Your Guide To Using At-Home Covid Tests

Home COVID tests, or over-the-counter (OTC) COVID tests, are tests you can take from the comfort of your home or anywhere outside an official testing site. Many yield rapid results, providing a test result in 15 to 30 minutes. Note that these tests differ from home collection tests, which the Food and Drug Administration (FDA) defines as tests in which a sample is collected at home but then analyzed in a laboratory.

At-home COVID tests typically come in two forms: molecular and antigen tests.

Molecular tests detect genetic material from the virus. These tests include nucleic acid amplification (NAAT) tests like polymerase chain reaction (PCR) tests and are known for their accuracy. You might be able to conduct certain forms of this test at home, but it may take longer for you to receive the results, as many require lab processing.

Antigen tests are the more commonly used option for at-home testing. They specifically detect viral antigens in the body, typically via nasal swabs. If there’s a large presence of viral load or if a person is symptomatic, it will likely appear in this test’s results. This form of testing is known to be slightly less accurate than a NAAT test, but it’s recommended by the Centers for Disease Control and Prevention (CDC) as a helpful COVID screening measure.

The CDC notes that at-home tests can help reduce risk of COVID exposure and infection alongside vaccination and boosters, mask wearing and social distancing. Anyone can take a test, vaccinated or unvaccinated, with or without symptoms.

“My number one recommendation is to get vaccinated—the full set of shots including the booster,” says Robert G. Lahita, M.D., director of the Institute for Autoimmune and Rheumatic Disease at Saint Joseph’s Health and a Forbes Health Advisory Board member.

“The vaccines are extremely safe and effective,” he says. “I also recommend wearing a mask and frequently sanitizing your hands and surfaces, especially in larger groups or when traveling (like for the upcoming holidays). Aside from these practices, it’s critical that we become immunity strong. Our immune system can benefit from a number of lifestyle changes, including diet, exercise and stress reduction.”

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As at-home tests can be more convenient than point-of-care or lab-based testing, they’re recommended by the CDC as a precautionary measure for the following situations:

• If you have symptoms of COVID-19
• If you’ve had exposure or potential exposure to COVID-19
• Immediately before an activity (such as a holiday party or travel)
• Before gathering with unvaccinated children or adults, immunocompromised people, older adults and people at risk of severe disease

“I would recommend doing both [a self-test and PCR, lab-based test], especially before going to a holiday party or large gathering,” says Dr. Lahita. “If you can’t get in for an in-person test, then the self-test is acceptable, but only if you’ve been fully vaccinated with all three shots (or two shots for the Johnson & Johnson vaccine).”

If you’re fully vaccinated and have been exposed to COVID, the CDC recommends testing five to seven days after your initial exposure for best accuracy. Anyone who is unvaccinated and exposed to COVID should test immediately after exposure and again five to seven days later, according to the CDC.

If you’re traveling, Dr. Lahita recommends testing the day before you leave. “Just one test a day ahead of time is acceptable. However, I don’t want to see someone test three days before because you can still wind up catching it in those three days before your departure,” he says.

At-home COVID tests can be purchased at retail and pharmacy stores or online. The CDC notes that some home COVID tests may have age limitations or expiration dates. To ensure as much accuracy as possible, check that your test has not expired and any other manufacturer guidelines available. Do not use a test if it’s damaged. For a list of FDA-approved tests, visit the FDA website.

Dr. Lahita, also the author of the upcoming book Immunity Strong, recommends looking for the following elements when buying a home COVID test.

Sensitivity: “Read the CDC website and reviews online to learn more about the different at-home tests that are available and how sensitive they are,” he says. Indeed, there are already published studies on the sensitivity levels of different rapid antigen tests, so do your research on your particular test.

Ease and simplicity: “They’re very easy to use—similar to pregnancy tests,” he says. Select a test that has clear instructions and easy-to-interpret results.

Affordability: “Try to buy them [the tests] from stores like CVS, Target and Walmart, where the prices are normal,” he adds. Dr. Lahita also warns against price jacking for home tests and urges people to avoid purchasing overpriced tests online. Most home COVID tests range from $10 to $40, although there are brands with prices reaching over $100.

In a statement on Dec. 21, 2022, the Biden administration announced its plans to provide U.S. residents with improved access to free, at-home rapid COVID tests. Starting Jan. 19, 2022, U.S. households can order up to four free rapid COVID-19 tests from COVIDTests.gov.

Before using your home COVID test, ensure the kit is stored properly and in suggested manufacturer conditions. When you’re ready to perform your test, carefully and thoroughly read the manufacturer instructions before proceeding to the following CDC-recommended steps:

• Wash your hands for 20 seconds or more.
• Disinfect any surface on which you plan to place testing materials.
• Open testing devices only when ready for use. Do not open prior to testing.
• Follow manufacturer directions for collecting a nasal or saliva specimen and completing the test.
• Use a timer if necessary for some steps, such as taking your nasal swab specimen or waiting for results.
• Wait the instructed amount of time before reading test results. Incorrect results may appear if read too soon or too late.
• Do not reuse any testing materials. If another test is necessary, use a new home test kit.
• Discard all specimens and testing components, and clean surfaces used during testing.

If an invalid result or error occurs on your home COVID test, look for instructions in your testing package and contact the manufacturer for further help. Invalid results and errors are rare but may occur due to collecting specimens incorrectly or a faulty test.

If your home test was created to be used in a series or for repeat testing (also known as serial testing), follow the manufacturer’s instructions. These home tests may include several testing kits and may provide instructions on how many days to wait between tests.

Home tests, specifically of the antigen variety, are known to be fairly accurate, especially for anyone presenting symptoms. Taking a home test before gathering with friends and family this holiday season can be a helpful safety measure and may reduce the risk of spreading COVID-19.

For further protection, Dr. Lahita recommends getting a PCR test as well. “The most accurate and most sensitive form of test is the PCR test (the swab in the back of the nose),” he says. “The PCR test looks for the viral RNA in the body. These are very quick to get results—perhaps, a couple of hours now, when years ago at the beginning of the pandemic, it took days.”

And, although uncommon, Dr. Lahita says it’s also important to be aware of the possibility of false positives, noting the recent November FDA recall of over 2 million Ellume COVID-19 Home Tests. However, according to the FDA, “the reliability of negative test results” was not affected.

What’s more, know that negative results don’t always rule out a COVID infection, as antigen tests can’t always detect the virus early or if the viral load is low. If you have symptoms but a negative test result, your health care provider may recommend a molecular test as well.

If you test positive on a home COVID test, you should quarantine for 10 days, according to the CDC, and wear a mask if it’s necessary to come in contact with anyone—even in your home. Speak with your health care provider for treatment recommendations, and seek medical care if your symptoms worsen. 

To avoid further spreading the virus, consider the following CDC recommendations:

• Cover your mouth and nose when you cough and wash your hands for 20 seconds, minimum.
• Avoid sharing dishes, cups, utensils and bedding with people in your household.
• Wash kitchen and bedding items completely after use. 
• Disinfect all surfaces in the space where you’re self-isolating. 

If you’ve tested positive for COVID, you also need to contact anyone you may have exposed. Contact people you’ve seen within the last 48 hours, as COVID can be spread two days before any symptoms are present or a positive test occurs.