Free Rapid At-Home COVID Testing can Make Pandemic Life Easier

On Friday, July 30, my band took the stage at the local pub for the first of a two-night stint. We were all vaccinated, as were all of our friends in the audience. We hadn’t performed since before the pandemic and poured our hearts out onstage and off it, hugging, chatting loudly in each other’s faces during breaks and singing at full volume. Back home with the babysitter, as we later found out, my son was developing the first symptoms of covid-19. By Sunday, my wife and I had symptoms, too, followed by my daughter on Monday. But we luckily didn’t infect all our friends because before I could return to the pub Saturday, we used a rapid antigen over-the-counter coronavirus test to test our son, got a positive result within 15 minutes, and immediately canceled everything. As far as I know, no one in the band or among my friends at the bar came down with covid-19.

In our long and ongoing battle against the coronavirus, these rapid tests are underutilized and under-discussed tools that have great potential to help us assess risk and keep each other safe at a time when the delta variant has made everything so complicated. I follow the news about the pandemic closely and have been writing about parenting, education and vaccines especially throughout. Nevertheless, until we ran to the drugstore to see whether we could get a rapid test, I only vaguely knew they existed and had the sense that they were just too inaccurate to be useful.

Since then, I’ve had conversations with friends and colleagues who were operating under the same misconceptions. This isn’t a coincidence, I think, because there’s been almost no public health messaging about this type of test — and little to no distribution to people who can’t afford them. But these rapid tests are inexpensive, easy to use and, when used in volume, could be a vital tool to make the school year safer and allow us to cling to some of the fragments of public life that the delta wave is threatening.

Our problem for testing our son was accessibility. He’s a 14-year-old autistic boy with Down syndrome, and he does not spit, so saliva tests are out of the question. He’s also very defensive of his body, which is good because people with developmental disabilities need to be encouraged in their bodily autonomy. But that means that shoving a swab deep into his nasal cavity is pretty much out of the question. The rapid tests, by contrast, were easy. My wife and I sat on the couch with him and showed him with cotton swabs how to rotate it just inside our nostrils, then gave him the test swab. No problem — we counted five circles per nostril together, and like that we had our sample. The unfussy process was a relief, especially because we were so sure it was just a cold, but the sample immediately came up positive for the coronavirus. Fifteen minutes later — the directed wait time for the test — it still showed positive.

There’s nothing new about this technology or the understanding of how it might be useful if deployed widely. It’s true that these tests also aren’t as accurate as the various kinds of laboratory tests, and I definitely had the sense over the past year that they were totally unreliable. But that’s just wrong. False positives are rare because the test rarely finds the coronavirus unless there’s virus to find. False negatives are more common, with higher accuracy during peak infection and if symptomatic, but lower in other situations. The FDA recommends serial testing as needed.

But they’re still hugely useful for circumstances when speed trumps accuracy. For us, any time anyone in the house has a sniffle, we’ll be testing before work or school, with time enough for me to still make breakfast and pack lunchboxes. The key is to understand that while in some circumstances, accuracy is the most important feature, even if the accessibility isn’t so critical in your household, speed and ease may still come into play. There have been so many times during the past year and a half where I wanted to quickly evaluate risk to the best of my ability, and surely that’s true for almost everyone.