Pediatrician Dr. Pilar Bradshaw says she understands why people still have questions about COVID-19, even 18-months into the pandemic.

“The pandemic is challenging for everyone in a million ways,” she says. “One of the things that’s challenging is keeping up with the latest recommendations involving testing, as well as isolation and quarantine.”

When should you be tested for COVID-19?
The Centers for Disease Control and Prevention (CDC) recommends that any adult or child with any signs or symptoms of COVID-19 get tested, regardless of vaccination status or prior infection.

“Don’t wait because you won’t know if you have COVID until you are tested and you may be unknowingly spreading it to your family or to the community,” Dr. Bradshaw says.

You should also be tested if you have been in close contact with someone who has tested positive for COVID-19. According to the CDC:

  • A close contact is anyone who was within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes).

An infected person can spread COVID-19 starting from 2 days before they have any symptoms (or, if they are asymptomatic, 2 days before their specimen that tested positive was collected), until they meet the criteria for discontinuing home isolation.

  • If you have been a close contact, you have no symptoms and you are unvaccinated, get tested.
  • If you were a close contact, have no symptoms but are vaccinated, you should be tested 3-5 days following that possible exposure.

Symptoms of COVID-19
How COVID-19 manifests in children and adults can vary significantly, with symptoms ranging from:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • A loss of taste or smell
  • Sore throat
  • Congestion
  • Diarrhea
  • Nausea or vomiting

Symptoms may appear 2-14 days after exposure to the virus. Since many of the symptoms of COVID-19 are also symptoms of other illnesses, pediatric infectious disease expert Dr. LoRanée Braun advises parents: “If your child has any manifestations of illness, it’s important not to send them back to school and not to put them in day care. Those children need to stay home and stay isolated. Call your health care provider. Your pediatrician or your medical provider can tell you how to get that child tested in a safe way.”
Which COVID-19 test is best?
There are two categories of COVID diagnostic tests that look for current infection with SARS-CoV-2, the virus that causes COVID-19.

  • Molecular test (RNA or PCR test): Testing is done using a nasopharyngeal swab that goes deep into your nose to the back of your throat and the results are highly accurate. Other methods include a throat swab or collection of saliva. Test results are typically available within one to seven days.
  • Antigen test (rapid test): According to the CDC, antigen test sensitivity varies depending on the time in the course of one’s infection but is considered to have “moderate to high” sensitivity during peak viral load. The turnaround time with this diagnostic test is much quicker than an RNA test. Results are typically available within a day.

While molecular tests are considered by medical professionals to be the most accurate, children are often fearful and anxious when receiving a COVID-19 nasal swab.

“It’s not harmful. It’s not a painful test,” says Dr. Braun. “It feels funny to have something going in our nose but it’s the best test collection we have to get the samples we need from the back of the nose.”

Quarantine vs. isolation
Another point of confusion for people is when to quarantine and when to isolate.

  • Quarantine = Stay home: If you were a close contact with someone with COVID-19, you are advised to quarantine, which means to stay home, away from people outside of those you live with for 14 days.

“Don’t be getting a contact trace test and then go off and do 15 errands because in that process you will have potentially exposed a lot of people to COVID,” Dr. Bradshaw says.

  • Isolation = Stay away from other people: If you test positive for COVID-19, regardless of whether you have symptoms or not, you must isolate, which means staying away from other people, including people who live with you. You may have to isolate for up to 10 days.

“And you should not come out of isolation until all of your symptoms are resolved except the loss of smell or taste. For sure your fever, cough and congestion need to be resolved before you come out of isolation.”

Reducing the spread of COVID-19
Since some children and even adults with COVID may be asymptomatic, doctors stress the importance of taking steps to reduce the potential spread of the virus, including getting vaccinated when eligible, wearing face masks in public spaces, practicing social distancing and making good hand hygiene a regular habit.