Do at-home COVID-19 testing kits work? Here's what you need to know

Now that the holidays have coincided with a rapid increase in COVID-19 cases, people are more interested in at-home testing for the virus than ever. And there is a growing group of products to meet the demand.

In November, the Food and Drug Administration announced that it had issued an emergency use authorization for an at-home rapid COVID-19 test created by Lucira Health. The test, which has users collect a specimen through a nasal swab and then drop it in a vial for testing, gives results within 30 minutes.

But while this is the only FDA-authorized at-home test kit on the market that delivers quick results as of this moment, there are plenty of others available that utilize a lab to achieve results.

Just this week, the FDA said it has issued an emergency use authorization for an at-home flu and COVID-19 test kit. The kit, which is called the Quest Diagnostics Self-Collection Kit for COVID-19 + Flu, is available by prescription from a doctor, the FDA said in a press release. With the kit, patients can take a nasal sample at home and ship it to a Quest Diagnostics laboratory for analysis.

LIVINGSTON, MT - JUNE 20: A Quest Diagnostics self administered  Covid-19 PCR test on June 20, 2020 in Livingston, Montana. (Photo by William Campbell/Getty Images)
A Quest Diagnostics self-administered Covid-19 PCR test. (Photo by William Campbell/Getty Images)

Both Walmart and Sam’s Club are selling at-home COVID-19 kits from myLAB, which offers two different collection methods — via nasal swab or saliva. Patients simply order a kit, take a sample and then ship it off to a lab. However, these kits are not FDA-approved.

American Airlines announced on Tuesday that it will sell at-home COVID-19 test kits to domestic passengers traveling to states with travel or quarantine restrictions, starting on Wednesday. American says on its website that the tests, which are part of the company’s LetsGetChecked initiative, have an average turnaround time of 48 hours. There are also plenty of other at-home test kits available, including Pixel by LabCorp, Everlywell’s COVID-19 Test Home Collection Kit and Vault Health’s saliva test kit.

But, as of now, the Lucira Health test kit is the only one that delivers rapid results without the use of a lab. That could change, though: President-elect Joe Biden specifically says on his transition website that his administration plans to use at-home testing, among other strategies, to try to help mitigate the spread of COVID-19.

When should you consider at-home testing vs. testing at a medical facility?

At-home test kits are often more helpful for seeing if someone is contagious with COVID-19 in a particular moment in time, infectious disease expert Dr. Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life. Many doctors are “trying to get people to switch the paradigm to at-home testing so they know their status and can make better risk calculations,” he says.

Under this strategy, at-home testing may be useful in helping people make more informed decisions, such as whether it’s OK to go to an event or meet with loved ones. “In that situation, at-home testing is best,” Adalja says. “You don’t want people to use PCR testing every time they want to decide whether to do something.”

These at-home tests can be potentially problematic, though, in people with symptoms who get a negative reading, Adalja says. “If their test result is negative and they’re sick, they still need to find out what’s going on,” he says, pointing out that even tests performed by medical personnel aren’t perfect.

That’s why Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Yahoo Life that he has some concerns about these tests. “Some people think about these tests as giving them the freedom to do whatever they want,” he says. “Other folks are using them as an excuse to behave irresponsibly.”

Testing will really only work if it’s combined with what Adalja calls “common sense” measures, like social distancing, hand hygiene and wearing masks when you’re around people who aren’t in your household.

How accurate are these tests?

Lucira Health says on its website that its at-home test kit has a 94 percent positive agreement and a 98 percent negative agreement with comparison tests. That means it’s 94 percent accurate for positive cases when compared with other tests conducted at that same point in time and 98 percent accurate for negative test results under the same parameters.

If samples for other tests are taken accurately, they should have results that are on par with having them taken by medical personnel, Joseph Petrosino, chairman of the Department of Molecular Virology and Microbiology at the Baylor College of Medicine, tells Yahoo Life. “The accuracy of at-home tests mirrors what we observe with clinically offered versions of the same tests,” he says.

Can these at-home tests really help drive down COVID-19 cases in the U.S.?

That remains to be seen. Adalja says that having people use these tests once or twice weekly can really help drive down transmissions. “Slovakia has seen major decreases in COVID-19 cases after testing like that,” he says. (A pre-print study found that Slovakia cut its COVID-19 infection rate by 60 percent through mass testing.)

Adalja has been advocating for at-home diagnostic testing for infectious diseases for years, and authored a report published in June that makes a case for their use during the pandemic. “Such tests when used to diagnose infectious disease, and coupled to information technology, could have a transformative benefit for future pandemic response,” he and his co-authors wrote in the report.

But Schaffner is less certain. “My mind is open to it, but I don’t know what the answer is just yet,” he says. “There are other at-home tests that are very useful — pregnancy tests, for example. But that tells you about your own personal health. This is about personal and public health.”

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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