10 tips for taking at-home COVID-19 tests
Getting tested for COVID19 used to mean long drivethru lines and a potential two-week wait for lab results during the earliest days of the pandemic.
Now there’s a litany of options to screen for the virus, including at-home tests, which can be purchased over the counter and in, some cases, give results in a matter of minutes. Chicago’s top physician recently touted the benefits of taking COVID-19 tests at home for quick and convenient screening.
“It’s the one that you can just take it home and have a result of in 15 minutes,” Chicago Department of Public Health Commissioner Dr. Allison Arwady said during a recent Facebook Live session. “It’s like a pregnancy test. You see it right off the bat.”
As demand for COVID-19 testing has picked up again in Chicago and Illinois, here are 10 things to know about testing at home:
1. There are two main types of at-home tests.
There’s self-collection kits, where saliva or nasal samples can be taken at home and sent to a lab for analysis. These are typically polymerase chain reaction tests, or PCR tests, used to detect the presence of genetic material of the virus that causes COVID-19.
The other kind are at-home rapid antigen tests, where a nasal sample is collected at home and the patient also performs the test, which detects certain proteins on the surface of the virus. Results are often available in a few minutes.
“The advantage of (rapid antigen tests) is they are quick and easy to use and give a result right away,” said Elizabeth McNally, director of the Northwestern University Feinberg School of Medicine Center for Genetic Medicine. “So if a person feels they had
an exposure, these tests can be done at home and give a quick result.”
But she cautions that antigen tests are generally less sensitive than PCR tests, resulting in more false positives or negatives.
“The performance of the tests is less good in asymptomatic cases or cases with a lighter degree of infection,” she said. “Despite the lower performance features, they can still be quite valuable.”
2. With self-testing and self-collection, experts say there’s generally a greater chance for errors.
“People who do things all the time are better at them than people who do them occasionally,” said Dr. Sheldon Campbell, professor of laboratory medicine at Yale School of Medicine. “People make mistakes.”
To minimize errors, Campbell recommends checking the package
expiration date, reading instructions carefully and evaluating test results during the prescribed time window.
3. Take the test on the right day.
The Centers for Disease Control and Prevention recommends testing three to five days after exposure to someone who has, or is suspected of having, COVID-19.
4. Clean before and after testing.
Make sure to wash hands with soap and clean surfaces before and after collecting the sample and testing, so as not to contaminate the test or potentially spread virus, according to the CDC.
For nasal swab samples, Campbell said to make sure to stick the swab up the nostril as far as the instructions say to go.
“Swab it vigorously,” he
5. Get a good sample.
said. “Rub it around. Don’t just stick it up there and say that’s enough.” The CDC also offers diagram guides for self-collection of different nasal samples.
6. Many at-home tests can be performed on kids, but check the instructions for age requirements.
Some of these tests indicate on the package that they are available for ages 2 and up; check individual test instructions to see if there’s any age stipulation. McNally added that rapid antigen tests might not perform as well in children compared to adults.
7. Testing at home can get expensive.
At-home rapid antigen tests can range from about $20 for two tests or around $45 for one, depending on the brand, product or store. At-home collection tests are often more pricey. While many COVID-19 tests performed by a health care
provider are free, at-home tests often aren’t covered by insurance.
8. If the test is positive:
Self-isolate according to CDC guidelines. Notify close contacts who might have been exposed.
An infected person can begin spreading COVID19 about two days before having symptoms or testing positive, according to the CDC.
“By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone,” the agency says on its website.
Contact your health care provider or local health agency for potential treatment and care instructions. Health experts worry that millions of at-home rapid antigen tests might be going unreported, leaving cases potentially undercounted by public health authorities.
“As a doctor, I worry some people might test positive at home and then not connect with health care,” McNally said. “But better to test than not to test. These tests can help us a lot.”
For positive results from rapid antigen at-home tests, McNally recommends retesting with a PCR test performed by a health care provider.
9. If the test is negative: If a rapid antigen test is negative but you’re symptomatic, McNally urges retesting with a health care provider.
Campbell added that a PCR or rapid antigen test screens only for an active infection in the moment, not any time in the future.
“Remember that a negative test today is a negative test today,” he said. “It’s not a negative test tomorrow or a week from now.”
10. At-home testing — or any kind of COVID-19 testing — isn’t a substitute for vaccination or other pandemic protocols.
Health experts stress that everyone should still get vaccinated if eligible, as well as wear a mask and social distance.
Campbell likened following multiple mitigation measures during a pandemic to a driver abiding by all traffic safety practices while on the road.
“You obey the traffic laws and you maintain your car as well as you can,” he said. “You don’t drive drunk and you wear your seat belt and you have your kids in a car seat.”
Drivers can’t just choose one of the above and expect to keep safe, he said. Similarly, individuals can’t stay safe through testing alone, even if they’re screening for the virus routinely.
“An at-home test isn’t going to keep you from getting sick,” Campbell said. “The value of it might be that you have less chance of passing it on to others. But I wouldn’t use a test as a substitute for any of that.”