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WHAT YOU NEED TO KNOW ABOUT AT-HOME COVID TESTS

At-home tests have soared in popularity as lab tests have become harder to get.

ByMary Kekatos
14 January 2022, 19:13
• 12 min read
Share to FacebookShare to TwitterEmail this article
4:10


At-home COVID-19 tests: How they work and how to interpret their results

Amid confusing testing guidance from the CDC, ABC News spoke with infectious
disease...Read MoreRead More
Chandan Khanna/AFP via Getty Images

With the rise of the highly transmissible omicron variant and the need for
widespread testing at school and work, as well as over the holidays, at-home
COVID-19 tests have exploded in popularity in the U.S. over the last several
weeks.

The shift came amid reports of long lines and scarce appointments for testing
sites around the country and longer-than-normal turnaround times for lab
results, leaving Americans seeking other options to find out if they were
infected.


MORE: COVID may be with us for a long time. What kind of testing do we need?

The Centers for Disease Control and Prevention (CDC) and other health officials
recommend people use at-home tests if they have COVID-19 symptoms, have been
exposed or potentially exposed to an individual with COVID-19 or before
gathering indoors. On Thursday, President Joe Biden said his administration is
attempting to acquire 500 million additional free at-home tests to distribute to
Americans, bringing the total promised to 1 billion.

But with several different brands available on the market and changing testing
guidance from the CDC, Americans may wonder how the tests work and how they
should be used.

ABC News spoke with two infectious disease experts about how to use at-home
rapid tests and what the results mean.

John Moore/Getty Images
Residents line up at a drive-up distribution site to receive free at-home
COVID-19 test kit...Read MoreRead More

What are at-home tests and how should they be used?



At-home tests, also known as rapid tests, look for antigens, or proteins, of the
coronavirus and return results very quickly, typically within an hour and some
within minutes. These are different from lab tests, known as PCR tests. They
look for viral genetic material but can take up to three days to return results.

With PCR tests, a patient does not need a lot of viral genetic material in their
nose for a result to be positive compared to a rapid test.

"For the at-home test to be positive, you actually have to have quite a bit of
protein from the virus," Dr. Susan Butler-Wu, an associate professor of
pathology at the University of Southern California Keck School of Medicine, told
ABC News.

MORE: Biden's big test on COVID-19 tests: The Note

To make sure the test is being performed correctly, experts recommend people
make sure they have a clean workspace and to carefully read the instructions.

"When you have the test open and you are getting the swab, there are going to be
instructions about whether to put it in one or both sides of the nose and how
long to have it there and how many times to turn it," Dr. Stuart Ray, a
professor of medicine at Johns Hopkins University, told ABC News. "Those
instructions are important because you want to get an adequate sample."

The swab is then placed in a liquid, which is turn placed on a piece of paper
and flows up through a strip. Most tests have one line to indicate a negative
result and two lines for a positive result.

Because some lines can be faint or hard to see with the naked eye, Ray
recommends taking a photo of the result with a cell phone to confirm it.

Can I use at-home tests if I'm symptomatic?

The CDC recommends that Americans can use at-home tests, regardless of
vaccination status or whether or not they have symptoms.

If the result is positive, the agency suggests staying home or isolating for at
least five days and wearing a mask around others for additional five days.

Although Americans may wonder if their results are a false positive, the experts
say that when there are high amounts of COVID-19 in the community -- such as
during the omicron surge -- a positive result from an at-home test is likely a
true positive.

"Right now, when COVID-19 is absolutely surging, if I have symptoms and I get a
positive result [on an at-home test], I should assume that this is COVID because
we know there's so much of it circulating," Butler-Wu said. "But, for instance,
if we were to come out of this wave and I'm symptomatic and I test myself and
it's positive, I may need to confirm that because we know there's not much
circulating virus."

MORE: Home COVID tests to be covered by insurers starting Saturday

Ray added, "They often come two in a pack for a reason. It's a good idea if you
get a surprising result to repeat that." The CDC recommends repeat (or serial)
testing based on the test manufacturer's instructions.

Additionally, the CDC advises telling close contacts that they may have been
exposed to COVID-19 so they can get tested and/or quarantine.

Chandan Khanna/AFP via Getty Images
Employees of the Miami-Dade Public Library System distribute Covid-19 home rapid
test...Read MoreRead More

What if I'm asymptomatic?

If a person is asymptomatic but has been exposed to someone with COVID-19, the
experts recommend testing five days after exposure regardless of vaccination
status.

If the result from the at-home test is positive, the CDC says the person should
isolate for five days, assuming no symptoms develop. Butler-Wu said it's a good
idea to confirm with a PCR test.

Ray agreed that a person should make sure they're positive by getting a lab
test.

"Go to an urgent care center or a state facility to get a test to see whether
it's a true positive," he said. "The value there is that, right now, we have a
limited supply of medicines that can be used to prevent severe COVID but,
depending on the situation, the person, there may be opportunities to prevent
you from getting sicker so it's worth at least whether or not this is truly
COVID."

However, if the at-home test is negative, the experts suggest waiting a day or
two and then test again. This is because a negative result from a rapid test
does not mean a person is not infected but rather that the virus could not be
detected yet.

They also suggest Americans follow CDC guidance about quarantine and isolation
based on vaccination status.

Does a negative at-home test result mean I can gather with people?

The CDC recommends that Americans self-test before gathering indoors, especially
with people who are not in their households.

A positive result means a person is infected and should not socialize with
others and should isolate for at least five days, according to CDC guidance. A
negative test means a person is unlikely to be infectious.

The agency also urges those who are not fully vaccinated or are aged 2 and older
to wear a mask in indoor public spaces. However, masks are not recommended for
outdoor gatherings.

Should I report my positive at-home COVID-19 test result?

Although there are some at-home COVID-19 tests that automatically report
results, most do not.

"The reporting piece for at-home tests is a hot mess, to be honest," Butler-Wu
said. "In most cases, it's up to folks to do it themselves, which we know isn't
happening in the vast majority of cases."

David Goldman/AP, FILE
Maya Goode, a COVID-19 technician, performs a test on Jessica Sanchez outside
Asthen...Read MoreRead More

This means that the average number of 761,000 cases per day (as of Jan. 13) is
likely much higher.

Ray said people with positive results should contact their doctor or the local
health authorities to be added to the official count.

MORE: NY Rep. Ocasio-Cortez recovering after positive COVID test

However, he urged Americans with mild symptoms not to call 911 or visit the
emergency room, with hospitals reporting exponential increases in people
visiting just to get tested.

"If they are very ill, of course, they should seek urgent or emergency care as
appropriate. But if they are not very ill, they should avoid adding to
already-overwhelmed emergency services," he said.

Can I use an at-home test to leave quarantine or isolation early?

The experts strongly recommend against this and urge any COVID-positive patients
to complete at least five full days of isolation after first developing symptoms
or first testing positive.

When the CDC released its updated isolation and quarantine guidance at the end
of December, the agency did not recommend taking a test before exiting. The
guidelines were later updated to suggest people can take a test on Day 5, if
possible.

"If after five days your symptoms have resolved or are nearly resolved, then a
rapid test negative would be reassuring that you don't pose a big risk to
others,'' Ray said. "If you're positive with a rapid test at that point, be
extremely cautious about going out because it's likely that you're infectious."

MORE: What to know about rapid COVID at-home tests as White House prepares to
mail them across US

The CDC advises anyone who tests positive for COVID-19, regardless of
vaccination status, can leave their house after five days as long as they no
longer have symptoms. However, they are also advised to wear a mask around
others for five additional days, in accordance with CDC guidance.

Those who have been exposed to a COVID-19 patient but have been boosted or
received the Pfizer or Moderna vaccine less than six months ago or the Johnson &
Johnson vaccine less than two months ago do not have to quarantine but are
recommended to wear a mask around others for 10 days and to test on Day 5, if
possible.

Lastly, those who have been exposed but are unvaccinated or unboosted and
received their Pfizer or Moderna vaccine more than six months ago or the Johnson
& Johnson vaccine more than two months ago are advised to stay home for five
days and then wear a mask around others for an additional five days, as well as
to get tested if possible on Day 5.

Both doctors recommend that COVID-positive patients continue to wear
well-fitting masks for another five days and avoid all essential travel.

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