At-home Coronavirus Testing

In late April 2020, the Food and Drug Administration (FDA) began issuing Emergency Use Authorizations for at-home coronavirus test kits. These authorizations came after the FDA issued warnings in March of that year to companies that were selling at-home test kits that were not FDA-approved. A number of companies have received Emergency Use Authorization (EUA) to sell at-home coronavirus test kits, some of which include: LabCorp, Everlywell, Quest Diagnostics and Hims & Hers.

These EUAs were issued in response to the pandemic and the need to increase testing capacity and accessibility to stop the spread.

There are self-collection test kits that allow you to gather a nasal or saliva specimen at home to give to your healthcare provider, who will record the results. And, there are at-home tests that allow you to complete the test at home and receive results, which you then report to your provider. You can get self-collection kits and home COVID-19 tests from your pharmacy over-the-counter or ask your doctor to fill a prescription.

How at-home COVID-19 testing works can differ slightly depending on the test you buy. Generally, self-test kits work like the tests being administered in hospitals and health clinics. With those tests, a healthcare worker takes a nasal swab from a patient and sends the specimen to a lab to be tested for genetic material that causes COVID-19. The test is conducted through a process called polymerase chain reaction, or PCR, and it can take a few hours.

There are also tests available that can provide results on-site in minutes. At-home COVID-19 tests adapt this process by allowing you to collect your own nasal swab or saliva samples. I Then, you mail o specimens to labs for testing, typically using a provided, prepaid shipping label. Depending on the company, results are available within a few days via a mobile app, email or phone call. Some pharmacies also provide kits where you can collect samples at home then drop off specimens for analysis.

Another type of at-home test in development is a serology test, which uses a blood sample to detect antibodies that the immune system makes when exposed to COVID-19. In April 2021, the FDA issued an EUA for the Symbiotica COVID-19 Self-Collected Antibody Test System, which is the first one authorized for use with home collected dried blood spot samples, which are then sent to the company’s lab for analysis.

As the coronavirus spreads, increased testing is critical to accurately identify how many people have contracted COVID-19. At-home testing also helps those who are ill get the help they need, and if they test positive, they can self-quarantine and stop the spread.

Although testing capacity at healthcare facilities around the country has increased, availability and accessibility varies based on location. This is why at-home COVID-19 testing is so valuable. It expands access to tests and helps decrease exposure for frontline workers, healthcare providers and patients.

Also, more test results mean more data for epidemiologists, doctors and other health experts to study and use in their efforts to stop the spread of COVID-19.

The  Accuracy is the main concern with at-home tests.. When tests are not administered by or under the supervision of a trained healthcare professional, there is an increased risk of error that could lead to a false negative. This means that test results show the individual does not have COVID-19 when in fact they actually do. With a disease as new and contagious as COVID-19, a false negative can be particularly detrimental. The FDA warns that inaccurate test results can cause patients to delay medical treatment while behaving as if they are not sick, causing further spread of the virus.

A number of issues can lead to inaccurate test results, including:

• Collection of samples too early, before the virus can be detected
• Incorrect collection of specimens by individuals
• Incorrect handling of specimens by individuals
• Temperature fluctuations during transportation to labs
• Length of time between collection and delivery to labs

If you are experiencing COVID-19 symptoms or have been exposed to someone who has tested positive, you should first contact your healthcare provider or your local or state public health department.

According to the World Health Organization (WHO), the most common COVID-19 symptoms are fever, dry cough and tiredness. Other notable, yet less common symptoms, include: aches and pains; sore throat; diarrhea; conjunctivitis; headache; loss of taste or smell; skin rash; or discoloration of fingers or toes.

COVID-19 symptoms can appear anywhere from two to 14 days after infection, although on average individuals begin to show symptoms five to six days after infection.

Currently, the CDC offers these guidelines for prioritizing who should be tested for the coronavirus:

Highest Priority:

• Hospitalized patients with symptoms
• Healthcare facility workers; workers in congregate living settings, and first responders with symptoms
• Residents in long-term care facilities, or other congregate living settings, including prisons and shelters, with symptoms

Priority

• Persons with symptoms of potential COVID-19 infection
• Persons without symptoms who are prioritized by health departments or clinicians, for any reason, including but not limited to: public health monitoring, sentinel surveillance, or screening of other asymptomatic individuals according to state and local plans

According to the WHO, individuals who are experiencing the following severe symptoms should seek medical attention immediately:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face
• Loss of speech or movement

Overall, at-home COVID-19 testing gives more people an opportunity to test for the virus, and this is crucial as we look toward a post-pandemic world with a return to activities, social gatherings, and the safe reopening of businesses and schools. The more people who are tested, the better we can reduce the spread.

Read more: When to Get Tested for COVID-19

• CDC | COVID-19 | Last accessed May 2021.
• CDC | COVID-19 Testing Overview | Last accessed May 2021.
• CDC | Guidance for Health Departments about COVID-19 Testing in the Community | Last accessed May 2021.
• Abbott Launches 5-Minute Virus Test for Use Almost Anywhere | Last accessed May 2021.