What experts told me to do after my positive COVID-19 at-home test

After two years of successfully evading getting COVID-19 — including a few brushes with close contacts, a couple of are-they-just-colds?

It felt both inevitable and shocking. I somehow avoided testing positive during the omicron surge that infected most of my friends this winter, so I figured that either I was invincible or I was next. Staring at my at-home rapid antigen test, I had to acknowledge that the long game of high-stakes tag was finally over. I was now “it.”

COVID-19 snuck up on me when I least expected it. Cases are low where I live in Queens, N.Y. And riding the subway felt low risk thanks to the federal public transit mask mandate. (A federal judge struck down the mandate on April 18, although the Biden administration announced April 20 it would appeal the ruling and some places, including New York City, are keeping masking requirements in place for the time being.) I had dined indoors, but I still wore my mask inside public spaces (SN: 3/25/22). So when I woke up with a sore throat on a Wednesday, I chalked it up to needing more sleep. Before I tested Friday evening, I was still convinced it was just another cold.

Two thick lines on my rapid test said otherwise (SN: 12/17/21). OK, I thought, I definitely have COVID. Now what?

COVID-19 at-home tests on a table

A. GIBBS

I had a pretty good idea of the first few steps, which had been drilled into my head ad nauseam: Isolate immediately. Text close contacts from the 48 hours before first symptoms. Stay away from other people and pets in the house.

It got blurrier from there. Since I tested myself at home, my COVID-19 test wasn’t official. Surely I should report my positive test; after all, public health regulations are often based on case numbers. But it turns out that playing my part was a lot harder than I would have thought.

When it comes to reporting at-home tests, “there is no formal recommendation,” epidemiologist at Boston Children’s Hospital who works on COVID-19 surveillance. Without a federal program for reporting at-home tests, states are left to their own devices, and it’s confusing to make sense of where to report, which means that many people won’t.

Cases being underreported is nothing new. Even early on, asymptomatic and mild cases where the person never got tested wouldn’t make the case count. But at-home testing will make underreporting even more prevalent. The Institute for Health Metrics and Evaluation’s data show that only an estimated 7 percent of all U.S. COVID-19 cases are being reported, an epidemiologist at the University of Texas in Dallas who writes Local Epidemiologist newsletter, reports April 13 in a post titled “Can we trust case numbers?”

To make my case count, I donned two KN95 masks and walked to the COVID-19 testing booth on my street to get a PCR test that would be officially reported. (An official PCR test result may also be necessary for coverage that require medical care.) The downside is that I was contagious there was a risk of exposing others to the virus, though I was masked for all but the swab. An alternative, suggests, is reporting your positive at-home test to a primary care provider. Some at-home test manufacturers also provide information about how to report results from that test.

But until public health reporting catches up with the quick transition to at-home testing, we’re flying blind. There are ways to find clues about what’s going on in your community, though

For starters, become familiar with your local public health department website, says epidemiologist the chief science officer at a company developing a system for at-home test reporting. Check to see if your community monitors wastewater, which is a better way to track the amount of SARS-CoV-2, the virus that causes COVID-19, in communities than case numbers or hospitalizations. Outbreaks Near Me, a project works on, also collects results from volunteers to help track COVID-19 trends down to the local level.