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What Can the United States’ Recent COVID-19 Self-Test Data Tell Us?

In a recent Morbidity and Mortality Weekly Report (MMWR) Researchers, published on the United States Centers for Disease Control and Prevention (US-CDC) website, summarized data collected by users of 10.7 million Coronavirus Disease 2019 (COVID-19) self-tests between March 31 and March 30, 2019. October 2021 and June 11 themselves. 2022.

The researchers compared this data to CDC data for approximately 360 million point-of-care (POC) nucleic acid amplification tests (NAATs), antigen tests, and laboratory-based tests during the same period.

Study: COVID-19 Self-Test Data: Challenges and Opportunities - United States, October 31, 2021-11.  June 2022. Photo credit: r.classen/Shutterstock
Study: COVID-19 Self-Test Data: Challenges and Opportunities – United States, October 31, 2021-11. June 2022. Photo credit: r.classen/Shutterstock

background

Self-testing has proven useful for anyone looking for convenient ways to test for COVID-19 and reduces the risk of onward transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through timely diagnosis of cases. However, the obligation to report all self-test results to health authorities could negatively impact self-test acceptance and use, which would be detrimental to minimizing the spread of SARS-CoV-2.

About the study

In the present study, researchers analyzed US COVID-19 self-test data collected between October 31, 2021 and June 11, 2022 to assess three key metrics:

1) weekly test volume;

2) seven-day mean percentage of positive test results; and

3) Overall coverage of socio-demographic variables, including age, gender, and ethnicity.

study results

During the study period, data from four COVID-19 self-test kit manufacturers represented 15.3% of all self-tests conducted in the United States, for a total of 393.4 million self-tests. During the same period, users voluntarily reported results from just 10.7 million self-tests via manufacturer websites or mobile applications, likely reflecting a small fraction of the number of self-tests used. In comparison, the number of laboratory-based POC NAATs and POC antigen tests reported through the COVID-19 Electronic Laboratory Reporting (CELR) system was much higher. There were 276,257,710 laboratory-based and 85,670,213 POC NAATs and antigen tests.

The authors experienced the peak of all test types in the week ended January 8, 2022. The highest percentage of positive laboratory and POC-NAAT results and self-tests were 29.1% and 17.3%, respectively.

However, in the weeks ending November 6, 2021 and April 23, 2022, there were 1,947 and 14 times more laboratory and POC NAATs than self-reported testing, respectively. POC antigen testing peaked at 19.8% in the week of January 1, 2022.

Study analysis showed that the NAAT data were robust and tracked trends in community transmission. On the contrary, the increase in self-tests led to an underreporting of the total number of cases. It is notable that more severe COVID-19 cases are more likely to use an NAAT when seeking help; Therefore, it made sense to focus national surveillance efforts on these cases. In addition, other types of surveillance data provided evidence of other aspects, such as B. Burden of disease, indicators of severity, demand for healthcare providers and disproportionately affected populations.

Interestingly, US surveillance activity for the COVID-19 pandemic has been robust, covering data from multiple sources. It included case monitoring, laboratory testing, syndrome monitoring, and data from genomic testing. In addition, the monitoring activities of the entire government used the school, sewage monitoring, vaccination and health data.

Conclusions

Overall, the current study highlighted that the limited amount and quality of data reported to the CDC from self-tests reduced its ability to expand existing surveillance. Apparently, there has been an underreporting of cases throughout the COVID-19 pandemic, most likely due to the lack of formal mechanisms allowing self-testing to be reported to public health officials and asymptomatic COVID-19 infected individuals who did not receive further support from the sought health care.

Public health professionals should continually evaluate self-test data for inclusion in future surveillance models. This would help improve their use for surveillance in future public health emergencies. Additionally, people using self-tests should be encouraged to report the results to healthcare providers, who can ensure they receive additional counseling and medical care if needed.

Future studies should examine how and to what extent self-testing replaces other testing modalities. In addition, these studies should examine what factors influence the decision to report self-test results, whether or not people who test positive by self-test self-isolate, and their treatment history. Above all, it should also be investigated whether or not they confirm their self-test results with laboratory-based tests.

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