Frequently asked questions about COVID-19

There are many questions about coronavirus, and many of the answers are changing as scientists learn more about the viral pandemic. One of the main areas of confusion for people is testing. What counts as a positive test? What kinds of tests are there?

That’s far from the only thing that’s befuddled some readers, however, and so the Delaware State News is attempting to clear up common misconceptions and answer frequent questions.

Below are questions posed to the Delaware Division of Public Health on key COVID topics and the replies.

Q: What is required for a person to count as having COVID? Is it just testing positive, or are there any presumptive cases?

A: The Division of Public Health (DPH) uses CDC case definitions to identify cases. This includes that confirmed cases have positive diagnostic test results while presumptive cases either have a positive serology test or an epidemiological link with clinical criteria.

Q: Similarly, can you elaborate on the criteria for a coronavirus-related death?

A: Delaware’s count includes both lab-confirmed and probable deaths, per CDC guidelines. Probable cases and deaths are determined based on the case definition defined by the Centers for Disease Control and Prevention. Delaware is using the CDC’s specific case definition, released April 11, to classify cases/deaths.

Q: Are all states keeping track of the same data the same way?

A: When it comes to data involving COVID-19, DPH uses the CDC case definitions. We cannot speak on how other states track their data.

Q: How common are false positives or false negatives?

A: Most of the COVID-19 tests have a higher concern for false negative results; therefore, clinical judgment should be used to guide if repeat testing is needed after a negative result.

Q: With so many tests being given now, can you outline what tests are available in Delaware and how they differ?

A: Delaware has several different COVID-19 molecular diagnostic tests that can test various different specimens (nasopharyngeal, nasal, oropharyngeal, oral) either in a laboratory or at point-of-care. The accuracy of the laboratory tests is comparable. Delaware also has serology testing to assess risk of exposure or infection.

Q: Do the rate of false positives and negatives vary among those tests?

A: The rates may vary insignificantly for laboratory tests.

Q: Symptoms for COVID have changed as more has become known about the virus. What are the most recent symptoms people may experience and what remains the most common sign?

A: Potential symptoms of COVID-19 include fever, cough, shortness of breath, sore throat, muscle/body aches, fatigue, chills, shaking with chills, new loss of smell or taste. Other symptoms such as headache or digestive symptoms (vomiting, diarrhea, abdominal pain or lack of appetite), and congestion/runny nose have been identified as potential symptoms. Cough and shortness of breath are the most concerning symptoms.

Q: What should Delawareans keep in mind in trying to understand the positive numbers and statistics on testing? What statistic(s) best reflects the presence of the virus in Delaware?

A: As Delaware expands the testing capacity with a goal of 80,000 tests per month, we will continue to see an increase in positive results. It will be important to watch statistical data including the percentage of positive cases, hospitalization trends and the number of COVID-related deaths to have a better understanding of the overall response in Delaware.

Q: Just to confirm, the state is not including “positive” antibody tests in the cumulative count, right?

A: Delaware began using rapid serology (antibody) tests when PCR test kits were in short supply, primarily to assess for evidence of risk for viral spread during the pandemic. Antibody tests test for the presence of IgG (indication of past infection) and IgM (indication of current infection). The state has shifted focus to PCR testing as availability has increased, but continues to use antibody testing in long-term care facilities as a way to identify potential outbreaks.

IgG positive results, which are indications of past infections, are not counted in the positive case count. IgM positive results, which are an indication of current risk for spread of the virus are counted in the positive case count as probable cases.

Probable test results include both antibody tests and epi-linked cases, which is where there was not a COVID-19 test done but the patient had a clinical diagnosis of the disease as “probable” per CDC definition.

It is worth noting that only about 10 percent of our positive cases meet the definition of probable and about 90 percent are considered confirmed cases.

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

Have a question, tip, or resources about the coronavirus pandemic? Submit it to our newsroom and we’ll do what we can to provide answers.