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At the beginning of the Covid-19 pandemic, diagnostic tests of any kind were challenging to find, and their use was generally limited to people showing active signs of infection. The tests had to be administered in a medical facility, and the results could take a week to obtain. Later, a rapid form of the test using nasal cells or saliva could detect the presence of antibodies or antigens within 30 minutes, but the test still had to be administered in a lab or doctor’s office.
Recently, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have approved several Covid tests for home use, although some still require analysis by an outside laboratory. One of the main selling points of these tests is privacy. If a person needs to know their current status, an at-home test eliminates the need to schedule a doctor’s appointment or stand in line at a busy testing center.
At-home Covid tests are becoming more widely available, and it helps to know how they work, how long it takes to get results, and how accurate they are.
There are a number of circumstances in which a self-administered test is preferable to one performed in a medical facility. Some people don’t have easy access to a medical professional, and ordering an at-home test provides an easier way to get fast results.
Employees who work at home can take an at-home Covid test whenever they start to experience any of the common symptoms associated with the virus. Many companies offer rapid-result testing for in-office employees but not necessarily for those working from home.
Some people need to know their current status as quickly as possible in order to make safer decisions about travel, family gatherings, or public events. Having immediate access to a rapid antigen test at home makes this process easier.
There are currently two methods for determining a Covid infection: measure the viral load (antigen test) or search for Covid DNA (PCR test). Each method has advantages and disadvantages, but both should provide a fairly accurate assessment of the tester’s current status.
Antigen or antibody test: This is the more rapid form, which gives you results in 30 minutes or less. The swab from the patient’s nasal cavity is placed in a special cartridge containing a reactant fluid. The reactant measures the amount of Covid virus (viral load) in the specimen. A high viral load indicates exposure to the virus and the presence of antibodies fighting the infection. Accuracy with a rapid antigen test can vary, however, so a second test at least 24 hours later is recommended.
Polymerase chain reaction (PCR) test: The second form of at-home test examines a nasal swab or saliva for fragments of viral DNA. The PCR test is considered more accurate than the rapid antigen test, but the specimen must be sent to an outside laboratory for proper analysis, and the results can take several days to get. At-home PCR Covid tests are notably more expensive too.
One important consideration when comparing at-home Covid tests is the way the test samples are collected. There are two common methods: nasal swab or saliva.
Nasal swab: While professional testing centers tend to swab deep inside the nasal cavity, most at-home tests only require a shallow nasal swab. The user places a sterile cotton swab into each nostril and turns it several times to obtain a sufficient sample. The swab is then placed in a cartridge for antigen testing or sealed in a bag for PCR testing.
Saliva: The other collection method is far less invasive, but it does have its own set of rules to follow to make sure the sample is of good quality. The user must refrain from smoking, eating, drinking, or chewing gum for 30 minutes before depositing saliva in a sterile collection tube. This is done for the more accurate PCR test because the laboratory requires a DNA sample. (The rapid antigen test does not work with saliva.)
Whether it’s a rapid antigen test or a lab-analyzed PCR test, every at-home Covid test should contain all of the items needed to complete the process. Users should not have to purchase any additional items to perform the test, such as swabs or sanitizers. Many test kits include a second set of collection tools to perform a retest, but not all of them do, so it pays to read the contents on the packaging or product information page.
Because a PCR test must be shipped to a lab for analysis, manufacturers include a special shipping container and postage to make the delivery process as easy as possible. The samples should be protected from the elements and any potential source of contamination. There should be no need for users to purchase additional postage or packaging material. The prepaid postage covers the cost of express or priority mail.
The purchase and use of an at-home Covid test may be a very private issue for a number of users, and manufacturers do take steps to maintain confidentiality. While the results of a rapid antigen test might be challenging to keep private, the results of a PCR test are often coded before release, and only the intended recipient should have access to them. If security and privacy are an issue, be sure to choose an at-home Covid test that maintains confidentiality throughout the process.
Improper specimen collection or a malfunctioning testing device can cause invalid Covid test results.
There are inexpensive at-home Covid tests available in pharmacies that cost less than $20. These are generally antigen tests that provide rapid results after a shallow nasal swab. There is usually a second test available to confirm or recheck the original results.
Many at-home Covid tests in the $30 to $65 range are essentially sample collection kits, not necessarily rapid-response antigen tests. The specimen must still be sent to a professional lab for analysis, and a confidential report is delivered within a few days. Some advanced PCR testing is possible, but most likely the initial test will be for antibodies.
The most expensive at-home Covid tests cost $100 or more, but the results are comparable to professional lab testing in many cases. A PCR test that checks for the presence of viral DNA fragments is more likely to cost this much.
A. The goal of many at-home tests is to provide users with a rapid yes/no result, and the accuracy rate is comparable to other forms of at-home testing. One commonly used antigen test failed to detect 15 infections out of 100, meaning a 15% false negative rate. However, only 1 case in 100 resulted in a false positive. At-home tests don’t perform the more accurate PCR test for the presence of viral DNA.
A. There are only a few companies authorized by the FDA to produce at-home covid tests, so the laws of supply and demand influence the retail price per test. The technology used in the tests is also very advanced and proprietary. Some companies will seek reimbursement from medical insurance companies whenever possible, however.
A. Both forms of sample collection yield fairly accurate results, so it’s often a matter of personal preference. Many find the saliva collection process to be less invasive than the nasal swab method, but the specimen may be more easily contaminated if it isn’t handled correctly. An at-home nasal swab collection doesn’t require the deep tissue contact of a standard laboratory test.
A. If you’re showing symptoms of a Covid-19 infection, you might want to get a more accurate PCR test performed by a medical professional. If you have a second at-home Covid test available (many test kits include two), you should wait 24 hours after the first test before performing the second test. Antibodies take time to form in the body and an early test may not detect their presence.
