You just tested yourself for COVID-19. Should you report the results to L.A. County?

The most recent surge in COVID-19 infections in California could surpass final winter’s tidal wave, well being officers say. And judging by wastewater checks, infections could also be much more widespread than the official numbers point out.

One purpose is that some individuals’s signs are so delicate that they don’t search remedy and even get examined. However one other important issue often is the giant variety of individuals utilizing at-home checks and never reporting the outcomes.

“Residence testing results in marked underestimates of case numbers,” Dr. Robert Wachter, chair of UC San Francisco’s Division of Medication, stated in an electronic mail. “Clearly many a whole lot of hundreds of individuals are actually diagnosing themselves with optimistic dwelling checks (typically plus signs), and these usually are not reported.”

Some check kits advise you to name your healthcare supplier. Others need you to make use of the check maker’s app.

The issue, although, is that the healthcare system frowns on user-generated check outcomes — native well being officers prioritize high quality over amount in relation to information. In Los Angeles County and plenty of different jurisdictions, there isn’t any method for individuals to report the outcomes from store-bought dwelling checks.

“COVID-19 surveillance continues to be based mostly on outcomes from laboratory testing,” not self-tests, the Facilities for Illness Management and Prevention says on its web site. Though information about new instances assist public well being companies as they attempt to gradual the unfold of COVID, “the general public well being group, together with CDC, is assured that situational consciousness stays sturdy with out receiving self-test outcomes.”

So what do you have to do after you’re taking a check? If it comes again optimistic, well being officers say, it’s best to isolate at dwelling, alert the individuals with whom you’ve been in shut contact and inform your healthcare supplier. The L.A. County Division of Public Well being has a hotline so that you can name — (833) 540-0473 — you probably have questions, want referrals or want assist in notifying your shut contacts. (Instances columnist Robin Abcarian just lately known as the hotline and reported a clean, useful course of.)

A spokeswoman stated the Public Well being Division “shall be documenting and interviewing people who do name us with optimistic outcomes.” However the division doesn’t need to be contacted about damaging check outcomes.

So the extra individuals check themselves with the free kits equipped by the federal authorities or the boxed checks offered in pharmacies, the much less the official numbers about new infections and positivity charges (that’s, the share of checks that detect the virus) will present an correct image of the general public’s well being.

That’s not essentially a nasty factor — it’s only a cautionary notice in regards to the information we depend on as we chart a path by means of the pandemic.

Why there are undercounts

Consultants say there has all the time been a disconnect between reported coronavirus case counts and the reality. As a result of many individuals who catch the virus expertise few or no signs, many infections go unreported.

Equally, check positivity charges are usually inflated, as a result of the individuals most certainly to indicate up at a testing middle are those with COVID-like signs. Giant organizations that require all members to be examined recurrently invariably have decrease positivity charges than websites that check solely individuals who assume they may be sick.

Testing extra individuals extra usually, as a variety of different developed nations do, might assist determine outbreaks and restrict their unfold. However for a wide range of causes, a rising reliance on at-home fast check kits could not assist public well being officers of their battle to trace and perceive the pandemic.

There are a variety of conditions which may immediate individuals to check themselves. The CDC suggests taking a self-test “you probably have COVID-19 signs or have been uncovered or probably uncovered to a person with COVID-19.” (The signs to look out for, the company says, embrace fever or chills, cough, shortness of breath, fatigue and sore throat.)

One other good time for a self-test, the company advises, is earlier than gathering with people who find themselves at better danger of being contaminated, reminiscent of those that are unvaccinated, aged or have weakened immune programs. Or possibly you need to attend an occasion that requires proof of a damaging check.

Well being officers typically usually are not together with dwelling check ends in confirmed case counts. One purpose is that low-cost fast checks are antigen checks, whereas clinics and county check facilities use polymerase chain response, or PCR, checks, that are higher at detecting infections of their early phases. Then there’s the query of whether or not individuals testing at dwelling are doing so accurately or reporting the outcomes precisely.

“Verification of outcomes is a large problem” for fast at-home checks, stated Gigi Kwik Gronvall, a senior scholar on the Johns Hopkins Middle for Well being Safety. After some preliminary mixups, states are actually reporting any antigen check outcomes they accumulate individually from PCR outcomes, Gronvall stated.

How a lot do undercounts matter?

Dr. Sara H. Cody, Santa Clara County’s well being officer and public well being director, agreed with Wachter that the brand new infections reported by well being officers every day are “an undercount.” However that is probably not as large a disadvantage as it could have been at first of the pandemic.

Again then, Cody stated, well being officers “adopted each case so rigorously” as a result of “it actually, actually mattered in our understanding of the pandemic and informing our coverage selections.” However now, she stated, “we’re in a spot within the pandemic that’s fairly totally different.”

Wachter, Cody and different well being specialists stated policymakers’ focus has been shifting away from case counts to different metrics, reminiscent of hospitalizations and positivity charges. Granted, positivity charges are thrown off by the exclusion of at-home check outcomes. However Cody stated it’s nonetheless significant to have an apples-to-apples comparability of optimistic check charges over time.

Regardless of the info points they create, at-home antigen checks are an vital complement to PCR checks, Cody stated. They alert individuals who must isolate and “cut back the possibilities that they will go on and infect others, which is vital broadly to public well being.”

Moreover, the L.A. County Public Well being Division says, coronavirus case counts aren’t as significant because the traits they reveal.

“As is true with many reportable ailments, the reported numbers have by no means captured all instances,” a spokeswoman stated. “However they’ve offered pattern strains for us to higher perceive what is occurring and to contribute to modeling what’s prone to be probably the most correct numbers.”