By Jason Arndt
Federal officials have recently pushed to make more at-home COVID-19 tests available through eventual free distribution to millions of Americans.
The distribution, according to Biden Administration, began this week and will allow people to request four tests per household using a new government-run website launched on Wednesday at covidtests.gov.
As the government looks to offer up to 500 million tests, federal officials implemented a new policy requiring health insurers to cover the costs of at-home COVID-19 tests for people under their plans.
In the meantime, at-home COVID-19 tests have been in high demand, with some pharmacies such as Walgreens limiting the number of kits people can purchase at a given time.
But, according local county officials, the increased demand and inevitable influx of new tests come with challenges and could potentially lead to underreporting of positive tests.
Jeff Langlieb, Racine County Public Health Officer, said his agency does not have a policy related to reporting at-home testing results.
Most, if not all at-home COVID-19 kits are for rapid antigen, instead of the gold standard confirmatory PCR recognized by health agencies locally and nationally.
“We do not have a position on how positive self-tests are reported,” he said. “At this time, the state considers home testing a preliminary test. Positive self-tests are considered a suspected case, and individuals with a positive self-test are usually referred to a testing site to be tested by a clinician.”
Meanwhile, Kenosha County Public Health Officer Dr. Jen Freiheit acknowledged at-home tests would likely result in incomplete data, since people do not need to report home results to her department.
She said Kenosha County Public Health does not have any mechanism in place to manage at-home positive tests.
“People do not need to report home results to public health. There is no real way to manage it,” she said. “We support the use of home tests as long as people follow all proper isolation and quarantine guidelines.”
Freiheit, like Langlieb, said people who test positive with an at-home COVID-19 test should seek official PCR confirmation.
“Getting a confirmatory PCR after a home is recommended, especially if one has symptoms or has been in close contact with a positive,” Freiheit said.
Walworth County officials support guidance from the Centers for Disease Control and Prevention in regards to at-home tests.
Jenny Quill, communications coordinator for Walworth County, said she recognizes the option could lead to an undercount of positive cases.
“Those who test positive for COVID-19 with an at-home test are encouraged to work with their primary care provider, isolate as instructed by the CDC, and inform close contacts of any exposures,” she said.
Langlieb called COVID-19 self-tests useful tools, however, he still encourages anyone who tests positive at home to schedule appointment with a healthcare provider, pharmacy or testing site.
“This also includes someone who has COVID-19 symptoms and tests negative on a home antigen test,” he said.
“Regardless of the ability to get a confirmatory test, Racine County residents who test positive on a home test should follow the current CDC isolation guidance and stay home in isolation for at least five days along with mask wearing for the next five days.”
Isolation, quarantine guidance
The CDC on Dec. 27 updated its isolation and quarantine guidance based on trends related to the more infectious omicron variant, which, according to state officials, has become the dominant strain.
Under the CDC guidance, people with COVID-19 should isolate for five days, and if they are asymptomatic or their symptoms resolve without a fever, they must wear a mask for another five days when around others to mitigate transmission.
“The change is motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days later,” the CDC wrote in a media statement.
In addition to isolation guidelines, the CDC also updated quarantine recommendations for anyone in the general public exposed to COVID-19.
For people who are unvaccinated, or are more than six months out from their second Pfizer or Moderna dose and did not receive a booster shot, the CDC encourages quarantine for five days followed by strict mask use for another five days.
However, if a five-day quarantine is not feasible, the CDC urged the exposed person to wear a well-fitting mask at all times when around others 10 days after an exposure.
“Individuals who have received their booster shot do not need to quarantine following an exposure, but should wear a mask for 10 days after the exposure,” the CDC states.
Refrain from emergency room
The Wisconsin Hospital Association on Jan. 10 urged the public not to visit emergency rooms for the sole purpose of receiving a COVID-19 test.
Emergency rooms, according to the WHA, have been under extreme stress because of surging COVID-19 cases as well as regular, seasonal increases in demand for medical services.
“Patients seeking COVID-19 tests at hospitals not only delay the provision of urgent care in emergency rooms, but also raise the risk of virus spread among medically vulnerable patients.”
The WHA further noted hospital officials are not only treating COVID-19 patients, but also people requiring care for heart attacks, motor vehicle accidents and other ailments.
The WHA, like local officials, encouraged Wisconsinites to seek a test through a primary care clinic that provides testing, free community testing site or requesting a free at-home collection kit from the Wisconsin Department of Health Services.
For more information on testing, visit dhs.wisconsin.gov/covid-19/testing.htm or call 211.