At-Home Tests for COVID-19: Drugstore Buys
At this point in the pandemic it’s clear that vaccines are our most powerful tool for crushing COVID-19. Yet experts point to another important strategy that is becoming increasingly overlooked: COVID-19 testing.
Even as a growing number of Americans are vaccinated, it’s vital that we keep testing, they say.
That’s because the virus is far from disappearing. Close to 15,000 people, on average, are are still becoming infected every day, according to the Centers for Disease Control and Prevention (CDC). And while an impressive 54 percent of Americans have received at least one vaccine dose, that leaves nearly half the country unprotected.
The good news is there are more testing options than ever, especially now that the Food and Drug Administration (FDA) has authorized several simple tests that can be performed entirely at home and provide rapid results.
“People attending gatherings or otherwise socializing in areas where COVID-19 is spreading can feel reassured by taking a home test,” says Gigi Kwik Gronvall, PhD, a senior scholar at Johns Hopkins Center for Health Security, who directs the Johns Hopkins Center’s COVID-19 Testing Toolkit.
This is especially true for people who have not yet been vaccinated, including all children under 12, but it also applies to those who are fully immunized, she says: The vaccine does not provide complete protection against COVID-19 and so-called “breakthrough” infections can occur, albeit rarely.
I for one plan to use home tests to make traveling and socializing safer. This summer, I’ll be attending a large indoor wedding in one city and a baby shower the following weekend in another city. Even though I’m fully vaccinated I will be packing a home test kit to use between stops, to help insure I don’t inadvertently bring the disease to the pregnant couple or their friends.
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Testing Rates Are Falling as the Need Grows
After a slow start, the rate of testing picked up, and more than a million tests have been conducted daily in the U.S. since the fall of 2020, according to Johns Hopkins University, which tracks this data. The number of tests peaked at nearly 2 million in January 2021.
Testing has been falling ever since. In May, an average of 1.2 million tests were reported.
This is understandable, Gronvall says, in part because public health resources in many communities shifted from testing people to vaccinating them.
It seems counterintuitive that the need for testing would grow as the percentage of Americans who are vaccinated increases. But testing “takes on even greater importance as you have more people vaccinated,” Gronvall says.
As fewer people become hospitalized or pass away, it becomes harder to track the disease, because those two metrics are used along with testing to gauge how much virus is in circulation.
Testing can also identify if people who are vaccinated are getting sick or if a new virus variant develops that can evade a vaccine’s defenses.
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Newly Authorized Home COVID-19 Tests Ease the Process
Fortunately, testing for COVID-19 has gotten easier. If you wanted to get a COVID-19 test last summer, you had to find a government testing site and stand in line — sometimes for hours — or find a doctor’s office or medical center administering a test.
This summer, you can simply head to a drugstore and pick up a test at the front counter next to the packs of gum.
COVID-19 self-tests have been around since last November, but most of the early models required a doctor’s prescription, an expensive testing device, and/or the sending of a nasal-swab sample to a lab in the mail.
In recent months, the FDA has granted emergency-use authorization for a number of tests that don’t require a prescription, are relatively inexpensive, and yield results at home in about 15 minutes.
These tests are available in many chain drugstores or can be bought online.
COVID-19 Home Testing Offers Convenience and Peace of Mind
Now that summer is here and people are returning to socializing, traveling, and perhaps working with colleagues in an office, home tests may be especially useful.
Guidance from the CDC calls for anyone who has COVID-19 symptoms to be tested whether or not they have been vaccinated; unvaccinated individuals who have been exposed to someone with COVID-19 also need to be tested whether or not they have symptoms. The CDC says that the test can be conducted at home or by a healthcare provider. (You should also quarantine until you know the results.)
“Home testing allows you to more conveniently find out if you’re contagious so you can isolate before passing the disease to someone else,” Gronvall says.
COVID-19 Home Tests Can Be Useful for Travel
Certain home tests can be used to meet requirements for international travel. Currently anyone arriving to the U.S. must show a negative test result taken no more than three days before flying. (Some other countries also require similar proof of a recent negative test.)
Home tests that include a telehealth component, where the provider confirms your identity, virtually observes your taking your sample, confirms that your test result is negative, and issues a document to that effect, can be used to meet this requirement, the CDC says.
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Three Different Types of COVID-19 Tests
When testing for COVID-19, there are several different technologies involved. Two main types can determine whether a person has an active infection: polymerase chain reaction tests (PCR) and antigen tests.
PCR tests are considered the gold standard, because they look for traces of the virus’s genetic material. These tests are used at testing sites, hospitals, doctor’s offices, and the like. A nasal-swab sample is examined in a lab, with results taking a day or longer.
Antigen tests seek to detect the presence of a specific molecule that implies a current viral infection but do not document it directly. They can be performed in many settings, from a doctor’s office to a workplace, college, school, and now also home.
The sample is taken with a swab in the nose, and results are revealed quickly, generally within 15 minutes.
However, antigen tests are more prone to error than PCR tests. According to the CDC, antigen tests are less sensitive than PCR tests so they may miss an early infection that a PCR would detect.
A third type of COVID test is an antibody test. This is a blood test that shows if you’ve had COVID-19 in the past. It does not measure if you are sick now. Having had COVID-19 in the past does not guarantee that you cannot get it again.
Brands of Rapid COVID-19 Tests for Home Use
There are three main COVID-19 antigen tests you can buy in a drugstore without a prescription to perform at home.
- Abbott BinaxNOW This test is available in many drugstores and sold in a package of two tests for $24. After swabbing both nostrils, you place the sample on a reactive strip in a test card. Like with a pregnancy test, a line appearing on the card indicates the test is positive; no line means COVID-19 is not detected. Because antigen tests can give a false negative result if you test too early after being exposed, instructions call for using the second test in the package within three days, at least 36 hours apart.
- Quidel QuickVue This test works similarly to the BinaxNOW but uses a tube of solution instead of a card to develop results. Results are available in 10 minutes. This test also costs $24 and is similarly sold as a package of two, with instructions to repeat a negative test within three days.
- Ellume A sample is taken with a nasal swab and transferred to a strip filled with processing fluid. The strip communicates via Bluetooth with an app the user is required to download, with results displayed on that app within 15 minutes. Ellume is available for $40, with one test included in each kit.
If the result of a home test is positive, the test taker is instructed to reach out to their physician and also stay home and isolate away from others.
To help local officials keep track of possible infection surges, many health departments also request that you inform them of a positive result.
COVID-19 Home Tests That Involve a Professional
Two other tests are performed at home but also involve a healthcare professional in some way.
The Abbott BinaxNOW Ag is performed similarly to the BinaxNOW and is also available without a prescription. Here, though, a telehealth professional accessed via an app guides the taker through the test and verifies the results.
Because of this oversight, this test can generally be used to document negative test results for international travel to the U.S.
The cost for the Ag is $35 for one test or $70 for two.
Pixel is a PCR test where a person swabs their own nose at home and sends the sample in an enclosed package to LabCorp for processing, generally within two days. If you have insurance and meet certain testing criteria, such as exposure to a person with the disease, you can get this test for free, with LabCorp billing your insurance company. Or you can pay $119. As with other home tests, this does not require a doctor’s prescription.
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COVID-19 Home Tests Have Limitations
Home COVID-19 tests offer a great deal of convenience at a relatively low cost. But they do have downsides.
Because most home tests are antigen tests, they can miss an active coronavirus infection, especially when it is in the early stages.
Although the tests are relatively simple to perform, it is possible that a person will complete it incorrectly, invalidating the results.
Most home tests provide results within minutes, but those that require sending a sample to a lab for analysis still take days to get results.
And if people don’t take it upon themselves to notify public health experts in their community of a positive test, officials may not learn when a disease hot spot is arising.
Home Tests Are Relatively Inexpensive, But They Are Not Free
Most home tests for COVID-19 involve a cost to the consumer, even if the majority are reasonably priced.
If you live in an area where PCR tests from the health department, pharmacy, or other providers are readily available, you might choose that over a home test, says Richard Martinello, MD, an infectious diseases specialist at Yale Medicine and associate professor of medicine at the Yale School of Medicine.
“It may be cheaper to seek out one of these options because there is no cost to get tested at many locations,” Dr. Martinello says.
The Government Is Evaluating Home Test Benefits
The federal government is currently evaluating whether regular home testing can be used to limit the spread of the virus.
The FDA already knows that for group care settings like nursing homes, “repeated use of rapid point-of-care testing may be superior for overall infection control compared to less frequent, highly sensitive tests with prolonged turnaround times.”
Now the CDC and National Institutes of Health (NIH) have started a community health initiative called “Say Yes! COVID Test.” Home test kits are being made available free to 160,000 residents in North Carolina and Tennessee to use three times a week for a month.
This new study will determine whether frequent home testing not only keeps an individual safer but also protects the whole community.