At-Home COVID-19 Tests
Diagnostics have been a key element in the management of the COVID-19 pandemic. Together with vaccination, reliable and accessible diagnostic tools are still essential in monitor the virus, form future strategies, and curb the spread of the disease. Nowadays, access to affordable and accurate diagnostic tools has become even more critical as schools, workplaces, restaurants reopen and attending events, gatherings, and social activities become usual.
With the recent availability of at-home COVID-19 tests, a new phase in COVID-19 diagnostics have begun. These tests are available online or at pharmacies and retail stores without a prescription. They can be performed anywhere and whenever needed regardless of your vaccination or symptom status. They are designed for self-administration, and they can deliver results in 15-30 minutes without the need for laboratory technology or professional assistance. Their accessibility, affordability, and speed have important implications both for public welfare and for pandemic management. Here’s what to know about at-home COVID-19 tests.
Are At- Home COVID-19 Tests an Alternative To PCR?
Compared to at-home COVID-19 tests and rapid antigen tests in general have clear limitations regarding sensitivity, specificity, and overall accuracy. Thus, despite their convenience, they cannot entirely replace SARS-CoV-2 over RT-PCR tests.
First, it has been clinically proven that rapid antigen tests are less likely to detect SARS-CoV-2 in low viral loads. Therefore, especially in people who are experiencing no symptoms or those who are in the early onset of the infection, rapid antigen tests demonstrate a significant decline in accuracy. Indeed, one study shows that one type of antigen test identified SARS-CoV-2 infections in only 41 percent of infected people without symptoms. The findings of another study demonstrates that these devices correctly identify a SARS-CoV-2 infection in 72 percent of the symptomatic cases and 58 percent of the asymptomatic cases. Likewise, it was shown that the tests could detect approximately 78 percent of cases in the first week of symptoms but only 51 percent during the second week. These findings assert the timing of sample collection as one of the most influential factors affecting the accuracy of the results when it comes to rapid antigen testing.
In The Case of Low Viral Loads of SARS-CoV-2
Especially when it comes to detecting SARS-CoV-2 in people with very low viral loads, asymptomatic people, and people who are in the early onset of the infection, PCR tests have a clear superiority. This means that PCR tests have a much lower threshold of viral load, and that they can detect a SARS-CoV-2 infection sooner and for a longer period. So far, PCR tests remains as the gold standard for COVID-19 testing. At-home rapid antigen tests, on the other hand, are mainly evaluated as a tool for public health purposes rather than a decisive diagnostic test. PCR testing of a proportion of positive specimen is also likely to remain essential for the detection of new variants. Altogether, despite their accessibility, affordability, and speed at-home rapid antigen tests cannot replace PCR testing as the main means of diagnosis. Still, rapid antigen testing contributes to public welfare and pandemic management as a complementary tool to diagnostic tests.
Advantages of At-Home Testing
Although they have clear setbacks when it comes to detecting SARS-CoV-2 in low viral loads, many experts agree that at-home rapid antigen tests successfully detect virus when the viral load becomes high enough to be associated with transmission. In other words, these tests may not detect SARS-CoV-2 when a person is infected, but they are very likely to detect it once the person becomes infectious. Thus, the use of at-home rapid antigen tests constitutes an efficient strategy to help curb the spread of COVID-19 by preventing highly contagious individuals from unknowingly transmitting the disease.
Besides, as we slowly return to our daily lives, being able to test ourselves as frequently as we need to, in order to make sure that we have not been infected from our activities is likely to become a priority. At-home rapid antigen tests certainly answers to this growing need. As they do not require a prescription and relatively more affordable than PCR testing, at-home rapid antigen tests are easily available for all. Therefore, they help societies adjust to their daily lives within the course of the pandemic by providing large masses of people a way to test themselves before and after activities. This way, they contribute to the prevention a return to complete lockdowns.
|Table1. Comparison of PCR and At-Home Rapid Antigen Tests|
|Time To Result||3 Hours||15 Minutes|
Advantages of At-Home Rapid Tests on Mass Surveillance
Further, as they allow self-collection, self-administration and quick results, at-home rapid antigen tests enable the mass surveillance of COVID-19 without bringing people with unknown infection status into proximity. By delivering results in 15 to 30 minutes, they reduce the exposure risk and ensure immediate isolation. They are also convenient for people at high risk of developing severe disease as they ensure immediate access to medical care and early treatment. Indeed, novel antiviral drugs against COVID-19 such as molnupiravir and paxlovid are known to be the most effective within the early stages of infection.
Finally, these tests help relieve the burden on healthcare workers and systems. Especially in low- or middle-income countries with insufficient diagnostic testing capacities, the introduction of at-home rapid antigen tests has helped answer to the high testing demand. Apart from improving testing capacity, resource use, turnaround time, and patient flow, they also reduce the exposure risk to COVID-19 faced by healthcare workers.
While PCR testing remains the golden standard of COVID-19 testing, at-home rapid antigen tests have significant benefits for public welfare and pandemic management. Altogether, they help the world continue living their lives on the course of the pandemic by facilitating regular mass testing and reducing the burden of the pandemic on healthcare systems and personnel. Thus, if they are stored and performed in accordance with the instructions, at-home rapid antigen tests can be very informative and constitute excellent complementary devices to assist diagnostic technology.
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