Knowing whether you tested positive for COVID two days ago is pretty useless when you want to go somewhere, and don’t want to infect anyone. At-home rapid COVID tests can help.
I woke up feeling sick
My allergies have been going crazy for a couple of months now. Many mornings over the summer I woke up sneezing. Most of the time it gets better as I get up and get moving (a shower really seems to help), but if I’m still sniffling and sneezing by breakfast I take some Claritin, and within about half an hour I feel normal.
Yesterday morning I was blowing my nose a lot more than usual though, and at one point I sneezed about twenty times in a row. I didn’t even wait for breakfast, I took a Claritin about fifteen minutes after getting up. It was my husband’s birthday, and I was trying to reorganize an entire floor of my house after some construction. I needed to feel 100%!
But I didn’t get better. I kept sneezing and sniffling, I had occasional coughing fits, and every time I bent down, my nose just ran uncontrollably. And I was tired—I was ready for a nap just a couple hours after waking up. This was not my allergies. Uh-oh.
Breakthrough COVID symptom checklist
COVID has a lot of possible symptoms, but there’s growing self-reported evidence that post-vaccination COVID has different symptoms. Since I’m fully vaccinated, I ran through the list of the most common breakthrough COVID symptoms:
- runny nose
- sore throat
- loss of smell
I had two of those (runny nose and sneezing), but they could also be symptoms of a cold. And my gut was telling me that this was a cold. Still…
Curiously, we noticed that people who had been vaccinated and then tested positive for COVID-19 were more likely to report sneezing as a symptom compared with those without a jab.-authors of ZOE COVID Symptom Study
So which one was it, a cold or COVID?
I cancelled my plans
Either way, I didn’t want to get anyone else sick, so I cancelled the one obligation I had for today, which would have put me in a room with a lot of people. That was kind of a big deal for me, because pre-pandemic, I wouldn’t have done that. I would have been afraid that people would think I was using a cold as an excuse to get out of doing something. I would have dragged myself out of the house, and gotten through it. (It’s not the only change I’ve made because of the pandemic: I’ve also lost weight and changed some behaviors related to germs.)
Now? Not passing whatever I have to others is more important. I can’t believe I used to go out and do things while sick, just to prove something!
And the response from the person I had to cancel on? Total understanding. We all look at these symptoms differently now. Besides, coughing and sneezing in a mask isn’t fun.
But, I have plans for this coming weekend that I don’t want to cancel. If this is a cold, hopefully it will be cleared up by then (different sources give different answers about how long you’re contagious with a cold, but the general consensus is that you’re most contagious a couple of days before you show symptoms, and for the first few days of symptoms; after that, contagiousness wanes).
If I’m contagious with COVID, though, I want to know. And I would want the rest of my family to know. Spreading COVID is so much worse than spreading a cold.
Why I chose an antigen test over a PCR test
I never really considered going out and getting a PCR test because of my sneezing. That’s the kind of test that has to be evaluated in a lab, and it can take a day or two to get the results back (much longer in some cases). People line up to get PCR tests before major holidays when they want to travel, or before going to weddings or other big, crowded events just to prove to the people they’re visiting that they don’t have COVID, but I never understood the logic of this.
Let’s say you get a PCR test on Wednesday for a trip you’re taking on Friday. Your test comes back negative, but what you don’t know is that you were exposed to COVID on Monday evening while having dinner with friends. By Wednesday morning the virus was busy replicating, but it was still too early for anything to show up on your PCR test.
By the time you see your grandparents on Saturday you’re contagious, but you’re walking around feeling like you’re a safe person because you have test results that say you didn’t have COVID at one point four days ago. No wonder we keep seeing COVID spikes after holidays.
At-home rapid antigen tests aren’t as accurate as PCR tests at telling you whether you have COVID, but they’re not designed to be. They’re supposed to be used frequently, as more of a screening tool than a diagnostic tool. Imagine if everyone took an antigen test before leaving the house in the morning? Imagine if you could know with about 95% accuracy that you were not likely to infect anyone that day, and that everyone around you had the same test result? Keeping 95% of contagious people home would make a huge difference in the fight against COVID, and makes a lot more sense than locking everyone down.
Besides, you can test positive for COVID with a PCR test long after you’ve stopped being contagious, so what use is that info when trying to decide whether to be around people? Add in the fact that you won’t even get the results for a day or two (way longer at many points in this pandemic), and I really don’t understand why we’re relying on PCR tests as our main form of testing (except that the labs processing them are doing very well: LabCorp’s stock price is up about 70% compared to the end of 2019; Quest Diagnostics is up about 40%).
If I’m getting on an airplane and sitting next to a stranger, I want to know if that person is likely to be contagious with COVID at that moment, not if they tested negative for COVID three days ago.
Why we need many more home antigen tests
People like Harvard epidemiology professor Dr. Michael Mina have been very vocal since the beginning of the pandemic about the importance of rapid antigen tests, which can be done completely at home and give you almost instant results. While PCR tests can give you a more definitive answer as to whether you have COVID (or have recently had COVID), what seems to me to be more important is whether you’re likely to infect someone else or not, and according to Dr. Mina, that’s what an antigen test measures. He has said that if you have enough active COVID to infect someone else, that would likely show up in a rapid antigen test.
On the other hand, this Atlantic article supplies some good context for how to use rapid antigen tests that seems to run counter to what Dr. Mina is saying (this one has a similar theme as well). The experts quoted don’t think it’s as simple as contagious/not contagious. Instead, they think you should look at rapid antigen test results in context. In other words, if you live in a place with high transmission, or you know that you had close contact with someone who has COVID, and you have symptoms, you should look at a negative test result with a bit of suspicion and not just assume that you’re safe to be around people. And you should definitely do another test a couple of days later.
The main difference in these attitudes towards rapid antigen tests seems to be one of scale. While Dr. Mina is looking at antigen tests as a way to conquer COVID as a society, with many, many people doing tests daily or multiple times per week, the Atlantic article is addressing situations like mine, where I’m using an antigen test as part of my decision-making process as an individual.
I live in a neighborhood with a good vaccination rate (71% of residents are fully vaccinated), I mask when I go into stores, and I have an occasional outdoor meal. And I sometimes see vaccinated friends indoors whom I trust would tell me if they thought they were at risk for having COVID. And while I do find myself indoors once a week in a neighborhood with a much worse vaccination rate (barely 50% have even one shot), around a lot of people, I’m double-masked almost the entire time. I try to be very careful in riskier situations.
So, with all of that in mind, I took a rapid home COVID antigen test, and it was negative. Combined with the fact that I haven’t had any known contact with a COVID-infected person, and that this just feels like a cold, my negative antigen test result is helping to confirm my gut feeling that it isn’t COVID.
The instructions say to test again in a couple of days, so I’ll take another one on Wednesday. If that one is also negative, and my symptoms have gotten better, I’ll feel comfortable seeing my friends over the weekend.
Now, what if we all had a stack of these tests in our homes, to use frequently and routinely? Even though my husband’s job requires employees to be vaccinated and masked, they’re supplying rapid home antigen tests and requiring employees to take those tests three times every week. This should be the standard in every business, everywhere!!
Where to buy antigen tests
Finding the antigen test I wanted, the BinaxNOW test, wasn’t easy. I’d been looking online for a couple of weeks before finally lucking out and finding it at a great price, and just a few hours after I bought mine, they were out of stock again. (They’re in stock as I’m writing this, but were out of stock as recently as this morning, so you have to keep checking.) There aren’t that many rapid antigen tests that have been given emergency use authorization by the FDA, and that’s causing some supply problems.
The main issue with supply and price seems to be how the FDA is classifying antigen tests. Even though experts like Dr. Mina say that large numbers of people knowing if they’re likely contagious is much more valuable than smaller numbers of people knowing if they have COVID, the FDA is holding antigen tests to the same standards as PCR tests.
In Europe, there are many more brands of antigen tests available, driving prices down to less than a dollar per test in some places. Many governments are giving them away for free.
But here in the US, we seem to be finding yet another way to keep COVID circulating for as long as possible, with at-home antigen tests usually costing $15 or $20 each. How many families would be able to afford that for regular screening?
I managed to get mine for $7 a test, but I got lucky. I saw them in stock online today at Walgreens for $24 for a 2-pack. I have not seen them in stock at CVS, but I know people who have. [Update: I’ve since found them often at CVS online] And many sites can also check the stock at your local stores.
There’s also this site, which tracks where you can find tests online.
The same BinaxNOW test that I took is also sold in a six-pack for $150, or a 2-pack for $70, but those more expensive versions includes a telemedicine visit where someone watches you take the test, and those results can be used in some situations where you have to prove that you actually took the test, like for travel or certain events.
Antigen tests really seem to make more logical sense for testing at this point, as we’re all trying to figure out how to live with COVID. The FDA just needs to get on board, so that more people can get their hands on them at cheaper prices.
Personally, I’ll be keeping some around for when people in my family are symptomatic, or when they’ve had a known exposure to COVID. I can’t control the rest of the world, but I can do my part to help stop COVID from spreading. However, I’m privileged to have the means to do this. We need cheap, plentiful home tests so that everyone can help stop the spread. But the current proposal is just a drop in the bucket.