How the Coronavirus test works:
Covid-19 is an RNA based virus that uses RT-PCR
The process of testing is essentially this:
1. Get a nasopharyngeal swap sample.
2. Isolate RNA from this swab. (~1 hr)
3. Convert RNA into DNA with reverse transcriptase enzyme. (RT) (~30min)
4. Amply coronavirus specific DNA through a process called polymerase chain reaction. (PCR) (~1.5hr)
So, if you are going to do this thoroughly, and in a manner that is scalable you want to have kits and machines that can do most of these steps, also have very few reagents that one has to mix together so that the Med tech can perform the test correctly every time, even on a night shift without screwing up. My time estimates are crude and depending on a variety of factors can be shifted one way or another. Once a lab receives the sample and they were ready to go and only did that it would be reasonable to have results in less than 4 hrs.
This is more automated and uses fancier machinery than what I would use in a lab and also you more of those fancy things called "controls". For thoroughness sake, 3 different regions of RNA that are specific and conserved in the coronavirus genome would be selected for amplification. This is done by carefully designing oligonucleotides (primers) that align perfectly with the CV sequence. After the RT step, PCR exponentially amplifies the specific chromosome regions. The growing amount of product has a third short primer that has two additional molecules added to the ends of them. This probe will bind to the PCR products. In each round of amplification or cycle, the enzyme that makes another product actually is a dual function enzyme that breaks down any piece of DNA (or probe in this case) that is in the way. Breaking down the probe these two molecules are released. They are actually a fluorophore and a quencher. When they are tethered together with the probe they do not emit or become exited. When they are free in solution they do. So the fancy RT-PCR machines are able to read the amount of fluorescence that accumulates with each cycle. The fancier the machine and with different fluorophores these reactions can be done in same tube at same time and are considered multiplexed. This test needs validated with positive (known coronavirus samples) and with negative controls, (not adding RNA early on) and optimization of timing and cleanliness of the readout for certification purposes. But that is essentially the process.