In a new study, University of Colorado Boulder researchers found that if only one at-home test is available, the most accurate results for COVID start two days after the start of symptoms. For the flu and respiratory syncytial virus, however, it’s recommended to take a rapid test immediately after symptoms arise.
For COVID testing, the reason it’s better to wait a couple days before testing lies in how the rapid tests detect disease, and their surprisingly high false negative rate when used too soon. Rapid tests are built to detect those who are the most infectious, said Daniel Larremore, senior author of the study and a CU Boulder professor of computer science at the BioFrontiers Institute. So, if the amount of virus in a patient is relatively low — such as in the beginning stages of an infection, especially in someone who has built up an immunity — the rapid test may produce a false negative.
“If you think about who you care most about detecting, those who have the highest viral loads — the most virus inside of them — are really who we would prefer to catch, and rapid tests are still really highly linked to your infectiousness,” said Middleton. “Thinking about the population as a whole, if we can just catch those people who have the most virus, that can still be really productive for preventing transmission.
Assuming that enough at-home tests are available, the study also suggests that a “test to exit” strategy — in which people test again before determining whether to return to work and socialize — can prevent more COVID infections with less inconvenience than the five-day isolation policy that was standard Centers for Disease Control advice until March.
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