So here we are in September, with the Delta variant surging, schools re-opening, masks and vaccines being mandated, and boosters likely to be soon implemented. With all that going on it’s confusing as to how safe you are and what risks you face. We know that even if vaccinated, you can still become infected with the coronavirus. But now that we’re heading into fall, when cold and flu season may be starting, the question becomes how do you know whether you’ve become infected with COVID or instead, are coming down with something else? Chances are, you’ll likely want to get yourself tested and, if trends are correct, you may want to avail yourself of the new home collection or test kits for COVID.

If you do decide to go the route of a home test, you won’t be alone. Demand for at-home test options has risen significantly in the last month, and some pharmacy chains are limiting how many you can purchase at a time. Before you decide to stock up yourself, it’s important to ask some questions about the at-home COVID tests: Are they accurate? Are they easy to use? How long do the results take? Can you find out results on your own or do you have to use a lab? Where can you buy these tests? And what do they cost? All of these are important questions but not always easy to answer.

The CDC has, on its website, a section devoted to what it calls “Self Testing.” This section discusses COVID tests that can be performed by a person at home or on the go, regardless of your vaccine status. There are two types of these “at-home” tests: Those through which you collect a sample (usually a nasal swab but could also be saliva) and send your sample to a lab for analysis and results. The other test is one you perform at home, without sending out your sample, with results back in as little as 15-20 minutes, akin to the rapid tests you can now get at many providers. The FDA has provided authorization for many of these tests, and it’s recommended that you look at the package of the test you purchase to make sure it’s FDA authorized. Many tests do not require a prescription and are available online (Amazon) or through local pharmacies, though again, many are currently sold out. There’s even the possibility in certain regions of the country that you can order a testing kit through Door Dash!

So how do you determine which at-home testing option makes sense for you? Regardless of which test you use, it’s critical to follow directions precisely and with care, as the test result is only as good as the sample upon which it’s based. The CDC advises that you check the expiration date on the box, only open it when you are ready to use it, and recognize that the test can only determine current infection, not prior infections. It’s also important to remember that these tests are not 100% accurate and depending upon whether you send out your sample or analyze it at home, the accuracy and reliability of the test may differ. For the at-home market, the tests that determine current infection rely on either antigen testing or PCR (Polymerase Chain Reaction) testing (which is considered more reliable). Most of the tests you can quickly use at home are rapid antigen tests and seem to work best when a person is symptomatic. Antigen tests, however, are considered less reliable when a person is asymptomatic and may be more likely to give you a false negative than a PCR test. Experts advise that if you do get a negative result but were exposed to COVID, you should probably conduct what’s called “serial” testing, which means follow up a negative test with at least one additional subsequent test a few days later to see if the negative results are confirmed. Depending upon your exposure, symptoms, and plans to come into contact with others, you may want to “layer” tests- for example, conduct an antigen test at home and then a few days later follow up with a PCR test. One rapid negative test result only tells you that you are not shedding enough virus at that time to be considered infected but that result could change in as little as 6-8 hours later. This is why many home kits actually include 2 tests, one as a follow-up to another (or, if you make a mistake the first time you try).

NBC News has a valuable guide to shopping for FDA authorized home COVID test kits, both the rapid antigen tests as well as the sample collection kits that you send to a lab for a PCR test. They warn that you may be at risk for a false sense of security with these home tests, as they are not as sensitive as professional tests and may yield unreliable results. Remember, the accuracy of the test depends on whom you are testing, when the test takes place (how soon after exposure- recommendations are generally 3-5 days), and what type of test is being conducted. It’s also worth noting that there is not yet data to support the use of these home tests on children. And regarding costs? The at-home rapid antigen tests seem to run about $20-35, while the home collection kits with PCR lab testing are likely more expensive, perhaps up to $100. Right now it’s unclear whether insurance companies are covering these tests.

Bottom line? The at-home test options can be useful if you think you’ve been exposed and especially if you think you have symptoms. But you can’t rely on them to be 100% accurate and if you have any doubts, you’re advised to follow up with additional testing either at home or at a care provider. Either way, should you have a positive test result, you need to follow up with your physician for advice and further recommendations. And no matter what- do not rely on the availability of these tests as a substitute for good public health behavior, such as social distancing, hand washing, masking indoors and especially full vaccination.