Extract from ABC News
It's no secret that COVID-19 testing is crucial to get control back over the virus situation in Australia.
From the number of people getting tested, to the way that data is reported, to exactly how it physically feels, there's no shortage of questions about COVID-19 tests.
If you're still not sure about getting tested and how it works, we've answered some frequently asked questions right here.
I'm not feeling too good … should I get tested?
Yes, you should organise to get tested if you're not feeling well — no matter how badly you don't want to see that positive result.
Menzies Health Institute infectious diseases and immunology director Nigel McMillan says if you're sick, particularly if you have obvious symptoms, just get a test.
"I think we should all feel comfortable with going and getting tested now, particularly if you have a sore throat, a high temperature, a dry cough or a loss of smell or taste," he says.
"You shouldn't be ashamed, you shouldn't feel embarrassed to go and ask for a test at any fever clinic, we want you to do that.
"The issue of course is that there's so many people who don't have any symptoms and don't know they've got it, and that's why this is so difficult — they never think about getting tested because they're perfectly fine."
If you're still not sure what your symptoms mean, HealthDirect has a handy coronavirus symptom checker — it's anonymous, and it takes into account your symptoms and other health-related questions to suggest what you should do next.
It's important to speak to your doctor about your specific circumstances.
Can I get tested if I don't have symptoms?
This depends where you are and who you've been in contact with.
If you've been in close contact with a confirmed case, get tested and monitor your symptoms closely.
If you're not a close contact, Professor McMillan says each state deals with asymptomatic testing slightly differently.
"When you go to a testing clinic, they'll ask you a series of questions," he said.
"If you're in a hotspot and even if you don't have symptoms, they're definitely going to test you.
"If you're from Mount Isa where we haven't seen any cases, you probably won't get a test because it's not really necessary, but if you're in Logan, for example, you will get tested for sure."
Catherine Bennett, Deakin University's chair in epidemiology, says anyone ruled a close contact should definitely get tested, but most of the areas where asymptomatic testing is common were high-risk hotspot areas.
"What they're saying is the hit rate for asymptomatic people is so low, it's not worth doing [elsewhere]," she says.
"They would have to process so many tests.
"We do know there are people who are positive who never develop symptoms, but we still don't know how infectious they are or for how long."
If you're unsure, chat to your doctor.
Do COVID-19 tests hurt?
Infectious diseases physician and microbiologist Paul Griffin says it's often described as uncomfortable rather than painful, but the good news is it's over pretty quickly.
"I wouldn't describe it as hurting," he says.
"The main thing is if people are prepared, they're not surprised by it.
"The specimen we want is quite far back so the swab does need to go in a long way, but it doesn't need to stay there very long.
"It's very quick and it's so worthwhile — for a tiny amount of discomfort for a few seconds, you get to know whether you're positive or not which is a huge thing."
Dr Griffin says the same thing goes for kids that need to be tested — a mission some parents have expressed some worries about.
"I think it's just about giving them a little bit of pre-warning — hold still, it'll be over really quickly," he says.
"I've certainly had my kids tested for respiratory viruses in previous years and for COVID this year, and they weren't thrilled to have it done but they were certainly able to tolerate it."
Why are rapid tests not used in Australia?
Rapid blood tests are predominantly used to detect antibodies, which don't usually develop in the early stages of an infection and therefore could return a negative result when you are in fact positive.
"These aren't really useful diagnostically for isolation, because we can't really tell when you've had the virus," Professor McMillan says.
"If you have a PCR [swab] test we know you currently have the virus, generally. That's going to detect it at a much earlier stage, and that's why we prefer that."
Dr Griffin also said the nose and throat swab tests are the best way to detect the virus at the moment.
"It's highly accurate and is often positive fairly early on in the course of the illness, which is what you want," he says.
"It's usually pretty quick anyway."
Professor McMillan says rapid antibody tests would be more useful to sample a section of the population to get a better idea of undetected cases.
"There is a rapid test and a more involved laboratory test, and they're going to be very useful in something we call seroepidemiology," he says.
"Antibodies should last for a good six months or so, hopefully longer but generally not for this particular virus, and we'll be able to get a really true idea of who has been affected.
"There may have been many people who have been affected and don't know it; in fact estimations from America and China suggest that about 80 to 90 per cent of cases are in fact not detected because people don't know.
"We're going to see further results like that come out, I expect, so as many as nine out of 10 cases are never discovered by PCR because people don't know they're sick."
I tested negative, but I have some new symptoms. Should I get another test?
If your symptoms get worse or more relevant symptoms appear, it's a good idea to speak to your doctor and arrange to get tested again.
Dr Griffin says there's nothing wrong with going back for another test if new symptoms arise.
"Our tests are very good, that's a huge part of why we've been so successful, but certainly early on they can be negative even if you go on to develop the illness," he says.
"If you do get new symptoms or your condition changes, it's a good thing always to seek expert advice and see your doctor but we do want people to have a low threshold to get tested."
Just because you tested negative, doesn't mean you're immune or haven't developed or caught the virus after that initial test.
One example is people in hotel quarantine. Some states have introduced mandatory or even 'strongly recommended' testing, which Professor McMillan says is usually done on day 10.
He says the vast majority of people with the virus will show symptoms within 14 days, but there are some cases that take longer which means you could test negative in quarantine but positive soon after.
"The record for someone not showing symptoms I think is 27 days and that's quite unusual; there are a few very rare individuals who seem to take much longer for the virus to incubate and come out, but generally you're covering the vast majority of people by that day 14," he says.
"There will be that rare individual who will be positive on day 11 or 12 and therefore the test comes back negative, we know those are the risks associated with it, but we know that's better than having them isolated for 14 days and letting them go without any test which is what was happening originally."
Why aren't we randomly testing everyone in hotspot areas?
Professor McMillan says random testing not necessarily a bad thing, but like asymptomatic testing broadly, it all comes back to capacity.
"If you've got a real hotspot in a particular location, that's going to be a good way forward, you're going to get cases," he says.
"In Victoria, I think the numbers now are so large and widespread, it probably becomes not economic to do it that way.
"Maybe in [south-east] Queensland they might want to do that, it has picked up cases that way and that goes back to the idea that as many as nine out of 10 cases we don't normally detect because people aren't sick."
Dr Griffin also says using resources on people who don't need them could limit access for those who definitely do.
"For people who have maybe just been infected and have no symptoms, a negative test isn't going to mean that they won't become positive in the coming days. It doesn't mean that you've not been exposed," he says.
"That's why targeting people when they have symptoms and making sure they have rapid access to accurate testing is a huge part of our strategy.
"We occasionally do that asymptomatic screening for particular reasons, but to do it more widespread isn't really an effective strategy and would be taking up a really precious resource."
But can people in high-risk areas be forced to get a test? That too depends on what state you're in and what the circumstances are — but the answer could be yes.
"Every state has a Health Act, and every Chief Health Officer in each state has quite broad powers in terms of detention, isolation, forced testing, forced drug-taking," Professor McMillan says.
"Ideally you want people to do it voluntarily. One of the big issues with the current outbreak is behaviour modification, getting people to isolate and do the right thing.
"Once you start fining you get people's back up and start getting resistance, it's the latter option of many that you want to take."
What percentage of tests are coming back positive?
As of Wednesday, Australia had conducted 4,098,249 coronavirus tests — 0.4 per cent of those have come back positive.
Victoria has recently overtaken New South Wales as the state with the highest number of tests at more than 1,500,000 and the Northern Territory has the lowest, with just over 23,500.
This of course doesn't factor in population variation, nor does it indicate how many people have had more than one test — but Dr Griffin says those are really good numbers overall.
He says Australia's testing rates are a big part of its relatively strong control over the pandemic so far.
"That low percentage of positives and high numbers of testing is a really big positive for our capacity in this country," he says.
"It may have gone backwards a little in recent times through some behavioural issues rather than system issues, and hopefully if we can address the behaviours of the community we can get this back under control fairly quickly."
I'm a few degrees separated from a positive case. When should I get a test?
Professor McMillan says if it's two degrees of separation or more and you're well, you won't necessarily need to rush to get tested immediately.
"Direct contacts need to be tested and isolate," he says.
"If you're a contact of a contact, unless your contact is positive, you just need to be aware and keeping an eye on your own symptoms. If you do develop symptoms, you get tested and isolate as well.
"If you're a degree removed you don't need to unless your contact tests positive, in which case you become a primary contact."
The ABC News Breakfast team ran into this exact dilemma this week — the wife of their floor manager tested positive, and while the floor manager isolated while awaiting his own test results, presenters Lisa Millar, Michael Rowland and Nate Byrne also went into self-isolation to be safe.
"This goes above and beyond Health Department requirements, but this precaution is being taken for the wellbeing of other ABC staff in Melbourne, and in the interests of public safety," Michael Rowland said on Twitter.
"Importantly, [floor manager] Joe's wife Laura is OK, as is Joe."
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