FAQs Regarding SARS-CoV-2 PCR Testing

Last Updated: October 5, 2020

These FAQs provide information and guidance for Columbia University faculty, staff, and students who are undergoing diagnostic testing for SARS-CoV-2, the virus that causes COVID-19, through the Columbia University Test and Trace Program. This guidance describes the type of test being used and the current understanding of the meaning of positive and negative PCR results in individuals with (symptomatic) and without (asymptomatic) symptoms.


Individuals who are SARS-CoV-2-positive, even without any symptoms, should self-isolate at home as described below.


Guidance for return to work and class is also described below.

There are two different types of tests for COVID-19; one determines whether one has it now (being the time the test was collected), and the other determines if one had it at some point in the past.

  • To diagnose a SARS-CoV-2 infection now, a nasal swab is used to detect the RNA of SARS-CoV-2 virus. This is the COVID-19 PCR test
     
  • To detect that an infection occurred at some point in the past, a serology blood test is done to detect antibodies to SARS-CoV-2

Note: The remainder of these FAQs apply to the COVID-19 PCR test.

Updated: October 5, 2020

All faculty and staff who are returning to campus on or after June 22 are required to have an initial gateway COVID-19 PCR test within the 14 days prior to returning to campus. A negative test result is required prior to return to campus. All employees who have been consistently working on campus prior to this time are eligible to receive a test, though not required.

All students returning to campus over the summer and in the fall (including those returning to campus housing) are required to have an initial gateway COVID-19 PCR test within one business day of their return to campus, and prior to resuming campus activities. Students living in Columbia dormitories will be tested before being allowed to move in, and students living in Columbia-owned housing will be tested within one business day of moving in. Students returning to campus are able to move into their residence but are then required to quarantine there until receipt of a negative test result on the initial gateway test. For those students who have remained on campus throughout the spring and summer and have not yet been tested, the initial gateway test should be completed between August 17 and August 28.

Individuals with symptoms of COVID-19 (including documented fever or subjective fever, cough, shortness of breath, sore throat, chills or shaking chills, congestion/runny nose, diarrhea, alterations of taste, or loss of smell) should contact their health care provider or campus health service to arrange for testing. Testing of symptomatic individuals SHOULD NOT occur at the Columbia surveillance testing sites; contact your health care provider or campus health service for guidance on testing in this situation. Individuals without symptoms who have had close contact with someone with laboratory-confirmed COVID-19 or with symptoms consistent with COVID-19 will also be provided guidance on accessing a follow-up test at the Columbia testing centers.

Summary of testing approaches, including the ongoing surveillance testing plans, can be found here:

Columbia University has two sites for COVID-19 testing for those who are eligible:

  • Morningside Campus: Roone Arledge Auditorium at Alfred Lerner Hall, 2920 Broadway (115th Street and Broadway)
     
    • Enter from the campus side
    • Follow directional signage and staff instructions to the testing center
    • Face coverings and completion of the ReopenCU app attestation are required for entry into the building
       
  • Columbia University Irving Medical Center: Schaefer Awards Gallery, William Black Building, 650 W. 168th St., 1st floor
     
    • Enter through the William Black Building (650 W. 168th St.)
    • Follow directional signage to the testing center
    • Face coverings and completion of the ReopenCU app attestation are required for entry into the building
  • Testing is available by appointment only; walk-ins will not be accepted
  • These appointments are only available for the required gateway and ongoing surveillance testing for Columbia University. These appointments are not for individuals with symptoms
  • To schedule your appointment, go to the Online Patient Portal (appointment scheduling is available for students now, faculty and staff will be able to access the system starting 8/14/2020)
  • Sign in with your UNI and UNI password
  • Select “Required COVID-19 testing” by location (Morningside or CUIMC).
  • Select the appointment day and time
  • Once your appointment is scheduled, the system will display a QR code. We encourage you to save the QR code to your phone as a screenshot or print it out. You can always access the code by logging back into the Online Patient Portal. The QR code is a touchless way to check in for your testing appointment
  • If you are unable to schedule through the Online Patient Portal, email covidtesttrace@columbia.edu for assistance
  • Complete your symptom self-screening (ReopenCU app) prior to coming to the testing center. Do not come if you are experiencing symptoms of COVID-19 (e.g., fever, cough, shortness of breath, sore throat, fatigue, muscle aches, loss of sense of smell or taste, or stomach upset). Those who are experiencing symptoms should self-isolate and contact their health care provider
  • Face covering is required when coming to your testing appointment
  • Bring your Columbia ID to your appointment
  • Arrive at the time of your appointment, and follow all directional signage and staff instructions
  • Have your appointment QR code ready to scan as you reach check-in
  • At the check-in desk, present your QR code for scanning. This will check you in for your appointment
  • You will be given a label for your specimen. This is your personal label and must not be misplaced
  • You will then be directed into a testing booth
  • You will be instructed to:
     
    • Immediately apply your label to the specimen tube
    • Lower your face covering to under your nose but keep your mouth covered
    • Blow your nose well using the tissues provided, and dispose used tissues into the garbage can
    • Use the hand sanitizer provided
    • Follow the directions on the table with the observer watching you to collect your nasal swab, including opening the packaging, collecting the swab, and placing it back into the tube
    • Leave the swab on the table in the testing booth
    • Use the hand sanitizer provided
    • Replace your face covering
  • Exit following the directional signage
  • The entire process should take less than 10 minutes

It will take between 24 and 72 hours to get the PCR test results back. This will be either through an email or a phone call. Emails will provide instructions on how to access results. More information about accessing results through email are found on the Testing Program page.

In the event of a positive test result, you will be contacted by telephone and provided with guidance for isolation, care, and follow-up.

Columbia is using an observed, self-collected nasal swab to detect SARS-CoV-2. You will be observed inserting a sterile, small, cotton-tipped swab gently into the anterior part of both of your nostrils to obtain respiratory tract secretions. The swab is rotated, removed, and placed in a viral transport media and sent to the laboratories where the test will be done.

Data continue to emerge about recovery from COVID-19 infections. Currently, there are no confirmed reports of a person developing reinfection with SARS-CoV-2.  However, studies have noted that SARS-CoV-2 testing can show positive results for several weeks after confirmed COVID-19 disease. This may be due to detection of viral remnants, low level viral shedding or intermittent shedding, with no evidence that these individuals can transmit the infection to others.   

As such, the current CDC recommendation is that individuals with a positive SARS-CoV-2 diagnostic test in the prior three months do not need to undergo gateway testing or surveillance testing during the three months since COVID-19 diagnosis, unless they have symptoms of COVID-19.

If you are scheduled for a gateway or surveillance COVID-19 test and have had a positive COVID-19 test in the prior 3 months, you may be exempt from a repeat test during that period of time. In order to evaluate your exemption, here are the steps required:

  • Provide documentation of prior positive COVID-19 diagnostic test (antibody tests are not acceptable).    
    • This should be in a laboratory report; doctors notes are not acceptable
    • Report must contain your name and date of birth, as well as the type of test done, date of the test, and the result
  • Upload the documentation through the Online Patient Portal:
    • After log in, select “Downloadable Forms” from the left side menu
    • Select “Upload Positive COVID19 Test Results”
    • Select “Upload” and browse your computer for the file you would like to upload – PDF, .PNG, .JPG, .JPEG, or .GIF file formats are all acceptable
    • Verify upload; edit if needed or select “looks good” if you are satisfied with the image
    • Click the “save” button at the bottom of the page after uploading your document
  • Your documentation will be reviewed by a medical provider, and if it meets the criteria for an exemption, you will be notified that you have completed the University’s testing requirements, and the date of expiration of the exemption.
  • If you do receive an exemption but then become symptomatic, you should reach out to your health care provider as they may recommend a repeat COVID-19 test.

The laboratories that analyze the specimens will use assays to detect the SARS-CoV-2 viral genetic material (RNA). PCR assays can detect live virus, dead virus, or fragments of virus.

A positive PCR test from an individual with symptoms means that a person has COVID-19 and can transmit the infection to others. These individuals need to be isolated. In order to return to work or class, all of the following criteria must be met:

  • At least 10 days have passed since the onset of symptoms
  • At least 24 hours have passed without fever without the use of antipyretic medications, e.g., acetaminophen (Tylenol), ibuprofen (Advil, Motrin)
  • Marked improvement in symptoms

Note: When these individuals return to work/class, they need to continue to use all protective measures against COVID-19 (e.g., use of face covering, adherence to physical distancing) because we do not know yet if someone can be re-infected with SARS-CoV-2.

The PCR test can detect both live and dead virus, or viral RNA fragments.

A positive PCR result in someone without symptoms could mean any of the following:

  • A person is pre-symptomatic or asymptomatic, meaning they may or may not develop symptoms, but is shedding the virus. Asymptomatic or pre-symptomatic people who are PCR-positive can sometimes transmit SARS-CoV-2 to others
  • A person has recovered from the virus, but is still shedding the virus and could transmit SARS-CoV-2 to others
  • A person has recovered from COVID-19, but the PCR is detecting dead virus or viral RNA fragments, and SARS-CoV-2 cannot be transmitted to others

This is why asymptomatic individuals who are SARS-CoV-2-positive will need to self-isolate. They can return to work or class as long as they remain symptom free after 10 days have passed since the date that their swab was obtained. The nasal swab PCR testing does not need to be repeated before the individual can return to work or class.

Individuals with positive PCR tests should obtain guidance regarding their health and how to protect their close contacts from their primary care provider or campus health service.

Note: When these individuals return to work or class, they need to continue to use all protective measures against COVID-19 because we do not know yet if someone can be re-infected with SARS-CoV-2.

No, individuals can return to work or class as described above. No further PCR testing is required to return to work or class.

Contact health provider to seek advice and care. Before seeking care, an individual should call their provider to help coordinate care.

  • Individuals should put a face mask on before entering a health care facility
  • Call 911 if there is a medical emergency like significant shortness of breath

People with symptoms consistent with COVID-19 may have a negative test for several reasons:

  • A negative test from an individual who previously had symptoms and is now well may mean that a person has cleared the virus and can’t transmit the virus to others
  • This may be a false negative test meaning that the person does have COVID-19, but that the PCR test did not detect the virus because the level of viral RNA was below the limit of detection. Levels of viral RNA are usually highest in the first 5 days of illness
  • False negative tests can also occur due to inadequate or improper nasal swab collection or problems in the transport of the specimen
  • Symptoms may not be indicative of COVID-19 as most of the symptoms are not specific for COVID-19 and could indicate another infection or seasonal allergies or asthma

It is highly likely that a person without symptoms with a negative PCR test does not have COVID-19 at this point in time. These individuals should observe all preventive measures and  self-monitor for symptoms of COVID-19.

If an individual has a negative PCR test result but has had close contact with a person who is known to be positive, this individual should self-quarantine and continue to self-monitor for symptoms of COVID-19 for 14 days from the time of last exposure as there is continued risk of transmission.

Initial gateway PCR tests must be completed and negative results obtained PRIOR to participation in campus activities (work or class). Students will quarantine in their residence while awaiting their test results.

Note: All Columbia affiliates (faculty, staff, and students) arriving from outside the United States or from U.S states with high prevalence of COVID-19 are required to quarantine for 14 days upon arrival as required by New York State, regardless of gateway testing results. The current list of states can be found on New York’s travel advisory webpage, with guidance on how to register arrival in New York. You are not exempt from quarantine with a negative test (except in the case of essential workers).

For individuals undergoing testing through the ongoing surveillance program (after the initial gateway test), either regularly or as part of the weekly random sample, the individual can continue to work, go to class, and participate in campus activities while waiting for their test result, as long as they have no symptoms. They should continue to observe all prevention measures. If asymptomatic individuals with close contact of a COVID-19 case get tested, such individuals should self-quarantine for 14 days from the time of exposure, even if they receive a negative test result during the self-quarantine period.

Note: For individuals in patient-facing positions, self-quarantine of close contacts is not required, consistent with NewYork-Presbyterian Hospital policies for health care workers.

Occasionally, a person will have an invalid or unsatisfactory PCR test result, which may be the result of excessive mucus in the sample, which interferes with the test, or other issues with specimen collection. This person SHOULD have a repeat swab sent for SARS-CoV-2 testing through the Columbia testing site.

If an individual tests positive through the Columbia Test and Trace Program, both the Columbia Test and Trace Program and the New York City Department of Health will be notified of the test result. The Columbia University Test and Trace Program assists the city and state with their efforts in contact tracing. The Columbia program will interview the individual to assess other Columbia close contacts and will notify these individuals of their potential exposure (without disclosure of the index case’s name or other information). They will be provided appropriate guidance regarding self-quarantine and testing, and provided the necessary support, in addition to maintaining confidentiality. New York City or state is responsible for identifying and tracing the contacts of the case outside of Columbia.

If you test positive for SARS-CoV-2, you will be contacted by a Columbia University health care provider to discuss your positive result and provide you with guidance on isolation and self-care. Faculty and staff should notify their health care provider of their positive test. Students will be connected with their campus health service (Columbia Health for Morningside students and CUIMC Student Health Service for CUIMC students) for care and support. This will include daily telehealth medical check-ins and access to psychological and mental health support.

You must follow the guidance of your health care provider regarding discontinuation of isolation. For those with symptoms, this usually occurs when:

  • At least 10 days have passed since symptom onset and
  • At least 24 hours have passed since resolution of fever without the use of fever-reducing medications and
  • Other symptoms have improved

For those with a positive test who never develop symptoms, isolation can be discontinued 10 days after the date of the first positive PCR test.

Repeat testing for individuals in isolation is not recommended by the Centers for Disease Control and Prevention (CDC), based on evidence that individuals who have completed the time course described above are no longer infectious and that some individuals may continue to have positive PCR tests due to viral debris or noninfectious particles that may be detected by the PCR assay.

Students who test positive should contact Columbia Health (Morningside campus) or Student Health Service (CUIMC) for clearance to return to campus activities. Faculty and staff may be asked to provide appropriate documentation to Human Resources prior to their return.

There will not be a charge for the visit or for the swabbing to obtain a sample through the Columbia Test and Trace Program for those eligible for the gateway testing or ongoing surveillance testing, and costs will be covered in full by the University.

No. Currently, New York State guidelines do not allow a “test out” option for the required 14 days of quarantine required for individuals traveling from states with high COVID-19 infection rates.  The staff member/ student must follow the NY State guidelines and only return to work/ class at conclusion of the 14-day quarantine period (see CDC’s quarantine guidelines here). Essential workers, as defined by New York State on the New York State’s Travel Advisory website are an exception.

The information provided herein is based on current knowledge and is subject to change as new information becomes available.