KNOWLEDGE CENTER

Diagnostic Testing (PCR and related methods)

What do the diagnostic SARS-CoV-2 tests offered by DoctorNow detect?

The tests offered by DoctorNow detect the presence of RNA (genetic material) from the SARS-CoV-2 virus that causes COVID-19. Most of the testing methods used by DoctorNow are reverse-transcription polymerase chain reaction (RT-PCR) tests.

All testing methods used by DoctorNow are nucleic acid amplification tests (NAAT) which are more sensitive and specific than antigen tests.

These tests are considered diagnostic tests, as they are used to detect current infection with the virus (as opposed to past infection which may be detected with an antibody test).

Is the SARS-CoV-2 PCR test offered by DoctorNow a nucleic acid amplification test (NAAT)?

Yes, PCR is the most commonly used NAAT technique for detecting specific nucleic acid in a sample. NAAT techniques such as PCR are both sensitive and specific for detecting the presence of SARS-CoV-2 in a sample. This contrasts with antigen testing which detects a specific viral protein in a sample. Antigen tests are more rapid than PCR tests but may not detect all infections (less sensitive) and are more susceptible to false positive results (less specific).

I have symptoms that I think might be COVID-19. Should I get the diagnostic (PCR) test?

Yes. The PCR test detects the SARS-CoV-2 virus and is used to diagnose acute infections. If you have any symptoms concerning for COVID-19 (fever, feeling short of breath, cough, muscle pain, sore throat, loss of taste or smell, new diarrhea) you should talk to your provider about getting PCR testing. DoctorNow has PCR testing locations throughout Los Angeles Counting, specifically in West Los Angeles, Beverly Hills and Northridge. Please feel free to contact us at the number on our website.

Can I use results from testing at DoctorNow for travel purposes?

Travel requirements vary by destination. All of the testing methods used by DoctorNow are nucleic acid amplification tests (NAATs) and test reports include language indicating the testing method: RT-PCR is explicitly mentioned.

What does a positive PCR/NAAT test result mean?

A positive PCR/NAAT result indicates that viral nucleic acid is present in the sample. Given both the potential severity of the infection and the potential for rapid spread, positive results should generally be treated as if the someone is infectious, with isolation to prevent spread and clinical care if symptoms warrant it. Individuals may test positive for weeks or even months after their first positive test even though they are not infectious. Repeat testing after the first positive test is generally not indicated.

What does an “inconclusive” result mean?

Many PCR tests target two or more distinct gene regions of the virus. When all targets are not detected above the threshold for positivity, the test is resulted as inconclusive. This typically happens when a low amount of viral nucleic acid is present. This should be treated as a presumptive positive and guidelines for isolation and clinical management based on a positive test should be followed.

Is the DoctorNow Laboratory a CLIA-certified laboratory?

Yes. CLIA certification is a requirement for clinical laboratories providing diagnostic testing.

Have the PCR tests offered by the DoctorNow Laboratory been granted Emergency Use Authorization (EUA)?

Yes. The tests performed by the DoctorNow Laboratory have been granted Emergency Use Authorization (EUA) by the FDA.

COVID-19 TESTING FREQUENTLY ASKED QUESTIONS

What types of COVID-19 testing do you offer?

We are currently offering 2 types of tests:

Molecular (PCR) Test
Collected onsite and sent out to participating laboratory
Results: Next Day
PCR testing is performed with a nasal swab. This tests for ACTIVE infection and detects viral genetic material (RNA).

Rapid Antigent Test

Results: As soon as 20 minutes to maximum of a couple hours depending on our back log.

Rapid Antigen Test is performed with a nasal swab. This tests for ACTIVE infection but is not as accurate as a PCR test.

Antibody Tests

Rapid Antibody Test: Small Sample of Blood from a Finger Poke (Results in 15 minutes).

Antibody tests look for antibodies in your blood which can indicate past or present infection of the virus that causes COVID-19.

Antibodies are proteins that help your body fight off infections and usually provide protection against getting that disease again hence developing an immunity. Antibodies are specific to a particular disease. For example, a measles antibody will protect a person who is exposed again to measles but will not offer protection of any kind if the person is exposed to mumps.

Depending on when someone was infected and when the antibody testing occurs, the test may not show antibodies in someone with a current COVID-19 infection. Antibody testing should not be used to diagnose active COVID-19 infection.

COVID-19 Lab Based Testing Information

For our most accurate Antibody test, which is sent to Quest, we send a single vial of blood to the lab. We often recommend patients go directly to Quest for the blood draw after their consultation with a Valley Urgent Care Medical Provider, who will order the test. Our clinic is currently experiencing a very high volume of calls and patient visits, so going directly to Quest could save you time. This is only for Antibody testing.

All Nasal Swab PCR Tests must be done at our clinic. Due to the time it takes to transport blood back and forth from our satellite clinics, your result will be available within 24-48 hours.

You will receive a call notifying you of your test results and any further instructions, so please make sure we have an accurate telephone number for you on file before leaving the clinic.

Is Antibody testing right for me if I have symptoms?

We are unable to diagnose COVID-19 based solely on antibody test results. Patients that are encouraged to have a PCR molecular nasal swab test.

What are the COVID symptoms I should look for?

COVID-19 symptoms* include the following:

– Fever or chills

– Cough

– Shortness of breath or difficulty breathing

– Fatigue

– Muscle or body aches

– Headache

– New loss of taste or smell

– Sore throat

– Congestion or runny nose

– Nausea or vomiting

– Diarrhea

* This does not include all possible symptoms. We will update as information becomes available from the CDC.

Can I schedule an appointment for COVID testing?

We do not take appointments in advance for Covid-19 Testing.

We provide testing on a Walk-In basis. We are open at 9 am Monday thru Friday and Sunday 12 pm.

Please call in advance so we can assist you with registering online.

Can I be seen as a walk-in and what are your walk-in hours?

Our clinic is open from 9 am to 5:00 pm Monday thru Friday and 12 pm to 5 pm on Sunday. We are closed on Saturday. We see patients on a first-come-first-serve basis.

Feel free to call us so we can send you a link to register online. You can come any time during clinic hours to be tested.

How long do you have to wait after being exposed to COVID-19 before testing?

You should be tested immediately if you start experiencing any symptoms.

We recommend waiting 3-5 days after exposure to do a PCR nasal swab test and at least 14 days before being tested for COVID-19 antibodies.

How long does it take to get COVID-19 PCR Test Results?

As of April 1 2021, the turnaround time for results is Next Day. You can call our staff to get updated turnaround times.

My provider told me that my antibody test was negative, what does that mean?

A negative test result with this test means that SARS-CoV-2 specific antibodies were not present in the specimen above the limit of detection. However, a negative result does not rule out COVID-19 and should not be used as the sole basis for treatment, patient management decisions, or to rule out active infection.

Patients tested early after infection may not have detectable IgM antibody despite active infection; in addition, not all patients will develop a detectable IgM and/or IgG response to SARS-CoV-2 infection. The absolute sensitivity of the qSARS-CoV-2 IgG/IgM Rapid test is unknown.

*Negative IgM – IgM is usually the first antibody produced by the immune system when a virus attacks. A positive IgM test indicates that you may have been infected and that your immune system has started responding to the virus. When IgM is detected you may still be infected, or you may have recently recovered from a COVID-19 infection. If you have a negative IgM antibody test but start to develop symptoms, it is recommended that you return to the clinic for a nasal swab test, as this the most accurate way of diagnosing COVID.

*Negative IgG – IgG antibodies develop in most patients within seven to 10 days after symptoms of COVID-19 begin. IgG antibodies remain in the blood after an infection has passed. These antibodies indicate that you may have had COVID-19 in the past and have developed antibodies that may protect you from future infection. It is unknown at this point how much protection antibodies might provide against reinfection, so it is recommended that you follow all social distancing guidelines and where a mask when in close contact with people.

My provider told me that my nasal swab test was negative, what does that mean?

A negative PCR nasal swab result means that the virus that causes COVID-19 was not detected in your sample. For COVID-19, a negative test result for a sample collected while a person has symptoms usually means that COVID-19 did not cause your recent illness.

This test result is merely a snapshot of the time in which you were swabbed. If you had additional COVID exposures or have developed symptoms after the date your swab was collected, it is recommended that you return to the clinic for repeat testing.

If my employer says I need to have the nasal swab to return to work, do you offer this test?

Yes, DoctorNow does offer a PCR Nasal Swab test for Covid-19. The average turnaround time for results is Next Day. DoctorNow can provide employees with a return to work note upon request with additional instructions regarding isolation guidelines, however, see below info from Los Angeles Public Health.

Below is the Los Angeles Public Health Guidance for Employers Responding to Covid-19 in the Workplace. We suggest you print this document to present to your employer regarding a work note for your positive COVID test:

http://publichealth.lacounty.gov/media/coronavirus/docs/business/GuidanceWorkplaceResponse.pdf

During the pandemic, employees who meet the above criteria for returning to work should NOT be required by employers to provide a healthcare provider’s note to return to work.

The Equal Employment Opportunity Commission (EEOC) as well as the Centers for Disease Control (CDC) have issued guidance, stating that while employers “may require employees who have been away from the workplace during a pandemic to provide a doctor’s note certifying fitness to return to work,” it is not recommended to do so.

The EEOC & the CDC advise that, practically speaking, doctors and other healthcare providers may be too busy to provide such documentation, so employers should consider allowing these employees to return to work as they see fit. Because of this, the CDC does not recommend that employers require their employees to provide communication from a physician or healthcare provider, “clearing,” them to return to work.

What is DoctorNow doing in its clinic to make it a safe environment?

We have set up a screening station for patients outside of the office in order to limit any exposure to our staff and other patients, in the event someone is showing signs of active Covid-19 infection.

We offer paperless electronic check-in to avoid having to pass documents, insurance cards, and IDs back and forth.

Consultations for ordering a Covid-19 are done via telemedicine to minimize the need for contact.

We are thoroughly and regularly cleaning all surfaces in common areas and reception desks throughout the day with hospital grade disinfectant.

Tape marks have been placed on the floor to provide for recommended social distancing.

DoctorNow’s team members are provided with personal protective equipment as recommended by the CDC and OSHA.

Our nightly cleaning crew utilizes hospital-grade disinfectant to wipe down all surfaces.

Interior doors are being propped open to minimize the need for hand to surface contact.