Since the COVID-19 pandemic spread across the globe, science has made great strides, from the rollout of multiple vaccines to the ability for people to now test themselves for the virus at home.
Adding to that latest accomplishment are the recent Emergency Use Authorizations (EUA) handed out by the U.S. Food and Drug Administration (FDA) for at-home COVID-19 tests that allow users to get results in 30 minutes or less.
To get a better idea of what you can expect from them, we talked to infectious disease testing expert Gary W. Procop, MD.
How at-home COVID-19 tests work
Dr. Procop and his colleagues reviewed three of the available at-home tests, two of which are only cleared for people who are showing symptoms of COVID-19 and require a prescription. The third doesn’t require a prescription and can be used by people who may or may not be experiencing symptoms.
These tests are essentially home versions of rapid test kits. You collect your own samples and get the results at home. There’s no need to send a swab to a lab and results are available in minutes instead of days. You’ll also eliminate the risk of possibly exposing others by not having to get tested at your doctor’s office.
In some cases, you can get the test from your healthcare provider. If you’re worried about doing the test on your own, your healthcare provider can test you. But if you feel confident, you can do the test at home. Many of these kits even come with instructions for testing kids. Be sure to read the directions carefully and report your results according to the instructions.
Rapid at-home COVID-19 tests can also be found at drugstores, but they’ve been hard to come by recently with the emergence of omicron and the arrival of the holidays. Health departments, community groups and even libraries in some areas have been giving out tests in an effort to keep up with the growing demand.
If you’re able to get a test — or a few — it’s good to know how each one works. Here’s some information about a few tests that are available.
Lucira COVID-19 All-In-One Test Kit
This test uses a process called isothermal amplification. It’s a similar process to the polymerase chain reaction (PCR) lab tests that are considered the “gold standard” for COVID-19 testing.
Like the PCR test, an isothermal amplification test makes copies of the genetic material from your self-collected swab, including any viral RNA that may be included, in a process called amplification. By making all these copies, it’s easier for the test to detect COVID-19.
There are two big differences between the home version and the laboratory version of this test. First, the laboratory version pulls out that genetic material, including any genetic material of the virus, from the rest of the sample. Second, while the laboratory version uses heat in the amplification process, the home version uses enzymes for amplification or antigen detection methods.
By removing the genetic extraction and heat from the testing process, Dr. Procop says this type of testing becomes more doable at home and doesn’t require the more complicated equipment that’s typically used for laboratory-issued PCR tests.
Antigen test kits
Two of the at-home tests — one produced by Ellume and the other by Abbott — are antigen detection tests. These tests look for antigens, proteins produced by the virus that prompt a response by your body’s immune system. “It’s the same process used to test for strep throat,” Dr. Procop explains.
Ellume COVID-19 Home Test
Of the two antigen tests, Ellume’s test does not require a prescription and has been cleared for use whether you’re experiencing symptoms or not. This test is for ages two and up and it even has a smartphone app that gives testing instructions.
The device tests your specimen and delivers results in about 15 minutes to the app by way of a Bluetooth connection. One thing to keep in mind: While you have the option to share the results with your healthcare provider, this system will send positive results, along with your age and zip code, to local health officials for case tracking.
Ellume did issue a recall for some of the tests because they had higher-than-acceptable false-positive test results. However, the FDA states that the reliability of negative test results was not affected. You can find out more information about the recall here.
Abbott’s BinaxNOW COVID-19 Antigen Self Test
When first introduced, Abbott’s BinaxNOW COVID-19 Antigen Self Test required an online screening before you could get the test. If your symptoms met the requirements, a test was shipped to you overnight. Now, the kit is available in stores.
The BinaxNOW COVID-19 Antigen Self Test comes with two tests. With this kit, you’ll need to test yourself twice within three days and at least 36 hours apart. This COVID-19 test is designed to detect an active infection with or without symptoms and, according to Abbott, it can detect multiple strains, including the delta variant. Results are available within 15 minutes.
One thing to keep in mind is that this test does not meet the Centers for Disease Control and Prevention (CDC) testing requirements to enter the United States when returning from a trip abroad. Abbott says the BinaxNOW COVID-19 Antigen Card Home Test may be a better choice for that purpose.
The pros and cons of at-home COVID-19 tests
There’s a lot to like about these at-home tests. Besides the previously mentioned advantage of keeping potentially infected people home, they’re relatively affordable, with a price range of between $24 and $50. But you should still keep some of the drawbacks in mind before using these tests.
Getting the test sample
“One of the issues with these tests can be the quality of the specimen that is collected by the person using them,” Dr. Procop says. “The collection is left to a user who has less experience than a healthcare provider and an incorrectly-collected sample can lead to an incorrect test result.”
While the idea of wiping a swab around the inside of your nose seems simple enough, Dr. Procop says it’s very important to follow the directions. “It is safe to perform the test yourself,” he says, “it’s just essential that it’s done correctly.”
How accurate are at-home COVID-19 tests?
Overall, the three tests perform quite well with accuracy ratings above 90%. But each has some issues to be aware of.
With the Lucira test, the removal of the genetic extraction step makes the test more convenient for at-home use. But Dr. Procop also says the at-home version isn’t quite as sensitive as the laboratory version of the test.
As for the Ellume and Abbott tests, they’re slightly less accurate (like healthcare provider-performed rapid antigen tests) than PCR tests.
“These rapid tests have a tendency to generate some false-positive results in asymptomatic people,” Dr. Procop notes. “So if a person is asymptomatic but has been exposed to someone else who has COVID-19, it can create some confusion as to whether it’s a false-positive or an accurately positive test.”
In that case, he says, additional testing would be needed.
If you’ve been exposed, when should you take a test?
If you’ve been exposed to someone who has COVID-19, you’ll want to quarantine and then get tested between five and seven days after you were exposed. If the test is negative, you should be OK. If you test positive, you’ll want to remain in quarantine, notify your doctor and monitor for any symptoms.
And it doesn’t hurt to test before gatherings
The CDC says that even if you don’t have symptoms and haven’t been exposed to an individual with COVID-19, using a self-test before gathering indoors can help decrease the risk of spreading the virus. This can also help protect unvaccinated children, older individuals, those who are immunocompromised or people who are at risk for severe health conditions.
How to test yourself for COVID-19 at home
You bought a test and you’re ready to use it. So how do you get started? Here are some helpful tips from the CDC.
Read the manufacturer’s instructions
Go over the instructions thoroughly to reduce the chances of errors. If you’re still unsure, the CDC has videos about self-testing and interpreting test results.
Prepare for collecting your test sample
Wash your hands with soap and water for at least 20 seconds. Open the box and collect your sample as directed.
Take the test
Follow the steps in order and use any video or resource links provided for a better idea of what you need to do. Not doing so could cause your result to be wrong.
Other ways to prepare:
- Store the test and everything that comes with it according to the instructions until you’re ready to use it.
- Check the expiration date. Don’t use expired tests or test items that are damaged or appear discolored based on the instructions.
- Clean the countertop, table or other surfaces where you’ll do the test.
- Don’t open test devices or anything else until you’re ready to start the process.
- Have a timer ready because you may need to time several of the test steps.
- Read test results only within the amount of time specified in the instructions. A result read before or after the specified timeframe may be incorrect.
- Don’t reuse test devices or other testing items.
- After you have your results, throw the collection swab or tube and test in the trash, clean all surfaces that the test touched and wash your hands.
What should you do if your at-home COVID-19 test is positive?
If your test is positive, isolate for 10 days and wear a mask if you can’t avoid being around others at home. If you start having trouble breathing, go to the hospital.
Notify your healthcare provider and stay in contact with them, especially if things get worse or you feel like your test result was wrong. You’ll also want to notify all of the people that you were around so they can take the necessary precautions.
What should you do if you test negative for COVID-19 at home?
A negative test result means the virus that causes COVID-19 was not found in your test sample and you may have a lower risk of transmitting it to others. If you had symptoms when you took the test and followed the instructions carefully, a negative result could mean that your current illness might not be COVID-19. However, there still might be a chance of infection. If you’re not sure, you can get tested by your healthcare provider.
What is a false negative?
When you get a negative test result but you actually have COVID-19, this is called a “false negative.” It’s also possible to test negative if your test sample was collected too early during your infection. In this case, it’s possible to test positive later on.
Be sure to complete the test series if multiple tests are required
With some at-home COVID-19 tests, you’ll have to repeat the test within a certain amount of time. More frequent tests can help detect COVID-19 faster. Your test instructions will say how often you’ll need to take a test. If you’re still not sure, refer to the instructions or ask your healthcare provider.
What should you do if you get an error?
If you get an invalid test result or an error, this could be the result of a bad test or the sample being collected the wrong way. If you have an issue, refer to the instructions or contact the manufacturer for help. That way, if the test is faulty, they can get everything sorted out for you.
While at-home tests are a big step forward, keep practicing the guidelines
These tests and their availability via the FDA’s EAU represent a big step forward for COVID-19 testing and prevention. “This means there are now more tests available and there’s a better chance someone who’s infected can more easily isolate thanks to these quick results,” Dr. Procop says.
But, even so, it’s important that everyone continues following current CDC guidelines, he says. “Taking precautions — maintaining social distance, frequently washing hands, wearing a mask, getting vaccinated, getting the booster — are still essential to preventing the spread of COVID-19.”