More People Are Using At-Home COVID Tests —How Will We Know if There's a Surge?

The growing use of at-home COVID tests can lead to unreported positive COVID infections. While this can affect how scientists predict COVID surges, databases exist to track how many people have COVID and how infection rates fluctuate. You can also self-report a positive at-home COVID test to the National Institutes of Health's Make My Test Count initiative.

From January 2022 to May 2022, the U.S. government mailed free at-home COVID tests to about 70 million households. A follow-up survey reported that about 40 million of those households used at least one at-home test. Since then, more resources have become available, including the ability to order free at-home COVID tests and/or buy them online and in stores.

Self-reporting if you have COVID can help scientists track infections, inform what vaccines are developed, and prepare the public with safety precautions when COVID surges occur. Read on to learn more about at-home testing, tracking COVID infections, and how to protect yourself from COVID and its variants.

How To Track COVID Infections and Surges

It is impossible to know the exact amount of COVID infections at any given time, but resources exist to track fluctuations, identify variants, and keep the public informed. Ways to get an updated estimation of how many COVID infections there are include:

• Centers for Disease Control and Prevention's (CDC) COVID Data Tracker
• World Health Organization's (WHO) COVID-19 dashboard

Why and When Does COVID Surge?

Since the COVID outbreak in 2019, infections have spiked and declined at different points. Many factors contribute to when COVID infections increase or decrease, including:

• Time of year: Like other respiratory viruses, COVID tends to spike in winter because people tend to be inside and travel more. Temperature and humidity may also make it easier for respiratory illnesses to survive. COVID also spikes in the summer due to decreasing immunity (if they got a vaccination the previous fall) and variant evolution.
• Variants: Since its outbreak, the virus that causes COVID has continued to evolve and mutate, creating variants. Some variants have been able to cause COVID infection surges, like the Omicron variant did in November 2021. This is why it's important to stay up-to-date on vaccinations, which are being developed to combat variants.
• Vaccinations: Getting the recommended COVID vaccination each year remains the best way to decrease COVID infection rates and prevent severe illness. It's estimated the first COVID vaccine prevented 14.4 million deaths.

With daily COVID cases in the U.S. being undercounted, it's important for health officials, political leaders, and citizens to keep a close eye on hospitalization and death rates to identify a potential surge, Mark Loafman, MD, MPH, chair of family and community medicine at Cook County Health and a family physician in Chicago, Illinois who specializes in infectious disease outbreaks and public health, told Health.

"As long as we don't see the surge manifest itself in admissions, we are at low risk for increased death and health care resource constraints," Rob Rohatsch, MD, emergency medicine physician and chief medical officer at Solv Health, told Health.

Should You Self-Report At-Home COVID Test Results?

If you take an at-home COVID test, you can self-report the positive or negative results to the NIH's Make My Test Count initiative. Even reporting a negative test can be helpful because it may help public health teams understand if an illness with similar symptoms to COVID is spreading in a certain area.

Of course, limitations exist. The benefits of collecting self-reported results include having more data and the ability to gauge what's happening in a community. However, there are concerns over people administering tests to themselves inaccurately and tests providing invalid results based on external factors (such as temperature and storage conditions), according to Dr. Loafman.

Ramifications of Uncounted Cases

Although there are methods health experts can use to identify a surge, the existence of unreported positive COVID-19 cases can be problematic, causing local health departments and agencies to lack a full understanding of transmission in their community, Pia MacDonald, MPH, an infectious disease epidemiologist, told Health.

This could also affect policies and precautions that may need to be implemented or reinforced in areas of high transmission, but Dr. Loafman said at this point, he doesn't see government leaders or officials putting mitigation restrictions back into place.

"Based on data that people can't feel or without consequence, it's not going to motivate people to do anything," said Dr. Loafman. "As much as we would like that data, I don't think it's going to change policy, it's going to be hospitalizations and death. That's what it's going to take, and right now, we're not seeing those. We are seeing them but not at a level that could change any behavior."

Uncounted COVID cases could also impact work policies and benefits that were initially offered to employees during certain spikes in the pandemic, including working-from-home options, extra sick time when exposed to the infection, and additional pay, said Dr. Loafman.

How To Prevent COVID

Anyone can get COVID, but prevention methods exist to lessen your risk of infection or help keep your symptoms mild if you do get sick. Ways to help prevent COVID include:

• Getting tested if you're exposed to someone with COVID or if you're showing symptoms
• Improving your indoor ventilation
• Practicing good hygiene, including frequently washing your hands
  
• Staying at home if you have COVID
  
• Stay up-to-date on your COVID vaccinations

A Quick Review

Many people use at-home tests to find out if they have COVID. This means there may be unreported COVID infections, which can affect how experts track COVID surges. However, data trackers exist that estimate how many people have COVID worldwide. You can even get an estimate of how many people have COVID in your county.

You can self-report your at-home COVID results, whether they're negative or positive. This can help officials and researchers track the spread of illness in your community. Surges in COVID happen based on the time of year, how many variants evolve, and how many people stay up-to-date on vaccinations. You can help prevent COVID by following vaccination recommendations and practicing good hygiene.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.