Home Covid Testing

[eroscott]

This is from Cigna when we log in.

Home test results in 1-3 days after receiving.

Check your symptoms or get your COVID-19 at-home test kit
Experiencing symptoms you think may be related to COVID-19? Answer a few simple questions to assess your symptoms and risk level. If you need to be tested for COVID-19, Cigna is waiving out-of-pocket costs for FDA-approved diagnostic tests.

Access COVID-19 testing at home with an FDA-approved specimen collection kit from LabCorp. Simply complete a short online survey and provide your Cigna insurance information. LabCorp will mail you an at-home specimen collection kit and a prepaid mailer to send back for testing.

Results are available 1-3 days after sample is received at lab. Must be 18 or older. Not available in Puerto Rico.

Button: Assess Symptoms Button: Order COVID-19 Test Kit

Link from there to here: https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test

Find out if you currently have COVID-19 without leaving home.
We'll send you an at-home kit to collect your nasal swab sample and ship it back to our lab. Our lab will test your sample for SARS-CoV-2, the virus that causes coronavirus disease (also called COVID-19), a respiratory illness.

The average time to deliver results is currently 24-48 hrs from when your sample is received at the lab. Our labs process samples seven days a week.

Please note this test does not detect antibodies or immunity; it is designed to determine active infection with the virus that causes COVID-19. For more information on antibody testing visit LabCorp.com.

 

[Aerides]

This is from Cigna when we log in.

Home test results in 1-3 days after receiving.

Link from there to here: https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test

While those are convenient for folks who don't wish to leave their home to get tested, they still have a few days baked into the process. It's really "home sample collection" and not actual home testing.

The game-changer will be something you can perform at home and get results there and then, real-time (in say an 15 mins or less).

 

[Gumby]

That will be good for most people, but I would bet dollars to donuts that there will be some who test positive at home and who still will not quarantine, because they've got oh so much more important things to do in their lives. If you have to go through a testing facility, at least someone else will know you are positive and that may serve as a deterrent to bad behavior.

 

[omni550]

While those are convenient for folks who don't wish to leave their home to get tested, they still have a few days baked into the process. It's really "home sample collection" and not actual home testing.

The game-changer will be something you can perform at home and get results there and then, real-time (in say an 15 mins or less).

Dr. Duc Vuong (an early-retired bariatric surgeon, who is active on facebook and YouTube) is selling Healgen One-Step Rapid Tests (under the FDA Emergency Use Act). They are like a home pregnancy test. You prick your finger, put a drop of blood in the depression of the enclosed short plastic wand, add reagent, and wait a 10 minutes to see your Covid antibody result. This has 95% accuracy as compared to nasal swabs at 70% accuracy. One test is $100, buying 15 tests drops the price to $75ea.

Dr. Vuong said something about they usually require them to be administered by a medical person. With his MD license he's able to purchase them in bulk.

No medical skill is needed, as it's a simple finger prick and adding 2 drops of reagent, waiting a few minutes, then reading the result. No interpretation needed. A result of IGM means you are actively infected and IGG means you were infected and now have antibodies.

These are merely to serve to you as to your Covid status, not as a travel or return-to-work test.

If they were to be sold to the retail market, given the current huge interest/demand, the price should drop significantly.

Details at the ~32 minute mark

omni

 

[Another Reader]

Dr. Duc Vuong (an early-retired bariatric surgeon, who is active on facebook and YouTube) is selling these. They are like a home pregnancy test. You prick your finger, put a drop of blood in the depression of the enclosed short plastic wand, add reagent, and wait a few minutes to see your covid result. One test $100, multiple tests drop the price to $75.

Dr. Vuong said something about they usually require them to be administered by a medical person. With his MD license he's able to purchase them in bulk.

No specialized medical skill is needed, as it's a simple finger prick and adding a drop of reagent, waiting a few minutes, then reading the result. No interpretation needed.

If they were to be sold to the retail market, given the current huge interest/demand, the price should drop significantly.

omni

What is the testing mechanism? If it's PCR, the test would look for virus in the blood. Yet we test for shed virus in the nasopharyngeal passages now...

 

[omni550]

What is the testing mechanism? If it's PCR, the test would look for virus in the blood. Yet we test for shed virus in the nasopharyngeal passages now...

Another Reader,

It checks for IGG or IGM antibodies. (I added some additional information to my original post #55 to help clarify and explain further.)

Here's a short video from the Healgen site https://www.healgen.com/post/covid-19-rapid-test-instruction-video

omni

 

[Another Reader]

Another Reader,

It checks for IGG or IGM antibodies. (I added some additional information to my original post #55 to help clarify and explain further.)

Here's a short video from the Healgen site https://www.healgen.com/post/covid-19-rapid-test-instruction-video

omni

I missed the antibody part on the first read. Do we know which antibody it tests? The problem with the hastily rolled out antibody tests from Abbott and Roche was that they measured antibodies to the nucleocapsid N protein, not the spike S protein. Antibodies to N are less reliably produced and fade faster.

A number of Long Haulers have positive antibody tests but are still very sick. One theory is that the virus is persistent, hides in immune privileged areas in the body, and reemerges. Some of the ID doctors on the front lines are finding incomplete clearance to be a problem.

 

[omni550]

I missed the antibody part on the first read. Do we know which antibody it tests? The problem with the hastily rolled out antibody tests from Abbott and Roche was that they measured antibodies to the nucleocapsid N protein, not the spike S protein. Antibodies to N are less reliably produced and fade faster.

A number of Long Haulers have positive antibody tests but are still very sick. One theory is that the virus is persistent, hides in immune privileged areas in the body, and reemerges. Some of the ID doctors on the front lines are finding incomplete clearance to be a problem.

Another Reader,

I don't know which antibody it tests. I was basically summarizing Dr. Vuong's comments.

(I have no personal knowledge.)

omni

 

[sengsational]

FDA Op Ed

So far in this thread I've quoted people from only one side of the discussion because I hadn't seen any response from the FDA.

Today I was made aware of an op-ed from Jeffrey Shuren, MD, JD and Timothy Stenzel, MD, both directors in the FDA, posted on September 9, 2020:

https://thehill.com/opinion/healthcare/515628-fda-were-constantly-working-on-covid-testing-options

They require the at-home tests to be of higher accuracy than the ones they've already approved for their big medi-business buddies (the ones requiring a machine and/or an approved lab and a doctor to "interpret" the results). They're making noises like they're willing to entertain at home testing, but I'm seeing all talk and no action.

They throw-up the straw-man concerning the risk of "returning to work" based on a home test that's less accurate than a lab test. That's BS because the primary use of the home test is for the public health aspect of keeping people who are not exhibiting symptoms, but shedding virus, out of circulation. If you have symptoms of any kind, you should see your doctor. That could be in bold print on the box. This tiny sliver people who might get a false negative, ignore the advice of seeing a doctor, and "returning to work"...I'm sure it will happen. But what about the 1000 other cases that will prevent a super-spreader event? They're letting the perfect get in the way of an overall huge win.

The FDA is underestimating peoples' ability to think for themselves and follow instructions. I think they're motivated not by keeping the virus from spreading, but instead keeping the higher revenue testing methods feeding their buddies with money. They DO say that they recognize that "access to testing outside a health care setting..." (leaving it up to the imagination whether they mean RESULTS outside of a health care setting) "...is crucial to supporting the efforts to address the pandemic."

 

[Badger]

I haven't followed up on this but it seems as if Costco has home test kits available for $130 that have decent accuracy. Takes a couple of days after received at the evaluation site for results and it isn't really affordable for most. Still if I did choose to use the kit I would be staying home for that time. As it is I am usually there anyway except for a run to get groceries while wearing protection.


Cheers!

 

[braumeister]

I haven't followed up on this but it seems as if Costco has home test kits available for $130 that have decent accuracy.

I just got an email the other day from Quest Diagnostics about this. They also offer one for the same price.
https://questdirect.questdiagnostics.com/products/covid-19-active-infection/2713afd8-3d0c-4819-b877-6880a776cc46?utm_source=vigorate&utm_medium=email&utm_campaign=2020-09-covid19-wave7-engaged&utm_content=collection-kit-header

 

[donheff]

I just got an email the other day from Quest Diagnostics about this. They also offer one for the same price.
https://questdirect.questdiagnostics.com/products/covid-19-active-infection/2713afd8-3d0c-4819-b877-6880a776cc46?utm_source=vigorate&utm_medium=email&utm_campaign=2020-09-covid19-wave7-engaged&utm_content=collection-kit-header

The Quest test, and I assume Costco's, are swabbed at home and sent to a lab. These are only useful for people who have no public testing available. I can get a free test a five minute drive away with results back in 24-48 hours. No way I would pay for one of these tests.

The government should have funded ubiquitous, cheap, rapid home tests that don't require labs. Even if these were not perfectly accurate they would be very useful for people in low positivity areas to test close friends and family members before small home gatherings. Where the positivity rate is 1-3% the risk of a false negative is very small. As Sengsational has pointed out such tests exist but the FDA is holding them back from the public. I would feel confident enough to accept that risk and have family or close friends over for dinner. I don't see misuse as a big enough risk to block them - people are getting together with no tests so how would these be worse than that?

In high positivity areas (some are over 20%) anything less that a 99%+ accurate test would still seem risky (to me). Instructions on when and how to use less accurate home tests could caution about the risks with bold letters over a skull and crossbones background.

 

[Aerides]

hey require the at-home tests to be of higher accuracy than the ones they've already approved for their big medi-business buddies (the ones requiring a machine and/or an approved lab and a doctor to "interpret" the results). They're making noises like they're willing to entertain at home testing, but I'm seeing all talk and no action...

The FDA is underestimating peoples' ability to think for themselves and follow instructions...

While I agree with most of your position and share your frustration with the slow progress in this space, I think that we tend to think of "people" as ourselves, our peers, folks who tend to lean on the higher half of the IQ curve.

But stuff for mass health use (and mass anything) has to work for the lower half of the curve, with less than average ability to think for themselves. Which doesn't seem insurmountable! The ideas about selling kits in 3 packs with clear instructions, and hey, if someone gets a false-negative and carries on, it's really no worse than if they didn't know at all. And we had no testing anywhere just a few months ago so how is not-perfect testing all that bad? The FDA could put out a massive comms campaign with the launch, get all over the news and ads and stuff, get some catchy slogans and graphics to let people know you need 3 negatives to be sure, stuff like that...But yeah...not happening.

 

[sengsational]

Takes a couple of days after received at the evaluation site for results and it isn't really affordable for most.

We have kind of a "definition problem" with "home test", to add to the complexity of roll-out. Of course these expensive mail-off tests have their uses, but it's not the big win that I think would be a solid step forward for public health.

Even "home results test" isn't descriptive enough (results could be mailed to the home and the test might need to be done in a lab).

"immediate results home test" might work, if you say 15 minutes is immediate.

Another definition problem we have is "accuracy". The one accepted and used in this context is a diagnostic medical one, which I dismiss. We need to judge a test's accuracy based on what it can do for public health. A test that is great at detecting virus, but puts a super spreader next to your mom for 3 days while you wait for results is not effective, no matter how well it segregates samples. And what we most want to prevent are people who are spewing the most virus. The PCR mail off or lab based PCR tests fail on that level as well, not discerning someone at the end of their disease, with tiny fragments of virus versus someone who's in the middle of a huge Covid build up, and has billions of viral particles in their nose. The rapid paper antigen tests could keep that really bad person out of circulation; this kind of test is actually better at keeping super spreaders out of circulation.

I agree that people will screw up, misinterpret, misuse, and do stupid stuff, and I include myself in "people". But rather than waiting for the perfect immediate results home test technology and perfect instructions and methodology, I say we go with what we have now, and iterate towards better solutions. The costs of not doing are devastating; waiting for perfect when we have good enough seems like it can't be the right choice.

 

[MichaelB]

The Costco home test https://www.costco.com/covid-test.html only $130.

It’s a home saliva test that is sent to a lab, results in 24-48 hours after reception. Normal mail would take about a week, which is too slow for a covid test. Overnight is another $30-$40, so it gets pricey.

 

[braumeister]

The Costco home test https://www.costco.com/covid-test.html only $130.

It’s a home saliva test that is sent to a lab, results in 24-48 hours after reception. Normal mail would take about a week, which is too slow for a covid test. Overnight is another $30-$40, so it gets pricey.

Interesting. The Quest test is a nasal swab and includes a prepaid FedEx shipping label to return it to the lab.

 

[sengsational]

I think the Quest test is nucleic acid amplification, if I'm reading the search results right.

It's practical, if you're able to spend the money, and able to wait for results, to find out if you "have it" or "had it".

I think the technology needed is the "lateral flow assay" that's used in the Binax Now test, which is approved, but requires a CLIA approved lab, so although rapid, can't be done in your house and provide immediate results.

Another use that I just read about is to pull the most infectious people out of certain populations. This would be good for prisons, homeless communities, and prisons.

Here's an article [ https://www.ucsf.edu/news/2020/10/418761/rapid-covid-19-test-shows-promise-community-test-setting ] that lays out the proposition pretty clearly.

Comparison of PCR and BinaxNOW results from the same individuals showed that the rapid tests accurately identified 14 of 15 (93%) individuals who were most likely to be actively infectious, as measured by the high amount of virus detected in their samples by PCR; nearly half of these individuals were asymptomatic at the time of testing.
Eleven people with negative BinaxNOW test results were positive on PCR tests, though all had lower virus levels than those who tested positive in the rapid tests. These results illustrate that the tests do not clearly distinguish between uninfected people and people with lower levels of the virus, for example at the earliest or later stages of infection. The researchers recommend that persons with negative rapid test results who are at high risk or who come in contact with vulnerable populations such as the elderly or immune-compromised should get additional confirmatory tests, as there is still risk of spreading the virus.

 

[donheff]

Interesting study Sengsational. Binax picked up 99.3% of those likely to be contagious. In a location like ours with a 1.5% positivity rate I would jump on that to screen my family before Thanksgiving dinner. The likelihood of getting infected would undoubtedly be smaller than picking it up grocery shopping with masks.

These, or something like them, should be available over the counter at CVS.

 

[sengsational]

Home Test Using (only) your PHONE?

I'm all about instant results home tests. I don't care what the technology is, as long at it's cheap, available, and not encumbered by a bunch of inane bureaucratic rules that remove it from being useful.

How about a "listen to me cough" mobile app. I would never have thought this would work, and I'm still skeptical, but apparently some researchers at MIT are convinced that they have trained an AI model to pick-out asymptomatic Covid-19 carriers.

The following web page has a tidy 3 minute story about it. And you can read the transcript if you don't want to listen: https://soundcloud.com/mitnewsoffic...symptomatic-covid-19-infections/s-AYB8DA1YwW9

This high-level story is all I've studied about it so far (the paper is here: https://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=9208795), but it sounds like they haven't done a blinded RCT, which is going to have to be done to convince me (and more importantly, the big bad FDA).

The saddest part of the story comes at the very end when they say that they won't be able to release the app unless the FDA approves it. Great. Here we go again. One thing about code, though, is that it can be open source or it can "accidentally" escape. Then even if the app can't be distributed through the Play Store or App Store, it can be side loaded.

 

[donheff]

I want that app.

 

[sengsational]

I want that app.

Well, maybe in the mean time, you can cough for the advancement of science:

https://opensigma.mit.edu/

If you have a microphone on your device and go to that page and answer a few questions, it will prompt you to force a cough. In my experience, once it got one cough recorded, it relaxed for a few seconds, and automatically was recording again! So I coughed again, then stopped recording and quickly dismissed the page. I'm not sure exactly how I'm helping because if I'm asymptomatic positive, there's no way to link that information back, should I become positive in the next few days. But they do have REAL, active clinical trials in three hospitals.

If you want to read a small paragraph about it, you can look here: https://arxiv.org/abs/2004.06510
There's a link to a PDF with a bit more about the project.

 

[easysurfer]

MIT Working on App to Detect Asymptomatic COVID-19 Patients by Sound of Their Coughs

The brainy folks at MIT are working on an app that can detect asymptomatic COVID-19 patients by the sound of their cough. I'd must rather cough in my phone than get a swab up my nose.

Scientists have developed an artificial intelligence (AI) model that they say can distinguish asymptomatic COVID-19 patients from healthy individuals through their cough recordings, and show the results on a smartphone app.
Researchers from Massachusetts Institute of Technology (MIT) in the US found that people who are asymptomatic may differ from healthy individuals in the way that they cough.


These differences are not decipherable to the human ear, but can be picked up by artificial intelligence, they said.

The researchers trained the model on tens of thousands of samples of coughs, as well as spoken words.
When they fed the model new cough recordings, it accurately identified 98.5 per cent of coughs from people who were confirmed to have COVID-19.
This included 100 per cent of coughs from asymptomatics -- who reported they did not have symptoms but had tested positive for the virus, according to the researchers.
The team is working on incorporating the model into a user-friendly app, which if approved and adopted on a large scale could potentially be a free, convenient, noninvasive pre-screening tool to identify people who are likely to be asymptomatic for COVID-19, the researchers said.

https://www.ndtv.com/india-news/can...s-using-smartphone-scientists-say-yes-2317729

 

[sengsational]

I was interested enough to dig for the code...they said they would share it and the cough library with the public, but digging, they finally admitted they haven't published the code "yet"

 

[MrsHaloFIRE]

I still dont buy into their insistence that a "home test" (however you define) be MORE accurate than a "not at home test." Regardless of which test someone is given, it has no real impact on their behavior in the cases of people that are going to do what they are going to do and we are not going to put people on house arrest and monitor/punish those that violate. Its the folks that WOULD behave differently if given positive results that could really sway some positive counts because they WOULD isolate orrectly. And for those folks I think i good enough vice perfect at home test would be a very good thing. The THanksgiving gathering example is a perfect example. We are driving east for a long Christmas. WOuld love to spit in a tube a few days after we arrive and get the results in a couple days. THat would tell us to GTFO or go ahead and unmask and get close into my parent's bubble and rile them up for Christmas like olden times. So we are looking at keeping a distance from them for a good amount of burn time to let the virus present or not. Asymptomatic scares me as we are both youngish with robust immune systems so we COULD be some of those that never get symptoms but we could certainly jack my parents up.

 

[braumeister]

https://www.nytimes.com/live/2020/11/18/world/covid-19-coronavirus/the-fda-authorizes-the-first-at-home-coronavirus-test

From the NYT:

The Food and Drug Administration on Tuesday gave an emergency green light to the first rapid coronavirus test that can run from start to finish at home, paving a potential path for more widespread testing outside of health care settings.

The test, developed by the California-based company Lucira Health, requires a prescription from a health care provider. People under the age of 14 also can’t perform the test on themselves. But with a relatively simple nasal swab, the test can return results in about half an hour, and is projected by the company to cost $50 or less, according to the product’s website. Clinicians can also run the test on their patients, including children under the age of 14, potentially delivering answers during a single visit to a care center or pharmacy, instead of routing a tough-to-collect sample through a lab.