One crucial step to your COVID self-test you may be missing
Testing yourself for coronavirus infection can be more convenient than getting a clinic or lab test, but from a public health standpoint, experts say there’s at least one key downside.
Only 7% of positive coronavirus cases in the United States are being detected, meaning case rates are 14.5 times higher than officially reported, according to the Institute for Health Metrics and Evaluation. Contributing to the problem has been the steep spike in use of self-tests, which has surpassed the number being done in laboratories, according to the National Institutes of Health.
In the U.S., positive results of COVID-19 tests administered by medical professionals are ultimately reported to the Centers for Disease Control and Prevention. But there isn’t any requirement for people to report their self-test results to health care providers or local public health departments.
Coronavirus self-tests — also known as home tests or over-the-counter tests — detect current coronavirus infections, not antibodies to the virus, and can easily and quickly be taken at home or elsewhere, regardless of your vaccination status, the CDC says. Most self-tests are rapid antigen tests, which can be less sensitive than PCR tests done in clinics or labs. Some home tests are PCR tests, but antigen versions are much more common and accessible.
Ideally, you should report positive results to both your provider and local health department for several reasons, said Dr. Georges Benjamin, the executive director of the American Public Health Association. For one, he explained, if you test positive, your health care provider might need to intervene with treatments such as monoclonal antibodies or antivirals to mitigate your symptoms, depending on your COVID-19 vaccination or health status.
Reporting positive test results to your local public health department helps experts understand the prevalence of a new disease in different communities, he added.
“Presence of disease is an earlier indicator than the hospitalizations and can help us predict workforce needs, staffing needs for hospitals,” he added. “If you know you’ve got a community that hasn’t had a lot of infection and all of a sudden you’re seeing it grow, then you can usually predict that two or three weeks from then, they’re going to be seeing more cases in the hospital [and] tragically, death, too. However, with this new BA.2 omicron variant we are seeing infections but not many severe hospitalizations.”
Awareness of positive self-test results can also help public health experts better understand how vaccines are holding up against the virus — and which activities might be particularly risky for getting COVID-19, said Dr. Jonathan Golob, an assistant professor of internal medicine in the Division of Infectious Diseases at the University of Michigan.
Knowledge of all these factors influences health experts’ recommendations, Dr. Benjamin said, including guidance on safety precautions and closures and mask mandates and how the disease affects unvaccinated and vaccinated people differently.
“The best way to answer all of these critical questions we all have about the pandemic is through reporting of cases of COVID19 to public health experts,” Dr. Golob said via email.
Have a few key details readily available, Dr. Benjamin and Dr. Golob advised, including the type of test you took (rapid or regular antigen or PCR); when you took it; when symptoms started, if applicable; your vaccination status, which vaccine you received, when your doses were and whether you have received a booster shot; any details about over-the-counter medications you have taken to treat symptoms; and names of people and places you were near in the days leading up to your test result.
As contact tracing experts, public health offices can help you figure out who else needs to know, as well as help you contact them in some cases, Dr. Golob said. The public health office won’t share your name with recent contacts. It will only inform those contacts of their potential or definite exposure, according to the CDC.
“It’s not 100% that all will get sick, but it can help people follow the suggestions of what to do after a close exposure to COVID-19,” Dr. Golob said. “If you were in a place like a school or workplace, it’s probably wise to loop them in too, and let them help you notify others of the possible exposure.”
The CDC also has a worksheet to help you determine what constitutes a close contact. If you prefer to anonymously inform your close contacts, there’s an online tool for that, endorsed by the CDC.