How to use a home COVID-19 test, according to experts

OLDarlos del Rio doesn’t mess around when it comes to his 87-year-old mother’s health. Even if he didn’t feel sick, the day before he was due to visit her, a professor of infectious diseases at Emory University in Atlanta performed a home COVID-19 test. The next day, he checked again as soon as he entered her house. “I wanted to minimize the risk of getting infected as much as possible before meeting her,” del Rio said.

It doesn’t take an infectious disease specialist to know that an 87-year-old is a high-risk person, but del Rio double-testing isn’t part of any formal procedure for how to interact with someone as high-profile as possible. so. years — it’s just a practice he’s developed on his own. That way, the expert is like the rest of us – following an experimental rule book that hasn’t actually been written.

Earlier during the pandemic, home test either don’t exist or, when they’re authorized, it’s hard for you to get your hands on it because demand skyrockets and supply slows. Now, there’s a lot to be had: The federal government will send some quick tests to your home for freeand insurance companies are required to reimburse insured individuals for 8 tests per month, so people can stock up on them for use when needed. But when exactly are they needed? Should you test yourself before you travel? After? When you visit a home with young, unvaccinated children? Before — or after — you attended a dinner party? At this time, there is no general agreement on when to use them.

So, what do experts do — infectious disease scientists? To find out, TIME asked several experts to determine how often they perform tests in their own households — and when they might ask others to test before visiting or interacting. with them.

When they have symptoms

If there’s any situation where self-examination is a must, it’s when you or a member of your family is going through symptoms consistent with COVID-19. Thomas Briese, associate professor of epidemiology at Columbia University’s Mailman School of Public Health, cautions that while taking the test is an important first step, the results may not tell you the whole story. . Symptoms can appear before a person’s viral load is high enough for a home test to detect it.

“There was a discussion about the sensitivity of those home tests compared to a lab test,” says Briese. “After testing negative, I tend to test again maybe a day or two later.” As an alternative to the second home test, he said, PCR test is also an option, and that is Briese’s own preference, as PCR tests are more sensitive than home tests and are likely to produce more accurate results. The downside, of course, is that a PCR test requires a visit to a clinic or testing center, and the results take longer—usually 24 hours or more.

What’s more, those results aren’t perfect, warns Michael Mina, a former assistant professor of epidemiology at the Harvard TH Chan School of Public Health and now chief science officer at eMed, a testing and marketing company. home treatment. PCR tests, which look for genetic material from the coronavirus, can also produce a false negative if you have a low viral load at the time. If in doubt, isolation for at least 5 days – as recommended by the US Centers for Disease Control and Prevention (CDC) – can help prevent the spread of COVID-19. Mina would even extend that five-day period to eight days, just to play it safe.

“There is a big difference in how quickly people get rid of the virus,” he said. “Some people will delete it four or five days in advance; some people will take 15 days”.

Read more: A new test could help reveal if you’re immune to COVID-19

When travelling

With mask-wearing duty now lifted for air and other transport, COVID-19 is likely to be more easily transmitted on planes, buses, and trains than if we all were. masked. Check before you travel is a way to take care of others and make sure you’re not a viral vector in a confined space.

Of course, that can help protect your travel companions, but that doesn’t mean everyone is as careful, and you may not be the one spreading the disease but the one with it. For that reason, del Rio carries the tests with him when he’s on the road. “When I travel, I check in on myself two or three days after I arrive at my destination,” he says. “Then I’ll do the same after I get home.”

Mina, the father of a currently unvaccinated baby girl, is strict about checking her family’s health before traveling — especially if they’re visiting other people in their home. “If we’re in someone’s house, we just don’t want to be the ones responsible for bringing in COVID,” he said.

When communicating

Before the pandemic, no one thought much about the health impact of a dinner party, but now that has changed. Del Rio makes it a habit to check in with yourself before gathering with a large group of people, especially if the gathering is indoors. During the summer months, there are more opportunities to go outside, but SARS-CoV-2 can be spread through the air – albeit significantly less effectively than indoors.

If you’re the host of a social event, things can be a little more delicate, raising the question of whether to ask your guests to take a quiz as a sort of entry ticket to your home. Here, del Rio play it safe. “Let’s say we’re going to have 10 or 12 people in the house: we’ll probably do an experiment,” he said. “I’ll provide testing just before they arrive.”

Mina agrees. “We let people in and we didn’t make a big deal of it,” he said. “We just say put on your mask and check right in before you come in and then just leave it alone for 10 minutes. We all feel a lot more comfortable knowing that everyone is negative.”

Visiting vulnerable people – the immunocompromised, the elderly or unvaccinated infants and children – is another area where experts agree on testing protocols. Mina’s parents are in their 70s and like del Rio to his 87-year-old mother, he checked in before visiting them. Briese tests before visiting anyone with any health conditions, even if he doesn’t know if the person is immunocompromised. And while vaccines are now available for infants under 6 monthsAbsorption is likely to slow, and pre-visit screening for any babies is a precaution worth considering.

Read more: Dogs can sniff out COVID-19 and lingering signs of COVID, study suggests

During the rise

As COVID-19 cases are on the rise, special vigilance is required. During the last surgery, Mina and his family checked in on average once a week, even if no one showed symptoms.

Briese sees children as a particular area of ​​concern here, as they spend their school days surrounded by many other children and generally have extensive social connections. Even if there are no known cases of COVID-19 in a child’s social circle, the risk of transmission persists — especially during a spike. “It would make sense to check on children on a more regular basis,” he said.

That said, if you have a limited number of tests, you don’t necessarily need to get tested immediately after knowing or suspecting contact with an infected person. Mina said: “If you’ve just been exposed, don’t bother testing for two days. “Wait at least that long, but usually you have to wait three days — if not four — after exposure. [to get an accurate result] because the virus must have a chance to be detectable. “

Ultimately, experts agree that testing is a personal decision and everyone has to figure out their own comfort and risk tolerance. However, for everyone, the goals should remain the same: to avoid both catching the virus and passing it on to others. Concealing and updating immunization information are key elements of that COVID-19 toolbox. Quick test should also be one.

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Write letter for Jeffrey Kluger at [email protected].

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