If you give yourself a COVID test, who tracks the results?

The wildfire spread of the Omicron variant may have inspired you, like many Californians, to snag a few rapid coronavirus test kits — if you could find them, that is.

And when you started worrying about catching the coronavirus, you might have used one of these kits. You gently swabbed the insides of both nostrils, mixed your sample with a few drops of reagent, placed it on a test strip, and waited 15 minutes to see your results.

But after you’ve done all of that — and gasped in either relief or dismay — you might have missed the kit’s final instruction: report your findings.

Some test kits advise you to call your doctor. Others want you to use the test maker’s app.

“Home tests lead to significant underestimates of the number of cases,” said Dr. Robert Wachter, chair of the medical school at UC San Francisco, in an email. “Apparently many hundreds of thousands of people are now being diagnosed with positive home tests (usually plus symptoms) and these are not being reported.”

Even if you try to report your findings, the information likely won’t help improve the public’s understanding of the virus. That’s because they’re not included in the data health authorities use to create their reports and guidelines.

So, as more people test themselves at home, the official numbers on new infections and positivity rates (the percentage of tests that detect the virus) will provide less of an accurate picture of the health of the population.

That’s not necessarily a bad thing — it’s just a cautionary tale about the data we’re relying on to chart a path through the pandemic.

Experts say there has always been a discrepancy between reported coronavirus case numbers and the truth. Because many people who contract the virus show few or no symptoms, many infections go unreported.

Similarly, test positivity rates tend to be inflated because the people most likely to show up at a testing center are those with COVID-19-like symptoms. Large organizations that require all of their members to be tested regularly invariably have lower positivity rates than sites that only test people who think they may be sick.

Getting more people tested more frequently, as a number of other developed countries are doing, could help identify outbreaks and contain their spread. But for a variety of reasons, an increasing reliance on rapid at-home testing kits may not be helping public health officials in their struggle to track and understand the pandemic.

There are a number of situations that might prompt people to test themselves. The Centers for Disease Control and Prevention suggests doing a self-test “if you have COVID-19 symptoms or have been or may have been exposed to a person with COVID-19.” (The symptoms to look out for include fever or chills, cough, shortness of breath, fatigue, and sore throat, according to the CDC.)

Another good time to self-test, the agency advises, is before meeting with people who are at higher risk of infection, such as B. People who have not been vaccinated, are elderly or have a weakened immune system. Or maybe you want to attend an event that requires proof of a negative test.

What are you doing after the test? If it comes back positive, health officials say you should isolate at home, notify those you’ve been in close contact with and inform your doctor. The LA County Department of Public Health also has a hotline you can call – (833) 540-0473 – if you have questions, need referrals, or need help notifying your close contacts.

A department spokeswoman said that “we will document and interview those who call us with positive results.” But the department doesn’t want to be contacted about negative test results.

Health officials also generally do not include home test results in confirmed case counts. One reason is that the inexpensive rapid tests are antigen tests, while clinics and county testing centers use polymerase chain reaction tests, which are better at detecting early-stage infections. Then there is the question of whether people who do home tests are using them correctly or reporting the results correctly.

“Verifying results is a big problem” for at-home rapid tests, said Gigi Kwik Gronvall, senior scholar at the Johns Hopkins Center for Health Security. So if you need a coronavirus test result to get on a plane, she said: “You either have to have a PCR test done in a lab or you can go to a website that could give you that [an antigen] test, but it’s verified – someone does it for you and you see it’s done right.

After some initial confusion, states are now reporting all antigen test results they collect separately from the PCR results, Gronvall said.

dr Sara H. Cody, Santa Clara County health officer and director of public health, agreed with Wachter that the new infections reported by health officials each day are “outnumbered.” But that may not be as great a downside as it was at the start of the pandemic.

Back then, Cody says, health officials “followed every case so carefully” because “it was really, really important to our understanding of the pandemic and to our policy making.” But now, she said, “we’re in a very different place in the pandemic.”

Even with limited testing, officials know case numbers will increase rapidly because of the Omicron variant. “What’s most important to us now,” she said, “is that we measure our hospital resources” to make sure people who need acute care can get it. And with vaccination and booster rates in her county high, Cody added, it’s hard to say at this point how many of those newly infected there will eventually need a hospital bed.

Wachter, Cody and other health experts said policymakers’ focus is shifting from reported case numbers to other measures, such as hospitalizations and positivity rates. Granted, positivity rates are hurt by the exclusion of home test results. But Cody said it still makes sense to have an apples-to-apples comparison of positive test rates over time.

Santa Clara County has been conducting around 20,000 tests daily, and the positivity rate was around 1.5% as of early December, Cody said. On Tuesday, she said, it was nearly 10.5%.

Despite the data problems they cause, home antigen testing is still an important adjunct to PCR testing, Cody said. They warn people who need to isolate and “reduce the chances they’ll go ahead and infect others, which is broadly important for public health”.

Also, the LA County Health Department says the number of coronavirus cases isn’t as telling as the trends they reveal.

“As with many reportable diseases, the reported numbers have never captured all cases,” said a department spokeswoman. “But they did provide trend lines so we can better understand what’s happening and to help model what are probably the most accurate numbers.”

https://www.latimes.com/science/story/2022-01-06/if-you-take-an-at-home-coronavirus-test-who-keeps-track-of-the-results-probably-no-one If you give yourself a COVID test, who tracks the results?

Russell Falcon

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