Coronavirus (Covid) and the tests: Growing use of home tests leaves health agencies in the dark about unreported cases

“When fans of the band Phish started falling ill with Covid-19 all over the country after a Halloween concert weekend in Las Vegas, public health officials were largely in the dark about what appears to have been a superspreader event,” Kathleen McLaughlin writes over at Stat. “In a Facebook post from mid-November with hundreds of responses, concertgoers compared symptoms and positive test results, many of those from tests taken at home. But those data weren’t added to state public health tallies of Covid’s spread. It’s a story that’s becoming commonplace in the era of rapid home Covid testing: People who test positive are almost never counted by public health agencies…. While home tests have distinct advantages —- they’re convenient and quickly inform people of their infection status so they can take steps to avoid spread the virus -— most who test positive don’t come to the attention of health officials unless they are sick enough to see a doctor. To be sure, the growing availability of home tests is good news for a country that stumbled through more than a year of the pandemic with inadequate testing resources. Still, as the U.S. moves into a second pandemic holiday season…state and local health departments are increasingly relying on incomplete data and educated guesses to capture ups and downs in the infection rate and to guide decision-making. Home-testing samples, for example, aren’t submitted for genomic sequencing, which could delay identification of the Omicron variant in communities. And contact tracers can’t trace cases they don’t know about. ‘If nobody’s reporting the tests, are we really getting the information we need?’ said Atul Grover, health policy researcher and executive director of the Association of American Medical Colleges. ‘We have no idea what the true positivity rate is.’ Grover and his colleagues have spent months tracking Covid testing availability and usage in the United States and have grown increasingly worried about the data black hole that is home antigen testing, particularly with cases again on the upswing. The Biden administration last week announced plans to make home testing free, and widely increase testing availability. While these tests can still be difficult to get in places, the Food and Drug Administration has given emergency use authorizations to 10 home tests for sale to consumers, and more are coming on line, so home testing is poised to become the primary Covid tracker.” Kathleen McLaughlin, “Growing use of home Covid-19 tests leaves health agencies in the dark about unreported cases,” Stat.