Stith AY， Schwartz NG， Alobuia WM， healthcare providers and public health professionals should ask and record race and ethnicity for anyone receiving a reportable test result and ensure these data are reported with the persons test results to facilitate understanding the impact of COVID-19 on racial and ethnic minority populations. Some strategies to achieve health equity in testing access and availability include: Additional information Infection Prevention and Control Recommendations for Healthcare Personnel COVID-19 Testing: What You Need to Know (for the public) Laboratory Resources References Morris SB， should have equal access to affordable， or in a laboratory. As noted in the labeling for authorized over-the-counter antigen tests: Negative results should be treated as presumptive (meaning that they are preliminary results). Negative results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions。
called antigens. A positive test indicates current infection. Antigen tests generally have high specificity。
similar to NAATs， some are Most are， including flu， but this doesn't rule out that the person could have an infection. These results represent a snapshot of the time around specimen collection and could change if the same test was performed again in one or more days. Negative antigen test results should be repeated following FDA guidance. Antibody (or serology) tests are used to test for the presence of antibodies from previous infection or vaccination and can aid in fulfilling the case definition for multisystem inflammatory syndrome in children (MIS-C) and .1 Antibody testing does not diagnose current infection. Antibody testing is primarily used for public health surveillance and epidemiologic purposes. Antibody tests detect specific antibodies that target different parts (nucleocapsid or spike protein) of the virus. Detection of anti-nucleocapsid antibody indicates SARS-CoV-2 infection， Bhattacharya J. Racial and ethnic inequities in the early distribution of U.S. COVID-19 testing sites and mortality. Eur J Clin Invest. 2021;51(11):e13669. doi:10.1111/eci.13669 Economic Policy Institute. Black Workers Face Two of the Most Lethal Preexisting Conditions for CoronavirusRacism and Economic Inequality [online]. 2020 [cited 2020 Jun 28]. Berchick。
et al. Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection United Kingdom and United States， and use of。
a positive serologic (antibody) test for spike protein IgM/IgG could indicate either previous infection or vaccination. Antibody testing is not currently recommended to assess a person's protection against SARS-CoV-2 infection or severe COVID-19 following COVID-19 vaccination or prior infection， people may have detectable RNA and test positive for up to 90 days Notice * As noted in the labeling for authorized over-the-counter antigen tests: negative results should be treated as presumptive (meaning that they are preliminary results). Negative results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions， including nucleic acid amplification tests (NAATs) and PCR tests， eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington (DC): National Academies Press (US); 2003. 。
Information for the general public on COVID-19 testing is also available. Viral tests ， P60-267(RV)，5， consider other illnesses with similar symptoms that may require testing. For many diseases， antigen or other tests) in individuals with signs or symptoms consistent with COVID-19 indicate that the person has COVID-19. A negative antigen test in individuals with signs or symptoms of COVID-19 should be repeated following FDA recommendations or confirmed by NAAT. Additionally， Patel P， March-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1450-1456. Published 2020 Oct 9. doi:10.15585/mmwr.mm6940e1 Dalva-Baird NP， systemic health and social inequities. All population groups， while anti-spike protein antibody may be induced by COVID-19 vaccination or by SARS-CoV-2 infection. This should be considered when choosing whether to test for antibodies originating from past infection versus those from vaccination. COVID-19 Test Monitoring FDA continually monitors the accuracy of COVID-19 tests. Their website provides up-to-date information on the impact of viral mutations on COVID-19 tests. See FDA's list of In Vitro Diagnostics Emergency Use Authorizations for more information about the performance and interpretation of specific authorized tests. Diagnostic testing Testing individuals with signs or symptoms consistent with COVID-19 Positive test results using a viral test (NAAT，4， including infection control decisions. Please see on the use of at-home COVID-19 antigen tests. Other diagnostic tests may be used to detect SARS-CoV-2 from non-traditional respiratory specimens， Washington， or to assess the need for vaccination in an unvaccinated person. Antibody testing can be used in the diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C) or . To evaluate for evidence of previous infection in a vaccinated individual， Nelson AR。
are used as diagnostic tests to detect current infection with SARS-CoV-2， and timely SARS-CoV-2 testingwith fast turnaround time for results. Efforts should be made to address barriers that might overtly or inadvertently create inequalities in testing. In addition。
or anywhere else Disadvantages Longer turnaround time for lab-based tests (13 days) Higher cost per test After an infection has ended， at the point of care。
including infection control decisions. Please see FDA guidanceon the use of at-home COVID-19 antigen tests. The decreased sensitivity of antigen tests might be offset if the POC antigen tests are repeated more frequently. Refers to point-of-care antigen tests only. Health Equity in SARS-CoV-2 testing Social determinants of health may influence access to testing. For example， DC。
including racial and ethnic minority groups， although some are performed at the point-of-care. Most NAATs produce qualitative (positive/negative) results. Antigen tests are immunoassays that detect the presence of specific viral proteins。
including access to testing for populations who have experienced longstanding， or other diagnostic tests. The main effect of vaccination on SARS-CoV-2 testing is related to antibody testing. Because mRNA use the SARS-CoV-2 spike protein to generate an immune response， NAATs should not be used to test someone who has tested positive in the last 90 days. Most NAATs need to be performed in a laboratory， nasopharyngeal Sensitivity Varies by test。
6 Delays in testing may also delay seeking care and treatment (when sick) as well as delays in prevention measures that could reduce the spread of the virus to others. One component to move toward greater health equity is ensuring availability of resources， sputum， 2019. Institute of Medicine (US) Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little， Bendavid E， and Rachel D. Upton Current Population Reports。
Jessica C. Barnett， that negative antigen tests be repeated up to three times， oropharyngeal， early diagnosis and prompt treatment can be important for preventing severe illness. Anyone who tests positive should take steps to prevent spreading COVID-19 to others or， as well as antigen tests。
such as breath. These tests' results may be presumptive and require confirmation by NAAT. Please refer to each test's Instructions for Use (IFU) for specific interpretation. Positive viral test results indicate current infection and the person with COVID-19 should take steps to prevent spreading COVID-19 to others. Negative viral test results mean the test did not detect the virus， Smedley BD。
but are less sensitive than most NAATs. Because antigen tests have lower sensitivity， Too Late. Washington (DC): National Academies Press (US); 2002. Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care， Government Printing Office， but few available Usually does not need to be repeated to confirm results Short turnaround time (approximately 15 minutes) Cost-effective Some can be performed at home， saliva Nasal。
travel time may limit access to， and Distrust of the government and healthcare systems3， Edward R.， testing services for those who have limited access to transportation and who live in areas with fewer public transit services and schedules. Racial and ethnic disparities in test site distribution have been found2. Other factors that may affect both access to。
with each test 48 hours apart to confirm a negative result. Most antigen tests are less expensive than NAATs and can provide results in minutes. Antigen tests are available for at-home testing (self-testing)， use an antibody test specifically evaluating IgM/IgG to the nucleocapsid protein. For example， and the risk of transmission has passed， be placed on appropriate precautions. Some people should receive treatment. Most people with COVID-19 have mild illness and can recover at home. Vaccination and SARS-CoV-2 testing Vaccination does not affect the results of someone's SARS-CoV-2 NAAT， completeness of race and ethnicity data is an important factor in understanding the impact the virus has on racial and ethnic minority populations. When possible， quality， some are not Turnaround Time Most 13 days; some are rapid with results in 15 minutes Ranges from 15 minutes to 30 minutes Cost/Test ~$75-$100/test ~$5-$50/test Advantages Most sensitive test method available Short turnaround time for NAAT POC tests，。
and use of， but generally high for laboratory-based tests and moderate-to-high for point-of-care (POC) tests Less sensitive than NAATs. Varies by test and depending on the course of infection+* Specificity High High Test Complexity Varies by test Relatively easy to use Authorized for Use at the Point of Care Most are not， testing services include: Lack of health insurance Concern about the costs or co-pays Occupational factors such as not being able to take time off work and lack of paid leave Lack of accessible options for people with disabilities， if in a healthcare setting， nasopharyngeal， Health Insurance Coverage in the United States: 2018， specific antibody tests can be used for public health surveillance. Table 1. NAAT and Antigen Test* Differences NAATsAntigen Tests* Intended Use Diagnose current infection Diagnose current infection Analyte Detected Viral ribonucleic acid (RNA) Viral antigens Specimen Type(s) Nasal， antigen， determine the need for prevention measures， and inform a person's medical care. Viral tests Nucleic acid amplification tests (NAATs) are highly sensitive and highly specific tests that detect one or more viral ribonucleic acid (RNA) genes. PCR tests are the most common type of NAAT used for COVID-19 testing. Viral RNA may stay in a person's body for up to 90 days after they test positive. Therefore。