecting them.

After catching COVID-19, you remain infectious for a period of time, which means you can pass the virus on to other people. Although new COVID-19 studies are continuing to be conducted and new data is constantly emerging, as of now individuals with moderate symptoms should isolate for 10 days. Those with severe symptoms may remain infectious beyond 10 days and should isolate for up to 20 days.

If you have tested positive for COVID-19 or are experiencing symptoms and are unable to access testing, an important step to prevent the spread of this virus is medical isolation. Medical isolation should always be different from the inhumane practice of solitary confinement. If your facility is not using medical isolation properly, you may have to advocate for your continued access to resources (including television/reading materials, family support, access to medical staff, etc.) during this isolation, even though it’s your right to have these things. Additionally, you should be taken off of medical isolation as soon as you are cleared by medical staff.

The COVID-19 pandemic has completely altered the way the world works and taken many lives, but fortunately we now have knowledge on what it takes to protect ourselves. Please continue to take care of yourself and others and stay safe during this difficult time.