COVID-19: Who should get tested for current infection of the virus and when

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INDIANAPOLIS — With testing guidance rapidly changing and the emerging variants of the virus, it might be difficult to keep up with information on who should get tested and when.

You might also notice that section on the website of a county’s health department varies from the Indiana State Department of Health (ISDH), which also looks a bit different from the Centers for Disease Control and Prevention (CDC) when it comes to exact wording, explaining who should be tested for the virus and how long after potential exposure.

“It is something that we’ve noticed that there is some differences and part of it is in the communication that happens between the various levels of health,” said Dr. Brian Dixon, director of public health informatics at the Regenstrief Institute.

Dixon said sometimes there may be a lag in the most updated information reflecting on websites because the information filters down from the CDC to the state-level health departments and then to the local level.

“What we know about the virus changes very rapidly and there’s a need to update the guidelines and policies on what feels like a daily basis,” Dixon said.

“There’s suggestions and guidelines and I feel like, it’s like we were a year ago and things change day to day,” said Stephenie Mellinger, administrator for the Madison County Health Department.

She said she understands the frustration of trying to keep up with the ever-changing suggestions and guidelines to testing.

“I have to stop and think when someone asks me when do I need to be tested, and there’s a series of questions that’s almost like an algorithm of how to arrive at the correct answer,” she said.

State health officials said they are seeing an increase in people being tested due to the spread of the delta variant.

“From a public health perspective, we need people to get tested because it’s the only way that we can track the disease,” said Dixon.

He said in order to find out how many cases there are in the community, what the positivity rate is, what has changed over time, and whether someone has the variant, it’s important people who are suggested to get tested — do — especially with the positivity rate and testing increase in recent weeks.

“A few weeks ago, we were at a couple hundred cases a week, things were really, really low. Now we’re up to 1,100 a day,” said Dixon, calling it a ‘dramatic increase’ over the last month.

“When that positivity is as high as it is, above 10 percent, where it’s at right now, that tells us there’s probably more infections in the community that we’re not documenting.”

Dixon compared the current status of the state’s positivity rate to that of early January.

“Early this year like in January when we were kind of coming down from that peak in the fall, but we still had very high levels of infection in the community, we’re kind of about back to that place,” he said.

Who should get tested and when?

ISDH is recommending Hoosiers follow the guidance set forth by the CDC. In an email to CBS4, a spokesperson for IDSH wrote, “The CDC recommends that anyone who has symptoms of COVID-19 get tested.”

The department said the CDC also recently extended the recommendation to include anyone who has been exposed to COVID, regardless of their vaccination status or symptoms, citing that the Delta variant is “much more infectious than previous strains of the virus.”

Health officials recommend testing three to five days after exposure.

“The recommendation is to be tested now even if you’re vaccinated because one, we need to document that so we can track the disease and two we want to be able to understand if you’re part of a larger outbreak,” Dixon explained.

He said once a test is conducted, health officials are able to test for variants and further analyze for the Delta variant or areas of concern.

According to ISDH, people who are symptomatic are encouraged to get a PCR test, which they said is the “gold standard and much more accurate than a rapid test.”

Mellinger said the Madison County Health Department, like the state, has experienced an increase in testing. She said the volume is not overwhelming, and she considers it manageable, but still a noticeable increase.

“We have schools back in session, we have students out as a result of quarantine, so we’ve had an increase in testing just in the past week,” she explained.

She said each week there is a video call with the local health departments and the state also holds one with the schools. On them, Mellinger said state health officials have provided guidance based off of what the CDC is recommending. She said things can change so quickly, even between the two calls held in the same week.

When it comes to driving decisions in Madison County, however, Mellinger said they are relying on state and local data, since the state’s metrics don’t match the national metrics, something she considers very frustrating.

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