Which COVID-19 Test Should You Get?

11 Aug.,2022

 

wholesale rapid test kit

[Originally published: Oct. 20, 2021. Updated: Jan. 20, 2022.]

Note: Information in this article was accurate at the time of original publication. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information.

As the highly contagious Omicron variant continues to sweep across the country, people—even those who are fully vaccinated—are wondering if the onset of cold and flu symptoms is really a sign of COVID-19 infection. 

But COVID testing has become a complicated issue. As Omicron surged, appointments at sites where results are processed by a laboratory became difficult to find in a timely manner. So, many turned to at-home COVID-19 tests. Often called rapid tests, such kits are sold in drugstores and online, allowing people to test themselves—and get results—in their own home in a matter of minutes. 

Unfortunately, at-home tests have also become difficult—if not impossible—to find. The federal government hopes to alleviate the bottleneck by requiring private insurance companies to start reimbursing customers for at-home tests and by distributing 1 billion free rapid tests to Americans. 

If you can get your hands on a test, you might find the different options confusing. In which situations is a laboratory-based (often called PCR) test best? If you are traveling and need to show a negative COVID test, which should you get? Are they all equally accurate? Do some produce results faster than others? And how far does that Q-tip go up your nose with each kind? 

Some of these questions are easy to answer, while others are more difficult—particularly when it comes to accuracy. That’s because all of the tests—and there are hundreds of them, from a growing number of companies and laboratories—are offered through a Food and Drug Administration (FDA) emergency use authorization (EUA). Therefore, they have not been as rigorously tested or vetted as other medical tests with full FDA approval.

And since the virus is new, all the tests are also new, meaning we have neither a long track record of comparing results, nor a true gold-standard test yet. 

Furthermore, with each new variant, new questions arise. Recently, there has been discussion about whether throat swabs or saliva samples are better at detecting Omicron compared to the more mainstream method of nasal swabs—or if rapid tests are less effective at detecting Omicron. 

Sheldon Campbell, MD, PhD, a Yale Medicine pathologist and microbiologist, cautions against getting caught up in what he calls mostly anecdotal data. 

“There is some PCR-based data that saliva is better, but the home tests are designed to work with a nasal swab and very few responsible people would think you should replace a nasal swab with a throat swab. That’s Twitter medicine,” says Dr. Campbell, referring to a #swabyourthroat hashtag that is trending. “And I have not seen good data that antigen tests are somehow less sensitive with Omicron than they are with other strains.” 

Below, Dr. Campbell and Yale Medicine infectious disease experts get into the nuances of the various available COVID-19 tests.