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COVID-19 Testing Task Force
The Loudoun County COVID-19 Testing Task Force was organized to help facilitate the availability of more COVID-19 testing in the community. It provides information and recommendations to the Board of Supervisors and the County Administrator who are closely monitoring the progress of the pandemic.
Purpose
The task force is addressing the following matters:
- Identity the steps necessary to increase the number of COVID-19 tests performed in the county overall.
- Identify the best diagnostic tests and the efforts necessary to have access to those tests, and all necessary testing materials, and safe specimen collection activities.
- Identify future steps to conduct serology, or antibody, testing and provide advisement/recommendations.
Resources
The documents included at the links below have been provided by members of the Loudoun County COVID-19 Testing Task Force as informative resources to physicians and the public. The information does not represent a formal position of Loudoun County Government or the Virginia Department of Health.
- Information for Physicians
- Includes weekly updates from task force infectious disease specialists Dr. Rhee and Dr. Levorson.
- Sanford Guide: Summary of scientific based conclusions on COVID
- Health care practitioners may email our infectious disease advisers to ask questions.
- Task Force Meeting Agendas and Summaries
- Includes meeting summaries and agendas.
- Information for Patients
- If you have been tested for COVID-19 and have questions about the results, additional resource information is included.
Testing Guidance December 2020
There are currently several testing methods to detect the virus that causes COVID-19 and many people have wondered which tests are best and which tests they should seek. The following guidance can help you determine the type of test to request, depending on your specific situation. This is general guidance and your specific care should be discussed with your health care provider. View more about the differences between the antigen (rapid) test and polymerase chain reaction (PCR) test.
Type of Test to Request
- If you have symptoms of COVID-19:
Testing can be done beginning day 1 through 5 of onset of symptoms with either an antigen (rapid) or PCR test. A negative antigen test should be repeated with a PCR test, as it could be a false negative reading. If you test positive for COVID-19, it is important that you self-isolate and stay away from others until it is safe. Learn more about when it's safe to be around others (PDF). - If you were exposed to a positive COVID-19 individual and are not experiencing symptoms (asymptomatic):
Testing should be done by PCR test, not antigen, and is best performed on day 5-7 after exposure to a positive COVID-19 individual. If you were exposed, stay home and away from others, quarantine, for 14 days after your last contact. - If you are asymptomatic and were not exposed to a positive COVID-19 individual. You might require a test for travel, returning to college campus or visiting a high-risk individual:
Testing should be done by PCR test, not antigen. A positive antigen test should be repeated with a PCR test, as it could be a false positive reading. You should carefully follow all public health precautions after being tested (PDF).
Loudoun County Testing Locations
The following table lists local providers who administer the antigen (rapid) and/or PCR tests and who serve on the Loudoun Testing Task Force or have shared their information with Loudoun County. If you are a testing provider and would like the details of your testing program to be included here, please email us.
Provider Name | Type of Test Administered | Must see provider first if symptomatic? | Must see provider first if asymptomatic & exposed? | Must see provider first if
asymptomatic & not exposed? |
Appointment Required? | Testing Hours | Cost without insurance |
---|---|---|---|---|---|---|---|
Healthworks for Northern Virginia | Antigen (rapid)
PCR |
No | No | Not testing asymptomatic and not exposed | Yes, available within 24 hours | Monday - Friday
8:15am-4:30pm |
No cost |
Loudoun Medical Group* | PCR | Yes, provider's order or telehealth visit required | Yes, preferably 5-7 days after exposure. Provider's order or telehealth visit required | Not testing asymptomatic and not exposed | Yes | Monday - Friday
5:30 pm - 7:30 pm; Saturdays
3:30 pm - 5:30 pm |
No cost |
Inova: Ashburn Healthplex | Antigen (rapid) (coming in January 2021);
PCR |
Yes, provider's order or telehealth visit required | Yes, preferably 5-7 days after exposure. Provider's order or telehealth visit required | Yes, provider's order or telehealth visit required. Only for procedures, travel and return to school. | Yes | Monday - Sunday
8am - 8pm |
No cost |
Inova: Dulles South Urgent Care | Antigen (rapid) (coming in January 2021);
PCR |
Provider seen at time of test | Provider seen at time of test | Provider seen at time of test | No | Monday - Sunday
8am - 8pm |
No cost |
MetroMed | PCR | No | No | No | No | Monday - Friday
8am - 3pm (weather permitting) |
Varies. If not covered, cost is $145 |
HCA/Care Now | Antigen (rapid)
PCR |
Yes, clinic or telehealth visit required. | Yes, clinic or telehealth visit required | Yes, clinic or telehealth visit required | No, web check-in at CareNow.com | Monday - Friday 8 am-9 pm; Saturday -Sunday 8 am-5 pm | Varies |
PatientFirst | Antigen (rapid)
PCR |
Center visit with provider required. | No | No | Asymptomatic: Yes;
Symptomatic: No
|
Check website to verify days/times. Asymptomatic testing: hours are limited. Antigen testing: patients must meet criteria. Test available during regular hours, based on availability. |
No cost |
Alexandria City
Dept. of Health & Curative Kiosks - Multiple Locations |
PCR
Oral swabs
Offering 24-hour results
|
n/a | n/a | n/a | Walk-up available
Appointment encouraged. Visit www.curative.com |
Times Vary | Free |
ResourcePath
|
Antigen (rapid)
PCR
|
No | No | No | Yes, readily available. | Monday - Saturday
8:30am-12:00pm; after hours service available
|
No cost if symptomatic/ exposed; fee for travel testing |
*LMG is providing community testing at the Cornwall Street drive thru location in the parking lot adjacent to 224 Cornwall Street, NW in Leesburg off of Memorial Drive. Testing will be conducted by appointment only for current LMG patients with an order from an LMG provider, First Responders, Pre-Operative patients for Loudoun Ambulatory Service Center, and Inova Loudoun Hospital Staff. Make an appointment by calling 571-707-2070. Testing hours are limited to 9 am-3 pm, Monday through Friday.
Please note that the listing of providers does not imply an endorsement of that business by Loudoun County or the Virginia Department of Health.
Find Additional COVID-19 Testing Locations
- Visit the Virginia Department of Health's website to find COVID-19 testing locations in Loudoun County and Northern Virginia, including one-day testing events. Enter your locality in the search field to find locations near you.
- Some Walgreens locations in Virginia are offering free COVID-19 drive thru testing. View more information and locations.
- Loudoun County free COVID-19 events can be found at loudoun.gov/COVID19testing.
- If you have questions about testing or need help finding testing, call the Health Department information line at 703-737-8300, Monday-Sunday 9:00 a.m. to 5:00 p.m.
Testing Task Force Recommendations
- Recommendation Sept. 2020
- Recommendation August 2020
- Update on Testing July 2020
- Recommendation May 2020
Asymptomatic testing
The Loudoun County Task Force is aware of the confusion regarding the best use and timing of COVID 19 testing if you DO NOT have any symptoms.
The recent statement by the CDC on this topic was interpreted in different ways by physicians, non-physicians, politicians, etc.
Here is a summary of your local trusted Infectious disease experts, healthcare practitioners, Virginia Department of Health and Government officials:
- The CDC states “If you do not have COVID-19 symptoms and have not been in close contact with someone known to have a COVID-19 infection you do not need a test.” There continues to be a nationwide shortage of testing material. Results from PCR testing can take anywhere from 2 to 14 days. In light of this, we agree that mass testing of asymptomatic persons who have no known contact and are not in a high risk group is generally not necessary. This does not apply to routine screening or surveillance testing at work, school, or similar situations.
That said, a known contact of a person with COVID 19, as determined by the Virginia Department of Health, should be tested, if supplies are available, on day 5-7 after exposure. A negative test does not provide absolute assurance that you may end quarantine. We recommend continued avoidance of all high risk individuals for 14 days after your last known contact with the positive case.
Brief description of testing options and interpretation of results:
PCR tests
Done by nasopharyngeal swab (swab inserted DEEPLY into the nasal passage) and detects genetic material unique to the virus (in this case Rna). Complex process and takes time to complete, as the sample must be heated, cooled, and reheated to complete.
This is the most common test done today, but our nation is facing shortages in swabs, testing reagents (like missing yeast to make bread), and there is a back log of tests, where the “turn around” time has climbed to as high as 14 days, rendering the results useless. By the time the results are known, the patient’s contagious period is likely over.
The other problem with this test is that it does not tell you WHEN in the course of the illness you may be presenting. For example, the Rna will stay in a person’s nasopharynx for up to 3 months AFTER you are contagious but is also detectable in the early “asymptomatic” phase.
Example: certain colleges/universities are asking for this test prior to students returning to campus. If negative, it is reassuring that the student is not sick or contagious on the day of the test, and likely has not had the virus in the recent past. But, if positive and they have no symptoms, the student could be on Day 2 post infection (contagious) or Day 50 (non-contagious).
This is why, once a person is known to have tested positive, a negative test is NOT recommended to drive back to work/school decisions.
Antigen tests
This is a test looking for protein from the virus that is unique to that virus only. The most common tests are “cartridge” based tests, used in offices, and have a 15-minute turnaround time. This is performed with a nasal swab (not as far into the nasal cavity).
These are not as sensitive at picking up small viral loads as the PCR. That does not mean they are not useful. WHEN SYMPTOMATIC, the sensitivity is around 80-95 percent. The best time to be tested is Day 1-5 of illness, and sensitivity drops as you reach day 7 (less virus, harder to detect).
These are not useful for asymptomatic screening, hence, the pre-college, or post exposure but asymptomatic patient will still need a PCR.
The utility here is the quick turn around and the ability to identify and isolate a potentially contagious person early.
A salivary test is under review and potentially exciting. This is a take at home test where saliva can be used to identify the spike protein on the outside of the coronavirus. It is less sensitive, but again, the rapid result makes it a possible tool in the prevention of spread within a community if used on a large scale, it could be helpful in reducing disease transmission through early identification.
Social distancing, mask wearing, staying away from others when sick, and seeking medical care when sick are the prudent measures to mitigate this disease. It is just not feasible to test every asymptomatic person every couple of days, as we do not have the testing supplies for such an endeavor.
Provider Name | Current # of Tests Per Day | Current Daily Capacity | Current Constraints on Individuals to be Tested |
---|---|---|---|
Healthworks for Northern Virginia |
60-75 between 3 locations | 75 | Must be enrolled as a patient; enrolling new patients. Testing symptomatic and asymptomatic. No Charge. |
Loudoun Medical Group |
100 | 200 1,000 for corporate testing |
Pre-op; contact, symptomatic and asymptomatic, contacts of positive patients and follow-up of positive patients; all PCR nasopharyngeal swabs; all in Loudoun County; ability to do unlimited numbers of Roche IgG test daily; limited only to capacity to draw blood |
Inova |
300 | 400 | Symptomatic patients, asymptomatic pre-procedure and long term care residents, all laboring moms (regardless of symptoms) and exposed newborns |
MetroMed |
120+ | 130 | Testing symptomatic and asymptomatic |
HCA/Care Now |
40-50 | 100 | Symptomatic patients; pre-op |
PatientFirst |
60/day, 7 days a week | 100 | Symptomatic patients, pre-op, contact, employment, first responders, health care workers, cancer patients |
Loudoun Free Clinic |
0 | Referring to other test sites (Inova, Loudoun Medical Group tents, Healthworks) |
Antibody Testing
At this time, we do not recommend antibody tests also known as serology testing for COVID-19. The antibody tests that are currently available are NOT specific enough for COVID-19 and false positives are a strong possibility. Remember, about 1/3 of all common colds are in the coronavirus family, and we have all likely been infected with a coronavirus at some point. Therefore a positive test does not mean you have COVID-19 immunity. There is also no evidence to suggest that past infection with COVID-19 is protective against re-infection with COVID-19. In addition, we do not have enough data about how human antibody patterns behave to COVID-19, so we could be seeing false negatives as well depending on how long people make antibodies. As more specific COVID-19 strain antibody tests are developed, these guidelines may likely change, but again at this time, COVID-19 antibody testing is not recommended.
Membership
- Dr. John Farrell, Loudoun Health Council - Chairman
- Charles Yudd, Deputy County Administrator - Co-chair
- Hospital Corporation of America (HCA) - Matthew Mathias
- Inova - Stacey A. Metcalfe and Dr. Jill McCabe
- Loudoun Medical Group - Dr. Kevin O'Connor
- Healthworks - Carol Jameson @(Model.BulletStyle == CivicPlus.Entities.Modules.Layout.Enums.BulletStyle.Decimal ? "ol" : "ul")>
- Urgent care facilities - Dr. Roshelle Beckwith and Michelle Fitz (MetroMed) and Dr. John Strazzullo (Patient First)
- Loudoun Free Clinic - Maribeth Goldin
- Dr. Henry Rhee
- Dr. Rebecca Levorson
- Loudoun County Health Department Director Dr. David Goodfriend @(Model.BulletStyle == CivicPlus.Entities.Modules.Layout.Enums.BulletStyle.Decimal ? "ol" : "ul")>