In many places, there is no system for sharing home test results with health officials, but the information may still be beneficial for public health.
So, you got a positive result on your home test for Covid-19. What do you do next? In addition to everything else on your plate — isolating and notifying close contacts, taking time off work and rescheduling appointments — it’s good practice to report your test results.
And while home tests have made it easier and faster to screen yourself and get treatment, it is not always easy to report an illness. This confusion has meant that many cases are left out of official counts.
If you test positive at a clinic or another community testing site, those results must be reported to public health departments under the CARES Act. Some home tests taken under the supervision of a trained telehealth provider are also reported to government health officials. But if your rapid test doesn’t fall into one of these categories, it can be unclear what to do.
The Centers for Disease Control and Prevention “strongly encourages” everyone who self-tests to report their positive results to a health care provider, who may order a P.C.R. test or otherwise report the data to state authorities. But only a few state health departments, including those in Colorado and Washington, collect data from home tests. Others, like in Massachusetts and New York, allow individual county health departments to decide whether they want to collect home test results.
The result is that official case counts are becoming an increasingly unreliable measure of the virus’s true toll. In New York City, for example, at the height of the Omicron wave, officials logged more than 538,000 new cases from January to mid-March. But a survey of New York City adults indicated that there could have been more than 1.3 million additional cases that were never detected or never reported during that time.
Health experts are concerned that public reporting of home testing is too sporadic and unpredictable.
“We do need a better sense of the amount of Covid in the community as people and organizations try to plan their behavior,” said Dr. Robert Wachter, the chair of the medicine department at the University of California, San Francisco. “When I’m deciding whether to eat indoors, for example, I don’t care about hospitalization numbers. I want to know the chance that my waiter or table-mate has Covid.”
But reporting relies on people being able to access home tests in the first place, which may put people in already underserved communities at a disadvantage. Data published by the C.D.C. in April suggested that home testing was most common among people who were young, white, highly educated and wealthy.
Even among people who have access to home tests, some may be nervous about volunteering personal information to local health authorities, said John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital who led the recent C.D.C. research on home test use. Others may be too sick or overwhelmed to deal with the administrative burden of calling, emailing or otherwise figuring out how and when to report their test results.
Developing standardized, easy reporting systems for home tests could help solve part of the problem, Dr. Brownstein said. And information gleaned from home tests could allow researchers to calculate a better Covid index even if there isn’t uniform participation from the public.
“You don’t need every single person reporting their home test in order for the data to be valuable,” Dr. Brownstein said. “You have to understand how representative the sample is and make appropriate adjustments.” By combining test positivity data with other indicators, such as imputed case rates, wastewater information and community demographics, scientists can better understand how virus transmission is changing and assist with continued prevention efforts, he said.
Given how important it is to track case counts, here are four easy ways you can report a positive home test result.
Use a test’s mobile app.
Some rapid test kits, like the BinaxNOW, iHealth and Lucira kits, include a way to report your results through a mobile app, which usually also has instructional videos for using the tests.
Last year, a pilot program run by the C.D.C. and the National Institutes of Health distributed more than 1.4 million home tests to households in Tennessee and Michigan and found that, while overall test reporting was low and fewer than 10,000 test results were recorded in companion apps, those who used the apps were more likely to report their test results to public health authorities in both states. About 75 percent of the app users in Tennessee reported results and 84 percent in Michigan reported theirs.
Share results with your doctor.
If you test positive at home, another way to report your result is to contact your primary care provider, which is what the C.D.C. recommends you do.
When calling or emailing your doctor, make sure you’re ready to share a few key details: the kind of test you took, the time you took it, the date you started experiencing symptoms and your vaccination status.
Your doctor may recommend taking a P.C.R. test for confirmation, and can provide a medical report to help you take time off from work or school. Your doctor can also help you track new or concerning symptoms, give advice about antiviral treatments and clear you to return to work once you have fully recovered.
Contact your local health department.
Many local public health departments have ways for people to report their results online, though their methods for obtaining test data often vary from region to region. You can find your health department’s website and information through the National Association of County and City Health Officials directory.
Some reporting methods are straightforward, like the one in Marin County, Calif., which has a simple online form for reporting results. Residents of St. Louis County, Mo., can call in, email or submit their results online. In Washington, D.C., you can use an iPhone or Android app, in addition to the Department of Health’s self-reporting web portal.
Other health department websites are notoriously confusing to navigate or even understand. New York State’s Covid-19 resource page, for example, says that residents are not required to report their test results. A representative for the Department of Health said that this was because New York had used only results from laboratories or official testing providers “to analyze trends and report consistent data to the public” since the beginning of the pandemic. But some counties in New York, like Albany County and Tompkins County, allow reporting of home test results, which is separate from the data the state collects.
Participate in crowdsourcing.
Although a national home test surveillance website does not exist, researchers from Dr. Brownstein’s group have developed a platform for crowdsourcing home test results called OutbreaksNearMe.org that is fairly intuitive to use.
Originally designed to track flu outbreaks, the site has expanded to help create maps and analyze Covid-19 case data submitted by volunteers. The site shares information with the C.D.C. and local public health agencies and makes it available to the public, Dr. Brownstein said.
“Home tests represent a huge change in how quickly people can identify an infection, how quickly they can get care and access therapeutics,” Dr. Brownstein said. “They are going to be a core way that health care is delivered in the future, so we need to make sure that we in public health keep up with testing data.”
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