For many of us, the 2021 holiday season hasn’t gone quite like we’d hoped on the COVID front. Yes, vaccines are available to pretty much anyone, including kids as young as 5. And boosters are available for some teenagers and all adults, too. But we’ve also now got omicron. The variant appears to be milder in these early stages, but global health leaders warn it has the potential to change the course of the pandemic.
Of course, people are still going to get together and celebrate. Rapid testing can theoretically help make that safer. But as previous outbreaks show, rapid tests have limits. So how can you use them properly? And when should you test to help give everyone peace of mind?
How rapid at-home COVID-19 tests work
Rapid home tests are for the most part antigen tests that require you to collect a nasal sample using a long swab, which you then dip into a card reader or solution. Then you just have to wait a set number of minutes for results, usually about 10 to 15.
There just isn’t good data at this point about the relative reliability of one brand of rapid home test versus another. There are multiple options, including Abbott’s BinaxNOW or Quidel QuickVue, and you can usually purchase them through the company’s website or from places like CVS, Walgreens or Sam’s Club.
On the whole, rapid tests aren’t as accurate as PCR (polymerase chain reaction) tests, the gold standard, but they’re still pretty good. One recent study found, for example, that a popular home test accurately detected COVID-19 in 87% of patients with symptomatic COVID and 71% with asymptomatic COVID. While false negatives are the biggest concern with rapid home test results, false positives can and do happen.
One thing to note when you’re shopping for tests: Rapid at-home tests are different from at-home collection tests, like those done through Labcorp, in which you take a sample and send it to a lab. (Results for those usually come within a few days.)
Also, plan ahead. Rapid home tests are more available now than they were just a few months ago, and the Biden administration is pushing for them to be widely available and free — though there are some real questions about whether that plan is feasible. To be safe, don’t wait to buy one until the day you need it.
Rapid tests provide only a snapshot in time
If rapid tests are a part of your holiday gathering strategy, it’s important to keep their limitations in mind: namely, that rapid tests really provide a look at only one moment in time.
“Rapid tests are not the best at detecting early disease before someone is symptomatic yet may also be spreading the virus, one to two days before symptom onset,” explained Alex McDonald, a family physician in San Bernardino, California. ”However, someone can test negative and then a minute later be exposed to COVID, and within a few days potentially be contagious, and then a few days later become symptomatic.”
For that reason, he personally recommends doing a rapid test (or, even better, a PCR) 72 hours before an event, then doing it again about an hour before your family gathering — “without going to other places, to avoid possible exposure,” he said.
Alexa Mieses Malchuck, a family physician in Durham, North Carolina, also thinks it’s a good idea to perform more than one test, separated by at least 24 hours — then self-isolate. “Repeat a second rapid test when you arrive at your destination,” she said.
The key point in both experts’ guidance is not only to do more than one test but also to isolate after you take whatever your final test will be. If you’re getting together with friends on New Year’s Eve, for example, and you take a test, then run to the grocery to pick up a last-minute ingredient before they arrive, there’s a chance of a new exposure.
Read the instructions carefully
That sounds obvious, sure, but user error can be a problem with home tests of any kind. Most of us don’t have a lot of experience conducting nasal swabs.
“Make sure you familiarize yourself with the test, its expiration date and how to use it. This information can be found on the test’s packaging and instructions,” said Christopher Scuderi, a family physician in Jacksonville, Florida, who said he’s personally planning to use rapid tests with his own family on Christmas morning before they spend time with elderly family members.
But that’s not all they’re doing to play it safe. “We are also planning on having our event outside if the weather is good,” Scuderi said.
If you’re unsure about a result, test again
If you’re totally asymptomatic, you’ve been masking up and being mindful of public spaces, and you get a positive on a rapid test that you’re surprised by, “you can always repeat it,” said Philip Landrigan, director of the Program for Global Public Health and the Common Good at Boston College. “That’s what we do in the hospital. One of the things we’re taught from the first day of internship is that if you get an unusual result in any sense, run the test again.”
Being able to immediately retest is one of the potential benefits of rapid at-home tests versus getting tested in a lab, where it might not be feasible to get another test right away. At-home kits tend to come with more than one test per pack, though it might be an even better idea to try again with a test from another manufacturer if you’ve got one on hand.
Of course, if a second test comes back positive, you should follow the Centers for Disease Control and Prevention’s instructions. Isolate and let your health care provider know.
Remember: Rapid tests offer ONE layer of protection
Every expert who spoke to HuffPost for this story emphasized that at-home rapid tests can be an important part of making the holidays safer but that they are not enough on their own.
First and foremost, everyone at your gathering who is eligible should be vaccinated and boosted, the experts said. Several were also careful to note that if anyone has any symptoms — even if they’re mild — they really should stay home, even if that is super disappointing. If possible, consider spending time outdoors or opening windows, washing hands frequently — again, all of the stuff we know works.
“I like using the car analogy: You wear a seatbelt, have an airbag, obey the speed limit and stay focused on the road to minimize any risk of an accident,” McDonald said. “Accidents are still possible, but if you do all of these things, you’re going to minimize the risk to yourself and others.”
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.