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While people had to wait in line for hours to get tested for Covid when the pandemic first began, companies are now selling kits to diagnose infection at home. And as Americans become increasingly concerned about Covid variants and as mask guidelines change across the country due to an increase in positive cases, access to tests may be on your mind. We spoke to experts about different at-home Covid testing methods and how they work, as well as who should use them.
We also rounded up FDA-authorized test kits you can use at home and purchase across retailers. Experts emphasized that at-home testing is not a substitute for mask-wearing or getting vaccinated, highlighting that at-home testing methods might show incorrect results. Regardless of your vaccination status, no one should exempt themselves from getting tested for Covid if they’re experiencing compatible symptoms.
At-home Covid testing, simplified
As it did with KN95 masks and Covid vaccines, the Food and Drug Administration issued Emergency Use Authorization to certain diagnostic tests, listing them online. There are two methods of at-home testing:
- Home collection tests: Samples are collected at home and sent to a lab for analysis — you typically find out the results in a few days.
- At-home testing: Samples are collected at home and you perform the test — you get results in a few minutes.
The benefit of at-home Covid testing methods is that they allow people to get tested more frequently, which could lead to catching more infections and, in turn, decrease spread, noted Cole Beeler, MD, director of symptomatic testing for Indiana University’s COVID-19 Medical Response Team and an assistant professor at the IU School of Medicine. But there’s danger in deriving a false sense of security from at-home testing methods as they’re generally less sensitive than tests performed by professionals in medical offices.
“These tests need to be used judiciously,” Beeler said. “If you had a high risk exposure and/or are symptomatic and you have a negative test, it still may be worthwhile to get a formal test done in a hospital lab.”
How accurate are at-home Covid test kits?
The best type of diagnostic Covid test is the Polymerase Chain Reaction (PCR) test, according to Omai Garner, PhD, chief of clinical microbiology for UCLA Health. No PCR test is approved for at-home testing, meaning “the most accurate Covid test cannot be done entirely at home,” he said. At-home testing kits are not as accurate as PCR tests done in professional labs because at-home testing — sometimes referred to as “rapid tests” — require a higher amount of virus in a sample in order to detect a positive result. If you test too early, there may only be low levels of the virus present in the sample, which could lead to an inaccurate result.
Home collection tests generally produce more accurate results than at-home testing kits. At-home collection kits prompt you to collect a sample and mail that sample to a lab — the lab performs a PCR test and then you get your results a day or two later. At-home testing kits do not require you to send the sample to a lab for testing.
So are at-home testing methods reliable? The answer is complicated and often comes down to who is being tested, when the test takes place and what type of test is being used, explained Sharon Nachman, MD, chief of the division chief of pediatric infectious diseases at Stony Brook Children’s Hospital.
“If you’re symptomatic and you’re testing because you don’t want to go to work sick, at-home tests are going to be very helpful,” she said. “But if you’re feeling fine, you may need to be tested much more frequently than just today to say you can go on that trip next week.”
Testing for Covid at home? Here’s how to start.
Home collection and test kits fall into two buckets on the FDA’s lists: molecular diagnostic tests and antigen diagnostic tests. The most well-known type of molecular test is the PCR test. Each one detects different parts of the Covid virus. The two testing methods are similar in that they can diagnose infection, and are performed on either nose or throat swabs. From there, the methods differ, and experts said those differences determine how reliable tests are and how you should use them.
While there are no approved PCR tests for at-home testing, you can collect the sample for a PCR test at home and mail that sample to a lab. When the lab receives the sample, experts run tests on it and you receive your results a few days later.
“These home collection kits have better accuracy than home testing kits,” Garner said. “And the reason for that is because the gold standard PCR test is run on the sample, and the people running the test are professionals.”
FDA-authorized home collection kits
Below are some of the most widely available Covid home collection tests on the FDA-authorized list.
After taking a nasal swab, mail it back to the lab, which performs a PCR test and delivers your results online. You can get results within 48 hours of your kit arriving at the lab, and the kit comes with an overnight return label. The brand says the test collection kit can be used for those 3 years old and above.
You can purchase this Covid test collection kit individually or in a pack of 10. It utilizes a saliva sample and the kit comes with a prepaid express return shipping. Results are available within 24 to 72 hours of the sample arriving at the lab.
Everlywell’s Covid test collection kit is designed for those 18 years old and above. You collect a nasal swab and mail the sample to the lab, which performs a PCR test and delivers your digital results within 24 to 28 hours of the sample arriving at the lab. Telehealth consultants are available at no extra cost to guide you if your result is positive.
Available for those 2 years old and above, this kit provides you with the materials needed to collect a nasal swab sample and send it back to the lab, which will perform a PCR test. It typically takes one to two days to receive results after the sample arrives at the lab.
Amazon’s Covid test collection kit allows you to perform a nasal swab and mail the sample to Amazon’s lab with the included prepaid UPS next-day shipping. You can expect to receive results within 24 hours of your sample arriving at the lab. This test is made for individuals 18 years old and above.
Like with home collection kits, at-home testing kits require you to take a sample, but instead of mailing that sample to a lab, you test it then and there. This allows you to receive a result within minutes, which is why these tests are sometimes called “rapid rests.”
Some home testing kits advertise themselves as able to screen asymptomatic individuals for Covid, which Garner said he “fundamentally disagrees with” because you cannot perform a PCR test — the most accurate Covid test — entirely at home. Thus, Garner does not think home testing kits are appropriate for asymptomatic testing, which all the experts we interviewed agreed with.
As for symptomatic testing, however, Garner said home tests perform well — there is typically a higher amount of virus present in the body, he explained, reaching a threshold home tests can cover.
Additionally, Nachman noted that most at-home test kits come with two tests and recommend that you perform multiple tests a few days apart — this is called serial testing, according to the Centers for Disease Control and Prevention. Especially in asymptomatic adults, on the first day you perform an at-home test, it might not be able to detect the virus and your result may be negative — this could be false. Thus, the CDC states “you could test positive later during your illness,” emphasizing why serial testing is recommended.
FDA-authorized home testing kits
This kit comes with two tests meant to be used for serial testing — the brand said you should test yourself twice within 3 days, at least 36 hours apart. It provides the materials needed to perform nasal swabs and the actual test, which is done using test cards and processing fluid. Results are ready in 15 minutes and the test can be used on those 2 years old and above.
Ellume’s test kit comes with a Bluetooth-enabled analyzer that requires smartphone connection through the companion app to administer and receive results. The kit provides you with the materials needed to perform one test using a nasal swab sample. It takes 15 minutes to receive a result and the test can be used for those 2 years old and above.
Sold individually or in a pack of 45, this kit is intended for you to test twice over two to three days with between 24 and 36 hours between them. You collect a nasal swab sample and dip it into a solution tube with a test strip to perform the test. Results are ready in about 10 minutes and the test kit can be used for those 2 years old and above.
Who can use at-home Covid tests?
According to the CDC, “self-tests can be used by anyone who is symptomatic regardless of their vaccination status,” and “unvaccinated persons with no COVID-19 symptoms can also use self-tests, especially if they were potentially exposed to someone with COVID-19.” The CDC states that fully vaccinated individuals should also take note of specific testing guidance.
As for kids, some at-home collection and testing kits advertise themselves as suitable to use for kids 2 years old and above. However, Nachman said she’s unaware of studies on these tests including symptomatic or asymptomatic children. And while it’s often assumed that tests used on adults can be used for children, she said there is not enough data to give a definitive answer yet.
Finally, in order to fulfill the CDC’s international travel Covid testing order, you can use an at-home collection or test kit. However, travelers can only use options that adhere to a very specific set of guidelines listed on its website.
Tips for using at-home Covid collection and testing kits
Nachman said each collection and test kit is different and requires its own specific set of procedures, so it’s crucial to read the directions before beginning and follow them exactly. “It sounds silly to say, but reading the directions carefully is actually quite critical to do,” she said.
Additionally, when you get your results from collection or testing kits, they’re simply reported to you, not explained, Nachman said. Because of this, it’s important to call your primary care doctor — especially if you test positive — to understand how to proceed. “At home tests are geared to get the information to you with the idea that you’re going to call for a helping hand to deal with the results, particularly if there’s a positive result,” she said.
Finally, Garner said some tests require the use of a companion app, so you should make sure your smartphone is compatible with it before purchasing an at-home collection or testing kit. And while Covid tests at walk-in clinics, hospitals and medical offices are typically free or covered by insurance, he noted that’s often not the case with at-home collection and testing kits.