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Are At-Home COVID-19 Tests Accurate?

Photo: Dan Kitwood/Getty/Getty Images

Along with preventative measures like social distancing and wearing a mask, testing is essential to controlling the coronavirus pandemic. Accurate tests help public health officials track the spread of COVID-19 and trace the contacts of those who’ve been infected. Even though access to testing has improved since the virus hit the U.S. in February, most states still lag behind the level of testing that experts believe is needed to significantly slow the spread. Along with in-person tests, several companies sell at-home testing kits — an attractive option if you want to avoid potential exposure at a doctor’s office or clinic, or aren’t able to travel to a testing site.

There are currently two types of COVID-19 tests: active infection and antibody. Active infection tests, also known as a polymerase chain reaction or PCR tests, detect the virus’s presence in a nasal swab or saliva sample. An antibody test is a blood test that detects if your body has developed an immune response against the virus. Right now, only active infection tests are authorized for at-home use.

Paul Sax, clinical director of the division of infectious diseases at Brigham and Women’s Hospital, explains that, after a delay in making tests available at the start of the outbreak, the FDA has issued emergency use authorization (EUA) for in-person and at-home tests. An EUA, according to an FDA spokesperson, allows a company to bypass some parts of the approval process while still demonstrating that its test is accurate and that the benefits of making it available to the public outweighs the risks. (You can view a list of all tests, including at-home collection kits, that have received EUAs on the FDA website here.)

Because of the limited supply, online testing centers still require a prescription from a healthcare provider — although you can also fill out a questionnaire confirming that you have symptoms of COVID-19 and/or have been in contact with someone who has the virus. Since you’re mailing them in, most take up to three days to receive results.

The tests are not without their flaws. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, says that the tests are so sensitive that they can detect the virus even after you’ve recovered and are no longer contagious. (How long you remain infectious varies from person-to-person and can’t be determined by a test.) Additionally, any test is only as good as the sample being tested, and Sax and Nachman agree that a trained provider will be more skilled at collecting a nasal swab than an untrained person. And of course, a trained medical professional is similarly best suited to assess your symptoms and address any diagnosis. With that in mind, if you do want to try an at-home test, the kits below have EUAs and include detailed instructions on collecting your sample (via nose swab or saliva) and how to return the kit to the lab.

Unlike the in-person nasopharyngeal swabs that must be inserted deep into the nose, this test allows for a shallow nasal swab that’s much more comfortable. After filling out a questionnaire about your symptoms and potential exposure, you’ll be sent the kit, along with instructions on collecting your sample. Everlywell will also provide you with an itemized receipt for insurance reimbursement. Because their lab only operates Monday through Friday, it’s important to collect and send your sample (via FedEx or UPS) on a weekday. This test is currently available in all states except New York, New Jersey, Rhode Island, and Maryland.

This test from Pixel, an offshoot of the diagnostic lab network LabCorp, ships to all 50 states, and also uses a simple nose swab. Like the Everlywell test, your kit comes with illustrated instructions for collecting the sample and a prepaid FedEx return label. For the most accurate results, your sample should be mailed back the same day you collect it. Results are available online within 72 hours and there’s no upfront cost as the test is covered by insurance or, if you’re not insured, federal funds allocated to the lab for testing.

If you’d rather not take a nasal swab, this Vitagene test was the first saliva-based test to earn an EUA. Like the tests above, you’ll get your results within 72 hours of sending your sample.

Here are two more FDA-authorized saliva tests. The one from Hims & Hers has a slightly longer turnaround time (3-5 days). As for Phosphorus, you can only collect and return your sample Sunday-Thursday as the lab doesn’t operate on Friday or Saturday.

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Are At-Home COVID-19 Tests Accurate?