At-home COVID-19 tests could be a passport to normalcy, but they can also give us false confidence


Credit: AIXabay / CC0 public domain

The next few weeks should bring a new stage to the pandemic. Policy changes and government-issued up to 1 billion rapid home testing kits promise to make diagnosing COVID-19 at home cheaper and easier.

Vaccines are the most effective way to prevent serious illness and death, but variants such as Omicron make breakthrough cases more common, and tests are vaccines in the toolbox of those who pay attention to COVID. Became an indispensable companion for inoculation.

The results of rapid antigen testing can be done at home and the results can be generated quickly, but the gold standard for accuracy remains the PCR lab test. However, it may take several days. According to experts, the value of a quick test depends on the situation. People who are already sick may want to see if they are infected with COVID-19, while others are tested to protect themselves or their loved ones from potential exposure to the virus. May be used. Many are optimistic that the test will return to their regular passport, adding a new level of confidence that it is safe to travel to meet family members or attend weddings. ..

However, misunderstanding the usefulness of rapid testing can give people false confidence and unknowingly infect the virus.

William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, said: “Unfortunately, life is more complicated than that.”

Antigen vs. PCR test

The government-provided kit is a rapid antigen test. Samples are collected with a nasal swab and the procedure included is simple. Results are available within 30 minutes.

Studies show that the sensitivity of antigen testing is 80% to 90%. That is, if it is shown to be infected with COVID-19, it is probably accurate. These are more likely to produce false negative results than PCR tests. This means that the test result is negative, but you are actually infected with a virus. Antigen tests were designed to confirm the presence of COVID-19 in highly infectious individuals, but recently exposed individuals may not have enough viral particles in their nose to be detected by the test. It is sexual and causes false negatives.

Ryan McCormick, primary care physician at Virtua Health in Marlton, said people may use rapid negative test results to justify social activity and ignore recent exposures and symptoms that should keep them home. Stated.

“Binary opposition can definitely be a problem, whether we are all positive or negative,” he said. “In testing, it’s important not to think it’s 100% accurate.”

Omicrons appear to appear in the upper respiratory tract and saliva a few days before they are detected in the nasal passages. This can partially explain why a rapid examination of the nasal swab was not so effective in detecting it.

Doctors are discussing whether wiping the back of the throat can better detect Omicron, but McCormick said, “it will be difficult to do at home because it stimulates the pharyngeal reflex.” rice field.

Don’t rely too much on negative test results

Testing is only useful as part of a more complete strategy to prevent the spread of the virus.

“The problem is when people use them and don’t respond accordingly,” said Karen Coffey, an assistant professor of epidemiology. public health Medicine at the University of Maryland School of Medicine. “It’s that behavioral element that really influences.”

European countries had immediate access to rapid COVID-19 testing before Americans, but even aggressively tested countries such as Germany were subject to a surge in Omicron. People need to make good decisions using the data provided by the test.

“With adequate supply and proper inspection frequency, people who actually know their condition and can be quarantined in the meantime can have a huge impact on the number of people infected with it,” he said. Bio-inspired engineering at Harvard Medical School. “Of course, the problem is that if people say,’I’m infected, but I wear a mask and go to the grocery store,’ it doesn’t work. “

If you have symptoms such as sore throat, fever, cough, if you are around a COVID-19 patient, or if you are in a high-risk environment, hanging out at a bar with an unmasked friend, and positive on the test In the case of, take it seriously.

“If they test positive, they have a COVID. There are no ifs, ands, or buts,” Walt said. “No need to retest. No need to go out and have a PCR test. I have a COVID.”

However, in addition to all these risk factors, a negative test result should be followed by a two-day quarantine and another home test. If that test is also negative, you can be more confident that you are COVID free. Until you are in danger again.

If a person is fully vaccinated, boosted, asymptomatic, wears a mask, limits indoor contact, and is not known to be exposed to the virus, a single negative test result is a friend. Before meeting or meeting a family, or an event.

“If you’re vaccinated, you’re encouraged and careful,” Schaffner said.

False positives (positive in the test but no actual COVID) are rare, but possible, Walt said. If you suspect a positive test result, get another test right away. It is highly unlikely that false positives will occur twice in a row, he said.

COVID-19 test cost

Routine antigen testing can quickly become expensive when a single test goes from $ 10 to $ 15. All households are eligible for one 4-pack test that can be ordered online for free and without shipping from the federal government via The first order will be delivered by early February.

Since the holiday season, the demand for home tests has outpaced the supply, so people need to take advantage of free tests, doctors said.

“It’s important not to stockpile them, but in the future it’s a very valuable tool to control the pandemic and resume life as usual,” McCormick said. “If you don’t have anything, accept the government’s offer.”

Apart from the government offering free tests Insurance company You must cover the cost of a maximum of 8 home-based rapid inspections per member per month. People may be able to use insurance to pay for the test in advance, or they may be able to claim a refund from the insurance company. Therefore, please do not throw away the receipt.

The state-owned Medicaid and Child Care Insurance Plan programs should also cover the COVID-19 test at no cost.

Although the test is widely covered Private health insurance, Medicare, Medicaid, and Federal Funds for Uninsured, Payment Rules can be confusing.

The insurance company covers up to $ 12 per test. If the purchase costs more, you will have to pay the difference at your own expense.

The PCR test should be free, whether it is done at the hospital or at the test site. If ordered by a healthcare provider or if the individual is symptomatic, private health insurance is required to cover the PCR test. As of January 15, the insurance company should also cover PCR tests that are done at home and sent to the lab for analysis without the notice of a doctor.

However, if the school or employer needs it, health insurance does not need to cover the test and people are facing problems with out-of-pocket or full cost of the test.

For example, Sabrina Collet, co-director of the Georgetown University Health Insurance Reform Center, said insurance companies could refuse to cover testing for people without symptoms or COVID-19 exposure.

“But in reality, I find it difficult for many carriers. At these large test sites, it’s a hassle to look at their claims and try to understand the purpose of the test.”

For home tests, tests that are done entirely at home must be covered by insurance without any cost or medical consultation. However, she said, if the sample collected at home needs to be sent to the lab, the insurance company may request a doctor’s note.

“It’s as clear as mud, isn’t it?” Said Corret.

To further confuse, test prices can vary significantly. In a price analysis of 93 hospitals in April 2021, the Kaiser Family Foundation found that PCR test prices ranged from $ 20 to $ 1,419 and had a median cost of $ 148.

COVID-19 tests part of “New Normal”

New accessibility to the test could be too late to make a big difference during the Omicron surge, and should subside in many parts of the country by the time the test arrives, Coffey said. However, it is still worth making them available.

“I want to say this is the last wave we get, but I don’t think it’s likely,” she said.

Prior to the pandemic, it was unheard of to diagnose a virus at home using the equivalent of Q-Tip and some chemicals. Currently, this technology may be adapted to thwart the spread of various other diseases. If someone in the house has a fever, tests to find out if they have the flu may be readily available.

“We could rule out having the flu. We could rule out having COVID. We could rule out having RSV,” Walt said.

According to experts, it would be a tedious distribution system for the government to send regular inspection distributions home, ideally for inspections to become more widely available and readily available.

“I think this is a good starting point and will probably encourage people to use these tests more comfortably and buy them themselves,” Coffey said. “We do not support the whole country throughout the pandemic.”

Rapid Covid Tests Are Not Accurate at Omicron: US Regulatory Authority

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