Expert Recommendations for COVID-19 Testing Frequency in 2023

If you have the sniffles, should you immediately take a COVID test?

Deaths and hospitalizations from COVID have risen in recent weeks, and experts say the US could see an uptick in cases in the coming months, as respiratory viruses start to circulate.

That said, COVID cases aren’t nearly as bad as they were at the start of the pandemic.

“[COVID] is nowhere near as unmanageable as it was,” said Amesh Adalja, MD, a biosecurity and emerging infectious diseases expert at Johns Hopkins Bloomberg School of Public Health.

However, the US is likely to see excess illnesses—and deaths—if Americans don’t embrace all the resources they have to slow the spread of the virus this cold and flu season, Thomas Russo, MD, an infectious diseases expert at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences, told Health.

“We’ve got the tools, so let’s use them,” he said.

Perhaps the most obvious tool available to understand and stop the spread of COVID-19 is the COVID test.

The Biden administration recently announced that all American households will be eligible for four free mail-order COVID tests beginning September 25. Orders can be placed at COVIDTests.gov.

However, according to experts, when—and how often—you should test largely depends on your individual circumstances.

“There are different questions that tests can help you answer,” Adalja said. When you’re considering a test, ask yourself why. “Are you sick? Were you exposed? Are you going to visit a high-risk person?”

Figuring out your motive for testing can help you determine when and how frequently you should be testing.

The Centers for Disease Control and Prevention recommends the following protocol if you have symptoms of COVID-19:

The agency recommends a slightly different protocol if you’ve been exposed to COVID but aren’t experiencing any symptoms:

If you’ve been exposed to COVID, it’s always in your best interest to test yourself, Russo said. Given that we may see an uptick in cases this winter, he recommends making sure your COVID tests are all up-to-date.

“A good strategy is to have these home tests on board,” he said.

It’s trickier to determine if you need to test because you’re experiencing symptoms compared to needing to test because of a confirmed exposure, Joseph Khabbaza, MD, a pulmonary medicine specialist at Cleveland Clinic, told Health.

That’s partially because the symptoms have gotten harder to spot as COVID-19 symptoms. And, public urgency toward testing has decreased.

At the beginning of the pandemic, patients were more likely to consider the fact that they might have COVID, and not just the common cold, than they are now, Khabbaza explained.

“There has been a lot of confusion this past year as severity of illness has gotten milder—with the strains becoming milder—and less unique symptoms,” he explained. “We’re hearing more and more of people who are really surprised they had COVID because their symptoms [felt like] usual stuff.”

Per the CDC, certain COVID-19 symptoms should prompt you to get emergency medical attention, including persistent pressure or pain in the chest, trouble breathing, new confusion, the inability to wake up or stay awake, or discoloration in the skin, lips, or nail beds.

As to whether or not you need to test if you’re experiencing any symptoms, much of that comes down to two things: Your health and the health of the people you interact with.

“Things to be aware of are our personal risk factors and [if] you may have to be around high-risk people,” Khabbaza said. If you—or someone you regularly see—have an increased risk of a bad outcome from COVID, like severe disease or death, you should test if you’re experiencing symptoms.

Given how many millions of people are considered high-risk, testing is definitely the safer route, especially if you do in-person work or frequently find yourself in public spaces for other reasons, Dr. Russo said. “We’re all in pre-pandemic mode,” he added.

If you are not high-risk and you don’t think you’ll be around high-risk people, it can be difficult to know whether to test, experts say. Much of your decision may come down to whether your illness seems more serious than the common cold.

“Most of us have had a bad cold,” Khabazza said. “But if it feels different than that, even if it’s a vague [difference], it’s worth testing.”

If you don’t know what to do, experts recommend erring on the side of testing. “You can never be too cautious or safe,” Khabazza reiterated.

Additionally, it’s still a good idea to test before going to a large gathering, like a wedding, Russo added.

If you’re having symptoms of COVID but you tested negative, you should still try to figure out what’s causing your illness, Adalja said. “In general when you’re sick, the ideal thing is to know what’s making you sick.”

Many doctors’ offices and urgent care centers are now testing all patients exhibiting flu-like symptoms for three common respiratory viruses—COVID-19, respiratory syncytial virus (RSV), and influenza.

“You can get them in one swoop, which, of course, you can’t do at home,” Khazabba said.

It’s especially true if your symptoms are getting increasingly worse and you’re basing the assumption that you don’t have COVID on a negative at-home test, since these tests are sometimes unreliable.

Following the recommended guidelines is the best way to keep yourself and your community healthy and avoid overtaxing the healthcare system this winter, Russo said.

“We really have the tools to minimize the consequences, but we’re underutilizing those tools,” he said. “If people had used these tools, we would have had a significant impact in decreasing mortality.”