At-Home COVID-19 Test Guidance

Updated 01/27/2022

Home COVID-19 tests or over-the-counter (OTC) COVID-19 tests are tests you can take anywhere outside of an official testing site. Most yield results in 10-30 minutes. These tests are a great tool in the ever-growing COVID-19 pandemic toolkit. Like any tool, however, it is very important to use these tests and the results they provide correctly. You'll be in great shape to use these tools properly after a quick read-through below!

At-home COVID-19 test overview
At home antigen tests can be purchased at pharmacies and online retailers, and limited quantities are available for US residents here. These tests are recommended by the CDC for the following situations:

• If you have symptoms of COVID-19
• If you’ve had an exposure or potential exposure
• Before gathering with at risk individuals
• Before certain activities (such as a group gathering or travel)

How accurate are at-home COVID-19 tests?
There seem to be widely varying sensitivities for these tests so when utilizing them it is important to understand what they tell you and what they don’t tell you. Here are the key takeaways:

• At-home tests are never meant to be used as the only method of prevention of spread - masking, staying home and seeking care when sick and vaccination are your other tools!
• At-home tests are not meant to be used as a single test only. The sensitivity (and likelihood of detecting a positive case) increases when used “serially”, meaning more than one test over a period of time.
• Most of the available EUA authorized antigen tests have a published sensitivity of about 85% when used for patients with symptoms; however, they have a lower sensitivity when used for people without symptoms.

What if I test positive on an at-home COVID-19 test?
If you test positive and you have symptoms of COVID-19:

• Isolate, monitor your symptoms and seek medical care if needed
• Consider scheduling a same-day Virtual Visit with a PhysicianOne Urgent Care provider to answer your questions, evaluate your symptoms and develop a care plan while you're ill. The likelihood of a false positive is very low since the specificity of the rapid antigen tests is greater than 99% when a person has symptoms.

If you test positive and do not have any symptoms and have no known exposure:

• Following up with a more sensitive PCR test would be prudent to confirm the positive result. All PhysicianOne Urgent Care locations offer PCR testing. Check in online, schedule a Virtual Visit or call our Call Center team at 860-650-3848 for help scheduling a visit.

What if I test negative on an at-home COVID-19 test?
If you are using the at-home COVID-19 test because you have symptoms and test negative don’t rely on this single result - you should still isolate, mask around others and be diligent in hand washing. Take a second test 24-36 hours later. If this test is still negative, you’ve increased the likelihood that this is not COVID (but you still don’t have 100% assurance). Depending on your symptoms, consider obtaining a more sensitive PCR test and consulting a medical professional to determine the cause of your symptoms. Schedule a same-day Virtual Visit with a PhysicianOne -Urgent Care provider to answer your questions and evaluate any symptoms you have. Or check-in online to be evaluated in the center by one of our providers.

If Testing Due to Exposure Without Symptoms
If you are testing due to a known exposure or a potential exposure the current CDC guidelines recommend testing at least on day 5 after exposure. If you test too soon, before the virus has had a chance to replicate, you might get a negative result and be lured into a false sense of security. And again, if you test negative, test again 24-36 hours later and again if you develop symptoms.

If testing to Increase the Safety of a Social Gathering
Remember, tests are just checking a moment in time. Therefore, testing should be performed as close in time as possible to a gathering to provide the most relevant information. Here is a strategy for testing prior to gathering that seems to make a lot of sense based on current information. This assumes everyone in the group is following the same plan and does not have any symptoms.

1. Everyone in the group should use an antigen test 1-2 days before the gathering and minimize risk leading up to the gathering (limit exposure risks and other gatherings, wear a good mask around others outside of the household, socially distance, be diligent with hand hygiene).
2. On the day of the gathering (as close to the time of the gathering as possible) use another antigen test (this should be at least 24 hours from the prior test).
   If both tests are negative, gather responsibly. If anyone tests positive on either of the two tests, that individual should isolate and all of their household and close contacts should not attend the gathering.