So you need the COVID-19 test?

Marc, age 22, developed a sore throat and dry cough. The next day, upon a friend’s suggestion, he did a drive-thru COVID-19 test at a local pharmacy. “Really easy,” he said.

He filled out a short online screening form, got an appointment within an hour. Before he left, he watched a video on do-it-yourself nose-swab. At the drive-thru, he was given a kit, swabbed himself and was done in minutes. The line was shorter than Popeye’s at dinner time.

Sponsored by the Family First Coronavirus Response Act, COVID-19 testing is free to Americans with or without insurance. Unlike hospitals and clinics, many drive-thru sites do not require a doctor’s referral.

What you should know: There are many COVID-19 tests – too many to track. But they can be grouped into two basic types. The first is a swab (nose, throat, saliva, etc.); the second, a blood test.

Within the first few days of symptom onset, you want the swab, which tests for the virus directly. The most common are nose swabs. The results take a few hours to a few days to run. They’re highly specific; that is, if you test positive for COVID-19, you’ve got COVID-19 (as opposed to other infections, including other corona viruses).

But if you test negative for COVID-19, don’t sleep too soundly.

In a perfect world, tests are done by trained professionals and rushed to specialized labs; swab tests perform consistently and very well. But in real life, accuracy falls flat.  

Why? Experts think a big problem is sampling. The ideal place to find living and multiplying corona viruses is past your nose at the back of your throat – the nasopharynx. Years ago, because of a persistent cough, I had it done by a colleague. As he advanced the swab, I heaved, coughed, teared and thought he was about to poke a hole through my brain. It’s unclear if most people, including me, can properly torture themselves for an adequate sample. New tests on saliva and throat may bypass this problem. We’ll see.

What about blood tests? They do not test for the virus – but test for your immunity against the virus. They can turn positive four days after the onset of disease, but it’s best done two to three weeks afterward. By that time, most are over the worst. Blood tests are good to confirm your immunity but can potentially be confused with immunity against other corona viruses. Currently we don’t know how long viral immunity will last; a “COVID-19 immunity card” is not a “get out of jail free” card. Sorry.

For an updated list of drive-thru test sites, I like’s listing – one click. There are two places around here – the CVS store in Westlake and one in North Olmsted. More sites will be opening.

After two days, Marc got his result: Negative.

Because of his persistent sore throat, I still recommend that he stays in isolation until all symptoms resolve. By the way, that’s the advice doctors have given for all respiratory infections. Imagine: I used to write notes so my coughing-up-a-storm patients could take their sick days. Let's hope this pandemic changes that.

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Volume 12, Issue 12, Posted 9:49 AM, 06.16.2020