Are the COVID-19 take home tests accurate? In a completely non-scientific study of my own patients and travelers over the past few months, I have concluded the following:

1. If you have illness symptoms and are home rapid-test positive, you end up truly positive (a home test “true positive”) nearly 100% of the time with our Abbott ID NOW rapid molecular test and, subsequently, PCR. Symptoms are most often cough, sore throat, runny nose, feverishness, diarrhea, or others that could be COVID-19. If you have symptoms and a positive rapid test, further testing is probably unnecessary, assuming that the rates of COVID at the time in the community are relatively high.
2. Nearly all of the patients who see me with one, two, or even three negative rapid tests at home with symptoms suggestive of COVID-19 end up testing positive with our rapid molecular test and subsequently are PCR positive! (a home test “false negative”)

Is it that all of the rapid tests were performed too early? Doubtful. The above abysmal results are likely due to both:

1. The very high false negative test rate.
2. The inability of a individual to get an adequate specimen. (Does anyone REALLY want to shove that swab far enough into the nostril and swish it around long enough to get an adequate specimen?)

IN CONCLUSION:

-A rapid home positive test when you have symptoms suggestive of COVID is likely very accurate if community COVID case numbers are relatively high. Believe the result!

-A rapid home test that is negative when you have symptoms should be completely ignored if the rate of infection in the community is high. In such a situation, speak with your doctor. They will likely recommend a rapid molecular test (such as Abbott ID Now, which we have at our office), or a PCR test.

Stay safe.

Julian Klapowitz, MD