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COVID-19 cases and hospitalizations are rising again in the US as the country approaches 1 million deaths — a once unthinkable number of lives lost to the virus. Newer versions of omicron, including BA.2 and BA.2.12.1, have become more contagious and continue to drag the global pandemic on.
In this phase of the pandemic, more people are testing for COVID-19 at home, thanks to broader availability of at-home rapid COVID-19 tests. And many people are also experiencing milder symptoms, thanks to COVID-19 vaccines and booster doses, which substantially cut the risk of severe COVID-19 disease and the need for hospital care.
As more people do at-home testing, however, an increasing number of COVID-19 cases are not reported. The US Centers for Disease Control and Prevention itself says there is “currently limited use for collecting self-test result data to inform public health surveillance,” though the agency remains confident in “situational awareness” without the receipt of self-test results.
Asymptomatic COVID-19 cases and at-home test results are a few reasons why experts think the current case numbers may be big underestimations. This year, the CDC changed the way it monitors COVID-19 risk in the US to include measures like hospitalization numbers, health care capacity and the level of virus in our wastewater. But knowing the case count in your community can still be an important tool when deciding whether it’s safe to go to a movie theater or dine indoors.
“These at-home rapid tests result in us underestimating the number of people who truly have COVID,” said Keri Althoff, epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “And therefore also underestimate the number of what we know as our COVID transmission rates per 100,000 population.”
Even though it may not make it into the US COVID-19 case counts, the CDC encourages everyone who tests positive to report that result to their health care provider (or public health department if you don’t have a primary care doctor).
Here’s what to do if you test positive for COVID-19 at home, and a brush-up on isolation and quarantine guidance.
2 things to do you test positive for COVID-19 at home
If you take an at-home rapid test and it turns up positive, assume you have COVID-19. While it’s true at-home rapid tests are less sensitive than the “gold standard” PCR tests (about 10% to 20% less sensitive, according to Hackensack Meridian Health), and more likely to give you a false negative result, positive results from self-tests are “highly reliable,” according to the CDC.
“If you test negative on an at-home test but think you have COVID-19 because you have symptoms or were exposed, consider testing again 24 to 48 hours later,” the CDC says. Then, after a couple of spaced-out negative tests, you’ll be able to feel more confident that your negative result is truly negative.
There are two important steps to take after a positive home test result.
Follow the CDC guidance on isolation
Once you test positive, start following the CDC’s guidance for isolating (staying away from others if you’re sick or test positive for COVID-19).
Regardless of your vaccination status, the CDC advises staying home for at least five days, with Day 0 being the day that you tested positive. You should also isolate from people in your home, or wear a well-fitting mask if you can’t avoid others. You can end your isolation after five days, as long as your symptoms are gone or improving and you’ve been fever-free for at least 24 hours. However, you should still wear a mask and avoid travel for at least 10 days.
Report to your doctor or health department
If you test positive with an at-home COVID-19 test, call your primary care doctor, Althoff said. Not only will your doctor be able to direct you to treatments like Paxlovid if you’re at high risk for severe COVID-19, but in some cases, your clinician will have a system at their disposal that allows them to funnel a self-reported test result into official COVID-19 counts.
But it’s a lot less likely your COVID-19 result will end up in your state’s official count than if you were to test positive a second time at the doctor’s office, or at a mass testing site or clinic, according to Althoff.
“Calling your doctor and giving them that information is important for your individual health, but we shouldn’t misconstrue that to think that that information is now going into our surveillance systems,” she said.
Many states have mandated the reporting of COVID-19 test results, Althoff said, but those tests are typically done in clinical settings. The information coming from a laboratory that processes a PCR test, for example, then goes straight to the health department; these are “established systems,” she says. Even if you report a test from home to your health department, it’s often lacking necessary data needed for an official report per the CDC. “The data element itself and the data structure are different,” Althoff said.
Still, you should call your health department or doctor to report a positive at-home test result. (Here’s a list of health departments in the US.) You can also check in directly with your county or city to see if they have a more direct way to report a test result. Some areas, like Washington state, have direct hotlines for reporting an at-home COVID-19 positive.
You may also be asked to provide additional information to the health department if you phone or email it in, like your age and vaccination status.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
