Is It Really Necessary to Get Tested for COVID Anymore?

Four years after the first case of COVID-19, the respiratory virus has become a fairly routine part of our lives — so much so that many people perceive the virus as something akin to a bad cold. 

At this point, experts have a better grasp on the course of the virus, and the treatment regimen for COVID in healthy adults looks very similar to that of the flu. Guided by the assumption that a positive COVID test would not alter the course of their treatment, this has prompted many people to forgo testing for the virus altogether.

But one expert advises against this, noting that although COVID may present in a similar way to other viruses like the flu, the risks associated with it are very different.

Daliah Wachs, M.D., a family practice provider in Nevada, tells The Messenger that there are several different issues with forgoing COVID testing and self-treating viral symptoms at home.

Here’s why you might want to reconsider skipping the test:

The risk of severe illness and long COVID

Since COVID can affect everyone differently — causing minor symptoms in some, and severe, life-threatening illness in others — and because it is so highly transmissible, it is important to test so that others who may have been around you will know what they have been exposed to. When it comes to COVID, what might present as a common cold in one person could have more long-term health ramifications in someone vulnerable to severe illness.

“It helps to know if COVID is the current culprit if isolation wasn't done prior to infectivity (many are infectious prior to feeling ill themselves) so vulnerable family members can know what they might have been exposed to,” Dr. Wachs says. “Moreover, if long COVID symptoms persist — cough, headache, loss of taste and smell, depression, anxiety, shortness of breath — we medical providers need to know if they had confirmed COVID in the past.”

Dr. Wachs notes that having the knowledge that a patient had a prior COVID infection or exposure could alter the course of how their symptoms are treated after their initial recovery period.

You might not get the right treatment

If someone tests positive for COVID within a short time of developing symptoms, treating the virus with an antiviral medication like Paxlovid could help prevent their symptoms from becoming severe. But without that positive test, antivirals are not an option.

The absence of a positive COVID test could also lead to someone’s symptoms being treated the wrong way. Viral symptoms can often be mistaken for a bacterial infection, but antivirals are not effective for bacterial infections and antibiotics cannot treat viruses. 

Not only does being prescribed the incorrect medication not relieve symptoms, in the case of antibiotics, it could also create antibiotic resistance, making the future use of certain antibiotics less effective in an individual. This could also contribute to the already growing issue of a national antibiotic shortage, Dr. Wachs says.

“The biggest issue we are having is antibiotic overuse, which is causing resistance and nationwide shortages. Patients are going to urgent care or calling telemedicine companies asking for antibiotics to hasten the recovery,” Dr. Wachs says. 

“If they were diagnosed originally and treated with Tamiflu (for flu) or Paxlovid (for COVID) maybe they wouldn't be asking for antibiotics four days in. We have people calling in on day seven [of symptoms] saying they are still sick and finally took a COVID test, which was positive, but by then they have passed the antiviral treatment window.”

Underlying health issues could be exacerbated

It has been well established that COVID is more likely to cause severe illness in people with underlying health issues, like hypertension, diabetes and heart disease. However, not everyone knows they have health issues.

“If the average person doesn't know that they are vulnerable (if they don't get regular physicals), they may think their illness is mild until they have severe sequelae,” Dr. Wachs says, adding that this can put them at risk of more serious complications, like stroke.

When it comes to testing, Dr. Wachs says that at-home COVID tests will typically suffice, but a positive result does warrant a call to your physician to discuss treatment options and symptoms to look out for. 

Although at-home tests are typically fairly reliable, they may not always detect the virus, especially as new strains emerge, Dr. Wachs points out.

“If a rapid antigen test is negative at home, because the newer strains could potentially evade our rapid antigen tests, retest a few days later. Or if symptoms are severe, seek medical care immediately and be tested in a medical setting,” Dr. Wachs suggests.