Can You Trust Coronavirus Home-Testing Kits?

As COVID-19 continues to spread across the U.S., the limitations of clinic- and hospital-based testing are becoming apparent.

In short: Presently, there simply aren’t enough tests and medical professionals to screen everyone who wants - or requires - a test.

In response to this challenge, a number of companies are developing at-home testing kids for COVID-19.

Private sector development of at-home COVID-19 tests

• At least one company, Radish Health - a New York City-based telehealth company - says it has an FDA-approved at-home testing kit for COVID-19 that will be available in New York City, with planned expansion to other locales.
• Radish’s founder, Dr. Viral Patel, says: 

“We wanted to solve the challenges of safely getting testing for COVID-19 in a timely and efficient manner. A reliable at home testing kit that can be processed quickly allows us to give our patients the care and peace of mind they need in the comfort of their own home, while maintaining the health of the general public."

• For New Yorkers, Radish’s test is fully covered by many insurance plans (except Cigna, HIP, and Community Plan).
• For uninsured patients or those whose insurance doesn’t cover its test, Radish’s total testing costs come in at $350: $100 for the medical visit, shipping, handling, and follow-up calls.
• The company is donating its portion of the proceeds to COVID-19 vaccine research.

How does home-testing work?

• Radish’s self-administered test includes a testing kit, plastic specimen bag, lab form, cold pack and padded envelope.
• To collect their samples, users are instructed to swab the insides of their nostrils until they meet resistance, and then to rotate a cotton swab in place for 5-10 seconds. Users then place the swab in a specimen tube and package it with a cold pack in a padded envelope.
• This sample collecting procedure is roughly akin to those of other at-home kits, although some will take either a nose or throat swab.

Additional at-home tests

• Everlywell - an at-home testing company that makes tests for food sensitivity, vitamin D deficiency, and metabolic disorders - has launched a $1 million initiative to create at-home COVID-19 tests. Its tests can be requested online by completing a screening questionnaire online with a telehealth physician from PWNHealth.
• If approved, customers can purchase Everlywell’s test for $135. Like Radish, Everlywell doesn’t plan to profit off the test. It says the test will produce no profit for the company, and will be covered by participating HSA and FSA providers.
• Everlywell has reached out to government officials and public health departments to see if the test can eventually be made available for free.
• Nurx (a telehealth startup), Scanwell, and Carbon Health are also jumping into the fray.

Known issues with at-home testing

• It’s important to note that there are concerns with at-home tests. Coronavirus testing is a delicate task even under controlled lab conditions: it’s essential to test people at the right place, to get samples from the right part of nose or throat, and to handle samples appropriately, among other challenges.
• Eric Topol, director of the Scripps Translational Science Institute, says that while at-home testing is “better than nothing,” it’s very difficult to collect proper samples in home environments, leading to a high chance of false-negatives.
• False negatives: A person who has COVID-19 doesn’t collect a sample that catches the virus. They send in a sample that tests negative even though the patient does have the virus.
• There are also questions about what patients will do if they test positive. Hank Greely, director of the Stanford Center for Law and the Biosciences and the Stanford Program in Neuroscience and Society, worries that customers may react in unexpected - and unhelpful or even dangerous - ways if they test positive at home without receiving their results from trained clinicians.

“If consumers using [these] tests get positive results, what will they do? Rush to an ER? Rush to a doctor’s office? Sink into depression? If they test negative, will they stop all precautions, forgetting that the result is a snapshot in time and that they can still get infected? If the test results suggest things for them to do, will they take the advice?”

—Lorelei Yang