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Are "HOME COVID TESTS" useful?

It is a remarkable that we even have these tests available to us, and the scientists who developed them, and the companies which have brought them to us deserve a great deal of credit.  What is missing is a clear indication of when these tests can be relied on. You may have gotten a "home Covid test" and be wondering what to do if it shows negative or, if it is positive.  Having examined the data, it is clear that these tests are fairly accurate when positive, BUT VERY UNRELIABLE WHEN NEGATIVE.  We have seen a small number of false positives, but these are rare and a positive test in a sick patient is very likely to be a true positive.  We have seen, and continue to see daily, MANY, MANY false negative results with "Rapid Antigen" or "Home Tests".  The consequences of a false negative test are serious: countless people may be exposed needlessly, a patient may be eligible for treatment that they never receive, close contacts may not be notified in a timely fashion... We have personally seen many classrooms have to shut down, an entire soccer season be canceled, life-threatening illness spread to a vulnerable family member, many cases of missed work and school and events, all BECAUSE OF FALSE NEGATIVE RAPID TESTS.  While these tests are amazing things to have acceess to, they need to be used responsibly with some understanding of what to do with the results.

HOME TESTS ARE MORE ACCURATE IF YOU HAVE SYMPTOMS BUT WILL MISS 3-4 OUT OF 10 POSITIVES: Antigen tests including home tests, are more likely to detect the virus when you are sick (symptomatic), than if you are asymptomatic. If you or your child are sick, using a home test is not a bad start, but it is not the end of the process.  If the result is negative, plan on getting PCR confirmation prior to return to school or work, and seeking medical attention for the illness. If the result is positive, we recommend informing your doctor and school, or work, and following the guidelines for isolation.  Even in positive cases there may be a need to confirm by PCR. 

HOME TESTS ARE VERY UNRELIABLE IF YOU HAVE NO SYMPTOMS AND WILL MISS 5-6 OUT OF 10 COVID POSITIVES: Antigen tests are not a good screen if you are asymptomatic unless you do multiple tests over a course of a few days.  If you were to test negative twice a day for four days with a rapid antigen test (eight tests total) you could feel assured that you do not have Covid similar to having a negatove PCR result. Even four tests in two days will only get 80% accuracy.  If the result is negative from one or a few rapid tests, plan on getting PCR confirmation prior to return to school or work and isolating from others in the meanwhile. If the result is positive, we recommend informing your doctor and school, or work, and following the guidelines for isolation.  Even in positive cases there may be a need to confirm by PCR. 

A PCR TEST IS THE MOST ACCURATE BUT IS NOT USEFUL IF YOU GET THE RESULTS IN 5 DAYS: We realize the need for fast and accurate testing. We offer several ways to get reliable result fast, either as a solo test or together with the rapid test result.  

1) One-day Covid PCR results that is covered by most insurance! This is our standard offering at Next Generation Pediatric Urgent Care.  There is no added cost.  This can mean the difference between making your flight or canceling travel plans!

2) "Rapid PCR".  This is a premium service that we have access to (as an added charge) that can give us PCR results (for Covid, Flu and RSV)  in about an hour. 

3) "Molecular Rapid".  We do have a "better rapid test" available, with 15 minute results that can be relied upon in most cases. This is closer to PCR than rapid antigen and is required for some travel destinations like Hawaii. 

WE OFFER ALL THE FOLLOWING TYPES OF  COVID-19 TESTS (Not all are covered by insurance):

“Send-out” PCR testing is the gold standard diagnostic test (the test by which all other tests will be judged) for Covid-19 diagnosis. This usually involves a nasal or nasopharyngeal swab that can be then sent to an outside lab to get results over a matter of days. The disadvantage of PCR is the turn-around time.

Rapid PCR offers advantages over other types of testing. It is fast (about 45 minutes) and accurate (approximately the same as “send-out PCR”.)

Molecular or Nucleic Acid Amplification testing is a term that sometimes includes PCR, but also includes another form of a diagnostic test or viral test. There are “rapid” molecular tests that take less time (15 minutes) than the “rapid PCR”, but do not offer quite the same accuracy as PCR. These are considerably better than the antigen tests, and less costly than PCR. Many travel guidelines accept NAAT molecular testing but NOT Antigen tests.

Antigen testing is, also, a form of a diagnostic test or viral test. They are generally the least meaningful tests and should be avoided if other options are available. Most antigen tests are taken via a nasal or nasopharyngeal swab and the test runs for 15-30 minutes in-house. Even though an antigen test is an approved test that is acceptable in some scenarios, there have been many cases of a false positive or negative, so they negative results generally require a PCR backup for cases where there reason to suspect Covid-19 infection. While Antigen tests may determine if there is an active infection of Covid-19 but might not detect the virus if the symptoms are too early or late in the illness.

Antibody testing is a serological test (serology or blood test) that is taken from the vein and results would be given withing 1-3 days as it is sent to the lab for testing. Antibody testing does not show an active infection in the body, but it does show if one has been infected by SARS-CoV-2, which is the virus that causes COVID-19 in the past. 

  • If you are having any symptoms of Covid-19 (fever or chills, cough, runny or stuffy nose, sore throat, headache, chills, fatigue, vomiting or diarrhea, body or muscle aches).
  • If you have been in close contact with someone (within 6 feet for a total of 15 minutes or more) who has tested positive for Covid-19.
  • If you have been referred to get tested by the health department or a health care provider.
  • If you have been part of a large group or any instance that may put you at a higher risk for getting the virus.
  • If you plan on spending time with someone who is at high risk from Covid-19 infection.
  • If you require it for travel or an event.

  • negative covid-19 test result means that the test did not detect the SARS-CoV-2 Virus. You may still need to quarantine. Sometimes a PCR test is needed to confirm a rapid negative test.
  • positive diagnostic test result means the test did detect the SARS-CoV-2 Virus (which means you most likely have covid-19). A confirmation test is rarely required for a positive result. If you have tested positive, isolate from others for the given period and take precautions depending on the symptoms. No repeat testing is needed for clearance after the required isolation period.
  • If you believe you received a false positive or false negative test, please see your doctor for the best course of action including getting retested.
  • If you have tested negative, still maintain social distancing, wearing a mask, and any preventive measures.

  • In serology (antibody) testing, a negative result indicates that no antibodies were detected, meaning that there has been no immune response to the Covid-19 virus. A positive serology test indicates that antibodies to the virus that causes Covid-19, were detected, and the body mounted an adaptive immune response to the covid-19 virus. Antibodies that are the result of vaccination can also be detected.