This story has been updated.

People no longer need to be in a pre-approved group of people nor have a doctor’s note to get a coronavirus test at San Antonio’s drive-thru testing centers at the Freeman Coliseum or a Westside Walmart.

Previously, health officials prioritized who gets tested based on a fairly strict set of standards. There have been more than 32,000 coronavirus tests conducted in Bexar County as of May 8.

The initial confirmed cases of COVID-19 in the county were travel-related, but local health officials have categorized recent cases as having been transmitted from person-to-person in the community. Until testing becomes more widely available, only residents with specific symptoms or in certain occupations qualify. Below are answers to some commonly asked questions about coronavirus testing:

What are the symptoms of COVID-19?

Some COVID-19 symptoms mirror those of the common cold and flu, so just because you have a sore throat does not mean you have coronavirus. The Centers for Disease Control and Prevention (CDC) says that fever, cough, and shortness of breath may appear two to 14 days after being exposed to the coronavirus. Many people who have tested positive for coronavirus report losing their sense of smell and taste as early symptoms. Other coronavirus patients have experienced aches, congestion, runny noses, sore throats, and diarrhea.

Click here to use a tool developed by Apple with input from the CDC, the White House, and the Federal Emergency Management Agency to help people determine if they might have coronavirus.

About 80 percent of people who tested positive for coronavirus recover without needing special treatment, according to the World Health Organization. Around 1 in 6 develop breathing problems and require medical attention.

Not everyone who has the coronavirus shows symptoms, so continue practicing social distancing to avoid spreading the virus.

What should I do if I start exhibiting symptoms?

Continue to practice social distancing with other people; stay at least 6 feet away, per CDC recommendation. With allergy season upon us, San Antonians may start coughing and sneezing independently of coronavirus. In either case, stay home and away from other people.

Then make an appointment with your doctor to figure out what is causing your symptoms. Even if your doctor recommends that you get tested, obtaining a test is not guaranteed, said Joe Arrington, spokesman for the COVID-19 Joint Information Center.

Can I go to a drive-thru site to get tested?

There are two drive-thru testing sites in San Antonio. One is located at the Freeman Coliseum. According to Assistant City Manager Colleen Bridger, the testing site started accepting people without a doctor’s note on April 3. People should first use a self-screening tool to see if they need a test.

There is another drive-thru testing site at Walmart at 8923 W. Military Dr; sign up for an appointment here.

Before, only a few groups of people were pre-approved for testing at the Freeman Coliseum site, according to the City of San Antonio’s COVID-19 webpage. Those were:

  • First responders, such as EMTs, firefighters, and police
  • Health care personnel, which means those who work in hospital settings
  • VIA bus drivers
  • Individuals who have symptoms and a doctor’s pre-approval

The testing site can take as many as 16 samples per hour. Hospital systems, UT Health San Antonio, and private labs also are testing for COVID-19.

What do I have to do to get tested?

The San Antonio Metropolitan Health District encourages everyone to take a self-screening quiz online to see if you qualify for a test. The quiz asks about any symptoms you might have, as well as other health conditions and travel history. The quiz also can act as a tool to help quell anxieties in the community, said Metro Health Director Dawn Emerick.

You can also call 210-233-5970 to make an appointment at the Freeman Coliseum testing location. Some urgent care clinics are also conducting coronavirus tests, including Texas MedClinic. Find a list of testing locations here.

Previously, health care providers had to first screen people for the flu and other respiratory illnesses before ordering a coronavirus test. But because there is a shortage of testing supplies, that is no longer a requirement, explained Anita Kurian, Metro Health’s assistant director. Now, people seeking COVID-19 tests who exhibit the three main symptoms – coughing, shortness of breath, and fever of 100.4 degrees or more (99.6 degrees for individuals 65 years or older) – can get a doctor’s pre-approval for a test.

“They may also ask if you have come into contact with a confirmed case, [or if] anyone in your household [has],” she said. “It’s up to the clinician’s judgment.”

Who else besides Metro Health conducts testing?

Your doctor can conduct a coronavirus test and send it to a private lab for evaluation or call the drive-thru testing site to set up a testing appointment.

The City of San Antonio and Bexar County intend to open more testing sites in the future, Bridger said.

Kurian said most of the COVID-19 tests in Bexar County are being processed by private labs, as Metro Health does not have the same capacity as large, commercial labs.

“We at Metro Health are prioritizing our tests for hospitalized patients, high risk patients, and for symptomatic health care providers, symptomatic first responders, and ruling out exposure in congregate settings,” she said. “These are all time-sensitive … for public health.”

How does the test work?

Samples are collected using a swab, which resembles a long Q-tip. Swabs are taken in the nose and in the back of the throat, so it might be a little uncomfortable.

The swab is placed in a tube, which is double-bagged and put into a box. The samples are sent to Metro Health or a private lab.

At Metro Health, samples are opened under a safety hood, and lab workers wear safety equipment to avoid contact with the samples. The tube holding the swab sample is then sterilized to avoid cross-contamination, then the sample goes into a refrigerator.

“In order to conserve the reagents for the testing and controls, we wait until we have at least eight samples before we move on to the next step, which is the extraction,” Kurian explained.

SARS-CoV-2, the virus that causes the respiratory illness known as COVID-19, is a ribonucleic (RNA) virus. In order to test for it, labs extract the genetic material RNA from the sample and try to match it to SARS-CoV-2. In order to do that, the samples are mixed with a chemical that helps extract the RNA and then are placed in an extraction machine for one to two hours.

After the RNA has been separated it is placed into a machine with other samples to be analyzed. After two hours, the machine that analyzes the RNA gives one of three results for each sample: positive, negative, or inconclusive.

Metro Health can turn around results in 48 hours, Kurian said, while commercial labs may take anywhere from three days to a week to provide results.

“You don’t want to make a mistake,” she said.

Will the test tell me where I contracted the virus?

No. If you know you’ve been in close contact with someone who tested positive for coronavirus, it’s likely you contracted the virus from that person.

Metro Health continues to use “contact tracing” to find people who you have had close contact with, and encourages those people to self-isolate and avoid spreading the coronavirus further.

Who pays for the test?

Health insurance should cover the test if your doctor recommends you be tested or if you’re in a pre-approved, high-risk group. A dozen health insurance companies have agreed to waive consumer costs for medically necessary COVID-19 tests, according to the Texas Department of Insurance.

If you don’t have a doctor’s recommendation to be tested, you can pay out of pocket to be tested.

If you don’t have insurance, you can still get tested for COVID-19 if a health care provider recommends it, according to the Department of State Health Services.

I got a test done. Now what?

Now, you wait for results. Until then, stay at home and away from friends and family, Arrington said.

“If you’re sick enough to get tested, you need to be isolating from other folks anyways,” Arrington said. “Better safe than sorry and expose someone in your family.”

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Jackie Wang covered local government for the San Antonio Report.