How Does The Coronavirus Test Work? 5 Questions Answered

BIOLOGY
How Does the Coronavirus Test Work? 5 Questions

Answered
A molecular biologist explains how the kits function, and why the U.S. has faced
problems
By Maureen Ferran, The Conversation US on March 12, 2020
An analyst at Fiocruz laboratory, a public health research institute, in Rio de Janeiro holds a sample of
mucus to be tested for COVID-19, on March 11, 2020. Credit: Carl de Souza Getty Images
The following essay is reprinted with permission from

The Conversation, an online publication covering the latest research.
The U.S. government is fighting to contain and slow down the spread of
the coronavirus. Testing is central to these efforts. Molecular biologist
and viral researcher Maureen Ferran answers some basic questions
about how these diagnostic tests work–and if there are enough to go
around.
WHO GETS TESTED FOR THE VIRUS?
Currently there are two main reasons someone would be tested for the
coronavirus: having symptoms or exposure to an infected person.
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The main symptoms of COVID-19, the disease caused by the coronavirus

SARS-CoV-2, are fever, dry cough and shortness of breath. These look a
lot like the flu and the common cold, so it takes a physician to determine
if testing for the virus is necessary.
Initially, the Centers for Disease Control and Prevention recommended

testing only people with symptoms and who had potentially been exposed
to the virus. But to the surprise of public health officials, several of the
first people in the U.S. who tested positive for the virus had no obvious
exposure. This development suggested that the virus was being
transmitted locally, meaning it was spreading from person to person
easily and/or that people may have been transmitting the virus without
experiencing serious symptoms.
In response, on March 4 the CDC changed its recommendations to

allow anyone with COVID-19-like symptoms to be tested as long as a
doctor approved the request. Since the number of available tests is
limited, the CDC is encouraging physicians to minimize unnecessary
testing and consider a patient’s exposure risks before ordering tests.
As of writing this, there are no specific treatments available for COVID-

19, but that does not mean testing is pointless. Perhaps most importantly,
testing is done so that infected patients can be quarantined and the
spread of the virus slowed. Another benefit of testing is that it lets public
health workers build a more accurate picture of the number of cases and
how the virus is spreading in the population.
WHAT IT IS LIKE TO GET TESTED?
For a patient, the process of being tested for the virus is easy and can
potentially be done almost anywhere. It typically involves taking a swab
from deep in a patient’s nasal cavity to collect cells from the back of the
nose. The sample is then sent to a lab, where it will be tested to determine
if the patient’s cells are infected with the virus. The same process is used
to collect a sample from a patient who is tested for flu.
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HOW DOES THE TEST WORK?
While collecting a sample is easy, actually determining whether a person

is infected with the coronavirus is much more complicated. The current
method looks for the virus’s genetic material (RNA) in a patient’s cells.
In order to detect the presence of RNA in the patient’s sample, labs

perform a test called reverse-transcription polymerase chain reaction.
This method first converts any viral RNA to DNA. Then the DNA is
replicated millions of times until there are enough copies to detect using a
specialized piece of equipment called a quantitative PCR instrument.
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If genetic material from the virus is found in the sample, then the patient
is infected with the virus.
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It takes 24-72 hours to get the results of a test. During the early ramp-up
of testing, there were some concerns about the test’s accuracy after one
study found 3% of tests in China came back negative when the samples
were actually positive. But this type of genetic test is generally very
accurate – more so even than rapid flu tests—and the benefits of testing
outweigh the risk of an error.
DOES THE US HAVE ENOUGH TESTS?
The availability of tests has been a big issue. Prior to Feb. 29, the CDC was
the only place approved by the FDA to develop, produce and process tests.
However, as the number of suspected cases climbed and doctors approved
more people for testing, demand to be tested soared.
The test for the coronavirus requires a kit, specialized equipment and
specially trained personnel. Faulty and slow development of test kits and
the initial requirement that all tests be processed at the CDC contributed
to the slow rollout across the U.S.
As pressure on the federal government to make tests available increased,

the FDA announced a new policy on Feb. 29 that made it easier for
commercial and academic laboratories to develop their own tests and
allowed other certified labs to test patient samples.
Integrated DNA Technologies, a CDC contractor, shipped 700,000 tests

to commercial, academic and health care laboratories on March 6. Quest
Diagnostics and LabCorp, two large commercial test manufacturers,
started making their own test kits, which became available on March 9.
Many companies, hospitals and other institutions are now racing
to develop more tests to diagnose COVID-19.
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On March 10, Alex Azar, secretary of Health and Human Services,

announced that 2.1 million testing kits are now available and more than 1
million have shipped to certified labs for testing. Millions more are
expected to ship out this week.
DOES EVERYONE REALLY NEED TO BE

TESTED?
Realistically, it isn’t feasible to test everyone who is sick in the U.S.

Therefore, most health officials believe it is important to prioritize the
testing of people who need it the most: those at high risk such as health
care workers who have been in contact with COVID-19 patients;
symptomatic people in areas with high infection rates; and people 65
years of age and older with chronic health issues, such as heart disease,
lung disease or diabetes. As more tests become available, it will be
possible to test more people.
There’s also a need to develop faster tests that do not require special
equipment and personnel. Testing allows experts to better understand
how the outbreak is progressing and try to predict the impact the virus
will have on society.
As with all outbreaks, this pandemic will end. In the meantime, however,
people need to wash their hands and try to minimize their risk of
exposure. There is much to be learned about this novel coronavirus. Only
time will tell if it disappears from the human population, as SARS did in
2004, or becomes a seasonal disease like flu.
This article was originally published on The Conversation. Read the

original article.
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Read more about the coronavirus outbreak here.

Crazy hack with soap in toilet
He poured some soap in his
toilet and then this happened
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ABOUT THE AUTHOR(S)
Maureen Ferran
Associate Professor of Biology, Rochester Institute of Technology.
The Conversation US
Scientific American is part of Springer Nature, which owns or has commercial relations with thousands of
scientific publications (many of them can be found at www.springernature.com/us). Scientific American
maintains a strict policy of editorial independence in reporting developments in science to our readers.
© 2020 SCIENTIFIC AMERICAN, A DIVISION OF SPRINGER NATURE AMERICA, INC.
ALL RIGHTS RESERVED.

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BIOLOGY

How Does the Coronavirus Test Work? 5 Questions

By Maureen Ferran, The Conversation US on March 12, 2020

The following essay is reprinted with permission from

The main symptoms of COVID-19, the disease caused by the coronavirus

Initially, the Centers for Disease Control and Prevention recommended

In response, on March 4 the CDC changed its recommendations to

As of writing this, there are no specific treatments available for COVID-

WHAT IT IS LIKE TO GET TESTED?

HOW DOES THE TEST WORK?

While collecting a sample is easy, actually determining whether a person

In order to detect the presence of RNA in the patient’s sample, labs

Sign up for Scientific American’s free newsletters. Sign Up

DOES THE US HAVE ENOUGH TESTS?

As pressure on the federal government to make tests available increased,

Integrated DNA Technologies, a CDC contractor, shipped 700,000 tests

On March 10, Alex Azar, secretary of Health and Human Services,

DOES EVERYONE REALLY NEED TO BE

Realistically, it isn’t feasible to test everyone who is sick in the U.S.

This article was originally published on The Conversation. Read the

Read more about the coronavirus outbreak here.

ABOUT THE AUTHOR(S)

© 2020 SCIENTIFIC AMERICAN, A DIVISION OF SPRINGER NATURE AMERICA, INC.

ALL RIGHTS RESERVED.

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