You simply examined your self for COVID-19. Should you report the outcomes to L.A. County?

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

One purpose is that some folks’s signs are so gentle that they don’t search therapy and even get examined. But one other important issue would be the massive variety of folks utilizing at-home exams and never reporting the outcomes.

“Home testing leads to marked underestimates of case numbers,” Dr. Robert Wachter, chair of UC San Francisco’s Department of Medicine, mentioned in an electronic mail. “Clearly many hundreds of thousands of people are now diagnosing themselves with positive home tests (generally plus symptoms), and these are not reported.”

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

The downside, although, is that the healthcare system frowns on user-generated take a look at outcomes — native well being officers prioritize high quality over amount relating to knowledge. In Los Angeles County and plenty of different jurisdictions, there isn’t a method for folks to report the outcomes from store-bought residence exams.

“COVID-19 surveillance continues to be based on results from laboratory testing,” not self-tests, the Centers for Disease Control and Prevention says on its website. Although knowledge about new circumstances assist public well being companies as they attempt to sluggish the unfold of COVID, “the public health community, including CDC, is confident that situational awareness remains strong without receiving self-test results.”

So what do you have to do after you’re taking a take a look at? If it comes again constructive, health officials say, you must isolate at home, alert the folks with whom you’ve been in close contact and inform your healthcare supplier. The L.A. County Department of Public Health has a hotline so that you can name — (833) 540-0473 — if in case you have questions, want referrals or want assist in notifying your shut contacts. (Times columnist Robin Abcarian lately known as the hotline and reported a clean, useful course of.)

A spokeswoman mentioned the Public Health Department “will be documenting and interviewing those that do call us with positive results.” But the division doesn’t need to be contacted about damaging take a look at outcomes.

So the extra folks take a look at themselves with the free kits equipped by the federal authorities or the boxed exams offered in pharmacies, the much less the official numbers about new infections and positivity charges (that’s, the share of exams 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 observe in regards to the knowledge we depend on as we chart a path via the pandemic.

Why there are undercounts

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

Similarly, take a look at positivity charges are typically inflated, as a result of the folks more than likely to point out up at a testing heart are those with COVID-like signs. Large organizations that require all members to be examined repeatedly invariably have decrease positivity charges than websites that take a look at solely individuals who assume they may be sick.

Testing extra folks extra usually, as a variety of different developed nations do, may assist establish outbreaks and restrict their unfold. But for quite a lot of causes, a rising reliance on at-home fast take a look at 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 folks to check themselves. The CDC suggests taking a self-test “if you have COVID-19 symptoms or have been exposed or potentially exposed to an individual with COVID-19.” (The symptoms to look out for, the company says, embrace fever or chills, cough, shortness of breath, fatigue and sore throat.)

Another good time for a self-test, the company advises, is earlier than gathering with people who find themselves at larger danger of being contaminated, corresponding to those that are unvaccinated, aged or have weakened immune systems. Or perhaps you need to attend an occasion that requires proof of a damaging take a look at.

Health officers typically usually are not together with residence take a look at leads to confirmed case counts. One purpose is that low-cost fast exams are antigen exams, whereas clinics and county take a look at facilities use polymerase chain response, or PCR, exams, that are higher at detecting infections of their early levels. Then there’s the query of whether or not folks testing at residence are doing so appropriately or reporting the outcomes precisely.

“Verification of results is a huge issue” for fast at-home exams, mentioned Gigi Kwik Gronvall, a senior scholar on the Johns Hopkins Center for Health Security. After some preliminary mixups, states are actually reporting any antigen take a look at outcomes they accumulate individually from PCR outcomes, Gronvall mentioned.

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.” But that is probably not as huge a downside as it could have been firstly of the pandemic.

Back then, Cody mentioned, well being officers “followed every case so carefully” as a result of “it really, really mattered in our understanding of the pandemic and informing our policy choices.” But now, she mentioned, “we’re in a place in the pandemic that’s quite different.”

Wachter, Cody and different well being consultants mentioned policymakers’ focus has been shifting away from case counts to different metrics, corresponding to hospitalizations and positivity charges. Granted, positivity charges are thrown off by the exclusion of at-home take a look at outcomes. But Cody mentioned it’s nonetheless significant to have an apples-to-apples comparability of constructive take a look at charges over time.

Despite the information points they create, at-home antigen exams are an necessary complement to PCR exams, Cody mentioned. They alert individuals who have to isolate and “reduce the chances that they are going to go on and infect others, which is important broadly to public health.”

Besides, the L.A. County Public Health Department says, coronavirus case counts aren’t as significant because the traits they reveal.

“As is true with many reportable diseases, the reported numbers have never captured all cases,” a spokeswoman mentioned. “But they have provided trend lines for us to better understand what is happening and to contribute to modeling what is likely to be the most accurate numbers.”

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