To Test, Perchance to Diagnose: Practical Strategies for SARS-CoV-2 Testing

Humphries, Romney M; Azar, Marwan M; Caliendo, Angela M; Chou, Andrew; Colgrove, Robert C; Fabre, Valeria; Ginocchio, Christine C; Hanson, Kimberly E; Hayden, Mary K; Pillai, Dylan R; Pollock, Nira R; Lee, Francesca M

Testing for SARS-CoV-2 in symptomatic and asymptomatic patients is an important component of the multifaceted approach of managing the COVID-19 pandemic. Determining how to best define testing strategies for different populations and incorporating these into broader infection prevention programs can be complex. Many circumstances are not addressed by federal, local or professional guidelines. This commentary describes various scenarios where testing of symptomatic or asymptomatic individuals for SARS-CoV-2 virus (antigen or RNA) can be of potential benefit. Consideration to pre-test probability, risks of testing (impact of false-positive or false-negative results), testing strategy as well as action based on test results are explored. Testing, regardless of setting, must be incorporated into overarching infection control plans which include use of personal protective equipment (e.g., masks), physically distancing, and isolation when exposure is suspected.