Public health officials in St. Lawrence, Jefferson and Lewis counties say that the increasing use of at-home rapid antigen COVID-19 tests is a positive development in the fight against the pandemic. But they’re sometimes hard to get and also skew a county’s positivity rate.
At-home testing also relies on an honor system — people who test positive are supposed to self-report results to their respective public health departments, which may not be happening 100% of the time.
Public health officials in the three counties agree that even though the at-home rapid antigen tests are less sensitive than a molecular PCR test, the antigen tests are still effective for fighting the COVID-19 pandemic.
“The advantage of the antigen tests is they can be done in the home, at what we call the point of care in a provider’s office, and the result comes back quickly and they’re inexpensive,” said Dr. Andrew F. Williams, president of the St. Lawrence County Board of Health. Dr. Williams is also associate chief medical officer at St. Lawrence Health, which owns and operates Canton-Potsdam, Gouverneur and Massena hospitals in St. Lawrence County.
“Currently at this point, they’re much more accessible than a PCR test. They give results quicker … if someone is symptomatic, it’s very likely an antigen test would pick up on it, rather than waiting for a PCR test coming back,” said Anna M. Platz, deputy director of Lewis County Public Health. “There’s many people testing regularly at home out of caution, which is wonderful.”
Anyone exhibiting symptoms of COVID-19 but testing negative at home should be careful. Rapid antigen tests are much more likely to show a false negative than a false positive.
“(At-home rapid antigen tests) tend to work well with people who have symptoms. And if they’re positive, we consider that a real result,” Dr. Williams said. “The risk with them is if somebody has symptoms consistent with COVID, but has a negative rapid antigen test, we recommend it be repeated with a PCR, or molecular test.”
“Positive tests are meaningful and help limit spread,” the doctor added. “Consulting a physician is always an option.”
Those who test positive with a rapid antigen kit at home are required to self-report to their respective county public health departments on the same day they test positive and await isolation orders.
“If they have a positive home test, we consider that a positive. They don’t need to get tested anywhere else,” said Stephen A. Jennings, Jefferson County public health planner. “Positive is positive.”
Due to the high transmission rates of COVID-19, it may take public health staff a day or two to get back to anyone self-reporting a positive antigen test. On Tuesday in St. Lawrence County alone, there were 250 new cases. Information on how to self-report a positive at-home rapid test is at the end of this story.
“If you have an at-home test that’s positive … please stay home and isolate yourself. Please hunker down and stay home,” Ms. Platz said.
Public health departments are swamped with the high number of people testing positive for COVID-19 with both at-home rapid antigen tests and molecular PCR tests. Officials believe most people are self-reporting, but there are concerns that reporting may not be happening 100% of the time.
“I’m concerned people may choose not to report a positive test to Public Health. They may be in denial they have the infection or they may be concerned about the potential consequences,” Dr. Williams said.
Mr. Jennings said Tuesday that Jefferson County has been “overwhelmed by people reporting their positives,” with “a huge number of positive cases over the last few days.”
“I would just say that we’re very grateful to our community members who are reporting these positive test results … we’ve seen a serious increase in cases over the last week,” Ms. Platz said Thursday.
At-home test kits tend to go out of stock quickly. Pharmacies, grocery stores and convenience stores that get shipments of the kits often sell out within a day. Some public health departments and school districts distribute them for free.
“The major push statewide has been schools, and getting tests into the hands of children and families,” Mr. Jennings said. “I’ve heard of shortages here and there … it seems to resolve and then be an issue again.”
Ms. Platz described the at-home tests as “an extremely hot commodity now.”
“I’d say once a store has a supply, they sell out quite fast,” she said. “I don’t think it’s too often stores have them in stock. You have to get them as soon as they come in.”
Rapid antigen tests skew any given county’s percent positivity rate. That number means the amount of total COVID-19 tests in a given timeframe that come back positive. For example, if a county has an 8% positivity rate for a given day, that means out of all the results returned that day, 8% of them were positive and 92% were negative. The skewed positivity rates occur because people are supposed to self-report a positive result, but aren’t supposed to report a negative result. Mr. Jennings said the real metric of COVID-19 prevalence in any given county is cases per 100,000 people.
“We don’t like that number (the percent positivity rate). There’s so many things that are not in that number. It’s an inaccurate percentage. It does not reflect all of the home tests,” Mr. Jennings said. “The best number to use is the positives per 100,000 population number.”
“We do get the positives reported to us every day, and it’s included in the daily report we issue, but it’s not reflected in the percent positive,” he added. “You’ve got to have those negatives in there too. And we’re not going to recompute.”
Fort Drum is also a factor skewing all COVID-19 numbers reported by Jefferson County — it’s not included in the county’s daily COVID-19 reports.
“In our county, (the daily report) does not reflect Fort Drum,” Mr. Jennings said. “The CDC numbers have everyone in it. States report to the CDC, and then the federal entities (like Fort Drum) report to the CDC.”
He said the CDC’s coronavirus tracker by county, at wdt.me/bCvEWT, shows true numbers for Jefferson County.
Anyone who is unvaccinated or needs a booster can contact their local public health department or local pharmacy to schedule initial vaccinations and booster shots. Officials maintain that vaccination is crucial to prevent COVID-19 transmission and severe illness if infected. People can learn more about vaccines from their health care providers.
“People need to get vaccinated, and they need to get boosted,” Mr. Jennings said. “If people aren’t boosted, they don’t have enough immunity (to COVID-19).”
To self-report a positive at-home antigen test in St. Lawrence County, go to wdt.me/FLv8HV and fill out the online form. Or, take a picture of your results and send the picture with your first initial, last name and test date by text message to 315-454-2363, or by email to SLCCOVID19SharedMailbox@stlawco.org. Those with no internet access can call Public Health at 315-386-2325.
To self-report a positive at-home test in Jefferson County, go to wdt.me/ZQJam5 or call the Public Health Service at 315-786-3730.
To self-report a positive test taken at home in Lewis County, go to wdt.me/p2MC9U or call Public Health at 315-376-5453.
Anyone testing positive should stay home, and if possible, away from other household members.