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Tuesday, May 17, 2022

With widespread at-home testing, more COVID-19 cases will be missing from official counts

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Widespread availability of at-home COVID-19 tests could be one of the more useful tools in an effort to reach the end of the pandemic, but they could also be a complicating factor as health officials try to keep track of how many cases there are at any given time.

That’s because it’s unlikely an at-home test result — whether positive or negative — will show up in an official count. The state health department knows tests are out there, but officials don’t include them in their counts because they don’t have a way to confirm results.

That doesn’t necessarily mean health departments are in the dark.

Dr. Virginia Caine, director of the Marion County Public Health Department, said the department can use the official case count and positivity rate to make a reasonable assumption about how widespread the virus is locally. People also regularly call the health department after testing positive at home to see what their next steps should be, giving health officials an informal idea of how many cases there are.

At-home tests have become difficult to find and can be pricy, but the federal government is trying to make them more readily available.

Every household can order four free tests at covidtests.gov, and President Joe Biden’s administration will require insurance plans to cover the cost of up to eight over-the-counter tests per month for each person on the plan.

The government plans to buy and distribute 500 million tests, many of which probably won’t become part of any official case count. Some counties in other states have set up systems to get a more formal collection of at-home test results.

With the rise of the omicron variant, which is more transmissible than previous variants, even among people who are fully vaccinated, some have wondered if it’s still useful to closely track the number of positive results.

FREE AT-HOME COVID-19 TESTS
Order four free at-home COVID-19 tests per household at covidtests.gov. The only information required is a name and shipping address. An email address is optional for shipping updates. Tests will be shipped through the U.S. Postal Service.

“It’s actually the best data that we have across the state,” said Dr. Michele Saysana, vice president and chief patient safety and quality officer at IU Health.

Health officials use case counts as a clue to figure out what trends in hospitalizations and deaths could look like in the near future. In general, higher case counts precede more hospitalizations, which precede more deaths.

The majority of positive results will still be reported, Saysana said, whether through a testing clinic, doctor’s office or another avenue such as a school district.

One area where experts seem to have more disagreement is whether it’s important to confirm an at-home positive result by going to a testing clinic. On one hand, it would add another data point for health officials, but the infected person also risks spreading the virus if they are actually positive.

Dr. Caine said people who test positive at home should still try to get confirmation, no matter if symptoms are mild or more severe. She said at-home tests are typically 85% sensitive, meaning if 100 positive people are tested, you could expect the test to detect 85 cases.

Kara Cecil, an assistant professor of public health at the University of Indianapolis, said it isn’t important in most cases to know for sure that you’re positive because a person’s behavior shouldn’t change just because of that information. Instead, she said anyone with symptoms should act as though they have the disease by managing it at home and trying to avoid spreading it to others.

Cecil said exceptions include if the person is immunocompromised or around someone else who is, in which case it might be important to know for sure if it’s COVID-19.

Contact staff writer Tyler Fenwick at 317-762-7853. Follow him on Twitter @Ty_Fenwick.

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