Do COVID Self-Test Kits Work?

Your travel kit includes hand sanitizer, extra face masks and disinfectant wipes. With new coronavirus variants like omicron, should it include an over-the-counter COVID self-test kit as well? 

Last year, COVID testing was only available at health care facilities, hospitals or dedicated testing locations. There was usually a long line before the test and a long wait for the result after the test. 

Companies developed rapid virus tests in April 2021, some needing to be mailed to a lab and some able to provide results at home, and a second wave of tests hit the market in October for those worried about the delta variant. By November, The Centers for Disease Control and Prevention (CDC) started recommending COVID-19 self-collection or self-test kits (also called home COVID tests or at-home COVID tests). 

“These self-collection kits and tests are available in pharmacies and retail stores. Some require a prescription. The Food and Drug Administration provides information on which self-tests are authorized for use,” writes the CDC. 

Today’s self-collection kits and self-tests are used for the detection of current infection.  

“COVID self-test kits are useful if you’re going somewhere remote with limited access to testing,” said Daniel Stretch, operations manager at Global Rescue. “You could save yourself an unnecessary end of trip or help prevent the spread in remote communities. Kits are small and light enough to fit into your travel kit and, at $10 to $40 per kit, should be considered for anyone traveling to areas where alternative testing is unavailable or slow to obtain results.”  

When should travelers use these self-testing kits? And how accurate are they? Stretch answers traveler questions about COVID self-test kits. 

[Related Reading: The COVID-19 Travel Bag]

What Is a COVID Self-test?

Over-the-counter COVID-19 testing kits are basically do-it-yourself COVID-19 tests. Buy a kit, read and follow the instructions, take a sample and get the results. The results may be determined at home for most of the products available in the market.  

What Kinds of COVID Self-tests Are Available?

There are two kinds of over-the-counter testing: molecular (also known as PCR tests) and antigen (also referred to as lateral flow test).  

The molecular test typically involves a nasal swab or saliva sample, while the antigen test uses a sample obtained from a nasal or throat swab.  

The antigen test result is determined in 15 minutes or less and results are read from the test kit, which is why they are usually called a rapid test. A molecular test, on the other hand, requires a laboratory to process the sample and analyze the result. 

Do Self COVID Tests Work?

A study by Dr. Jacqueline Dinnes reviewed 64 COVID rapid diagnostic tests and found molecular tests — generally employed by commercial labs — are more accurate. Molecular tests search for the virus’ genetic material over multiple testing cycles, which magnifies what’s in the swab sample, requiring a much smaller viral load for detection. 

Antigen tests are the basis for most at-home screening, but the FDA has also authorized two at-home options — made by Lucira Health and Cue Health — that use processes similar to a molecular test. These FDA-authorized COVID-19 kits are effective and retesting is not usually required.  

What if My Self-test Kit Isn’t FDA-approved?

While antigen tests are believed to deliver accurate positive results, false positives can still happen. A false-positive is when somebody tested positive but, in actuality, that person doesn’t have COVID-19.  

Most antigen testing kits in the market suggest serial testing. The packets usually contain two sets that should be done a few days after the first to confirm the results. A recent study on serial testing in the Journal of Infectious Diseases found using self-testing kits every three days boosts accuracy. With FDA-approved tests, using a test during the first week of symptoms then testing three days later will provide 85% accuracy. 

If you are symptomatic or there are any questions about the results, contact your health care provider to verify the self-test with a molecular test. 

When Should You Use an At-home COVID Test? 

You should test if you exhibit symptoms or are known to have exposure to somebody with suspected or confirmed COVID-19 with or without COVID vaccination history. You should consult with your health care provider if you have a history of COVID-19 infection and recovered within the past 90 days.   

Are the Results Accepted for Travel?

The rules and regulations vary for international air travelers. The United Kingdom now uses home test kits as part of their country entry requirements. 

For U.S.-bound travelers, some self-testing COVID-19 kits could fulfill the requirement that air passengers show a negative COVID-19 test before boarding. You should preferably choose the self-testing COVID-19 kit that has a video component, whether it is a molecular or antigen test, because it is conducted under a telemedicine administrator. 

According to the CDC, you can use a self-test meeting the following criteria for international travel: 

• The test must be a SARS-CoV-2 viral test (nucleic acid amplification test or antigen test) with Emergency Use Authorization from the FDA. 
• The testing procedure must include a telehealth service affiliated with the manufacturer of the test that provides real-time supervision remotely through an audio and video connection. Some FDA-authorized self-tests with a telehealth service may require a prescription. 
• The telehealth provider must confirm your identity, observe the sample collection and testing procedures, confirm the test result, and issue a report. 
• Airlines and other aircraft operators must be able to review and confirm your identity and the test result details. You must also be able to present the documentation of test results to U.S. officials at the port of entry and to local/state health departments if requested. 

Are COVID Self-test Kits Covered by Insurance?

If your health care provider prescribes a self-testing kit or orders a kit for you, then it may be covered by your insurance. It is recommended to check with your insurer first. 

Can I Purchase a Self-testing Kit?

A handful of rapid at-home tests are available without a prescription, including the Abbott BinaxNOW (currently the only one that meets CDC’s required supervised telehealth component for entry to the U.S. from abroad), the Ellume Covid-19 Home Test and the Quidel QuickVue At-Home Covid-19 Test.  

If you can bring a kit with you internationally, travelers should purchase government-approved kits from a reputable supplier. Take note of how to store them during travel to maintain accuracy.  

Responsible expedition providers in places like Nepal are carrying tests. Check with your expedition provider before purchasing your own.