At-home tests for COVID-19 may seem more convenient, but how do you take them, and what do you do when you have a positive result? Here, experts weigh in.
When the first COVID-19 at-home tests were developed at the beginning of the pandemic, accessibility was a huge issue, and many people reported waiting in long lines at testing centers. Once you were swabbed, it could take a week or more to get your test results. The process has gotten a bit better since then (though lines are getting longer again in some places as the Delta variant rages on), and the Food and Drug Administration (FDA) has even issued emergency use authorizations (EUA) for several diagnostic tests that you can take at home.
These tests generally fall into two categories: at-home self-collection tests, which involve collecting a sample yourself and sending it off to a lab to be tested, and at-home self-tests, where you take a sample at home to test right then and there, and results can be seen within minutes. Naturally, many are opting for at-home self-tests, since they allow consumers to be tested from the comfort of home and offer quick and easy results.
But it’s understandable to be a little confused about how to use these at-home COVID-19 tests, unsure about how accurate your results will be, and unsure what to do if you get a positive result. Here’s what you need to know about home COVID-19 tests.
How to take a home COVID-19 test
The FDA has issued EUAs for several home tests that don’t require prescriptions, but among the most well-known are the Abbott BinaxNow Self Test, Quidel QuickVue At-Home OTC COVID-19 Test, and Ellume COVID-19 Home Test.
Each of these tests is slightly different. Both the BinaxNOW and QuickVue tests involve swabbing your nose and then placing the swab in a special proprietary solution. If you choose the BinaxNOW test, you’ll be instructed to swab your nose and then insert the swab into a card, which contains the solution, until your results are ready. If you opt for the QuickVue, you’ll insert a test strip into the solution after your swab, which will indicate your result. Both tests will give you results in the form of lines matching a key, similar to a pregnancy test. Results will appear anywhere from 10 to 15 minutes. You’re encouraged to follow the latest CDC guidelines, which say that you should communicate your results to your health care provider, who will then report your test results to the state health department (more on that below).
The Ellume test includes instructions to download an app, swab your nose, and place the swab in a solution that syncs up with the app. The app will tell you within 15 minutes if your test result is positive or negative. Once you get your results, the Ellume test automatically reports required data about your results to health authorities through a secure, HIPAA-compliant cloud connection.
Given that each test is slightly different, the best thing you can do to get accurate results is to follow the instructions carefully, Richard Watkins, MD, an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University, tells Health.
How accurate are home COVID-19 tests?
In general, if you’re having symptoms and you’re trying to suss out what’s going on, you can feel pretty confident that a home test will give you answers. “Home tests are fairly accurate when it comes to symptomatic individuals trying to see what they may be sick with,” infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells Health.
Exact accuracy varies, but Ellume claims its test offers 96% accuracy in detecting symptomatic cases of COVID-19 and a 91% accuracy in detecting asymptomatic cases, while BinaxNow says it detects 84.6% of positive COVID-19 cases and 98.5% of negative cases. QuickVue’s test results matched up to PCR tests (aka the gold standard of COVID-19 testing) 83.5% of the time, with negative results matching up 99.2% of the time.
What happens if your test result is negative?
Both BinaxNOW and QuickVue recommend that you take two tests, spaced at least 24 to 36 hours apart, for the most accurate results. If you get a negative test result twice (with QuickVue or BinaxNOW) and you aren’t having symptoms, you can feel pretty confident that you don’t have COVID-19. However, if you’re still having symptoms, it’s a good idea to either test again in a day or two or call your doctor, Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo in New York, tells Health.
What should you do if your home COVID-19 test is positive?
While you may assume you don’t need to call your doctor if you get a positive result, experts say you really should. “There are a few reasons for this,” William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Health. The first reason, he says, is that you may be eligible for a monoclonal antibody treatment (a treatment that uses laboratory-made proteins that mimic your immune system’s ability to fight off SARS-CoV-2) if you’re considered high risk for serious complications from COVID-19. “This doesn’t apply to everyone but your doctor will know whether you fit into the criteria,” Dr. Schaffner says.
You’ll also want to tell your doctor so they can alert your local health department, he adds. (Heads up: If they do pass on your information, your identity will be disclosed for contact tracing purposes, Dr. Adalja says.) However, it’s unlikely that your doctor will want to test you again. “Usually, a positive home test is thought of as a reliable result,” Dr. Schaffner says.
If you aren’t under the care of a doctor at the moment, Dr. Schaffner recommends calling your local health department directly to report your positive test.
Another reason it’s a good idea to call your doctor, if you have one, is to get it on their radar that you’re sick, Martin J. Blaser, MD, professor of medicine, pathology, and laboratory medicine at Rutgers Robert Wood Johnson Medical School, tells Health. “Your doctor may have some practical advice on what you can do and, if you start getting worse, when it’s time to seek medical care,” he says.
If you took a COVID-19 test and got a positive result but you aren’t feeling any symptoms, it’s more than OK to call your doctor, too, Dr. Russo says. “They may recommend that you get a PCR test to confirm the reality of your situation,” he says. “In fact, I would highly recommend that.”
