As the number of home tests surges, questions arise about the accuracy of public COVID counts.

Millions of quick COVID tests at home pop out of the shelves of pharmacies across the country, allowing Americans to instantly (and sometimes incompletely) read whether they are infected with the coronavirus.

However, results are rarely reported to the public health sector, exacerbating the long-standing challenge of maintaining accurate case numbers during outbreaks due to Omicron variants.

At the very least, the widespread use of home testing has caused havoc in official positive rates and accuracy of case numbers. As another extreme example, it is one of the factors that raises questions that some public health professionals would never have thought of before. Does the number of cases of coronavirus serve a useful purpose? If not, do I need to continue?

“The entire approach to the pandemic was case-based monitoring. All cases need to be counted, but that’s no longer accurate,” said Chief Health Officer of the United States State and Community Health Officials Association. Dr. Marcus Precia, said. A non-profit organization that represents the public health agencies of the United States. “We are entering an era where we have to think about doing things differently.”

There is no comprehensive data on the number of rapid tests used daily, but experts say it is likely to be much higher than the number of polymerase chain reaction (PCR) tests completed in the lab. The PCR test requires more time to produce results. The results will be publicly reported as a total.

At least one home testing company has implemented a system to report results directly to health authorities. In addition, health departments in some areas have set up systems for people to report the results of rapid tests at home. However, such a voluntary system may not report millions of tests per day, says OraSure, a biomedical diagnostics expert at Arizona State University and a manufacturer of rapid COVID tests. Mara Aspinall, who also participates in the board of directors of, estimates. ..

“We certainly don’t want to discourage testing, but at the same time, we can’t blind public health authorities,” Aspinal said. “They are taking preventative and responsive precautions based on this information. It’s a very good balance.”

The surge in home exams can be a turning point in conversations that began for public health professionals a few months ago. The problem is the possibility of moving to infrequent case reports and “sentinel monitoring” systems such as those used by public health authorities to track other illnesses such as the flu. This is a virus, depending on the network of medical centers. The overall case numbers are estimated based on those case numbers.

There are also concerns about the accuracy of the test. The Food and Drug Administration said Tuesday that antigen testing detects Omicron variants, but is not as effective as detecting other variants.

Daily case numbers have played a central role in shaping the overall pandemic policy response. Cities have enacted mask mandates and closed schools and businesses, depending on the positive rate based on the number of cases each day. In New York City, the public school system was shut down when the positive rate reached 3%.

Public health authorities, and media outlets like the New York Times, continue to use daily case counts to portray the latest developments in the pandemic.

However, it has long been understood that the number of cases is artificially small due to limited access to tests and the prevalence of asymptomatic cases. And putting those numbers together is a labor-intensive task for the already tense public health sector.

As a result, many states have begun to shift from daily case counting to fewer reports per week during the summer as the number of cases declines. Some returned to more frequent reports when the number of cases returned. However, the state is aware that they cannot keep up with the Omicron variants that fuel the rapid surge in positive cases. And there is little motivation to try it, as there are so many cases that it has not been reported in home tests.

Dr. Marcelle Layton, Chief Medical Officer of the Legislature and Territorial Epidemiologist, said her organization was discussing the transition from daily case numbers with members. Several months. Her organization is also in contact with the Centers for Disease Control and Prevention for guidance that may direct the state to limit daily case reports. A CDC spokesperson said government agencies have no plans to change state reporting guidance.