In view of the second wave of COVID-19 that has put extreme pressure on diagnostic path labs, the Indian Council of Medical Research (ICMR) recently approved COVID-19 home testing using Rapid Antigen Tests (RATs). The self-use test can be used by symptomatic individuals and immediate contacts of confirmed cases as per the ICMR guidelines. Users of this test will not need sample collection by a healthcare professional. This will ease pressure on overburdened labs and reduce delays in testing. However, these tests should be done wisely and in lieu of the said COVID-19 norms.

According to the ICMR, individuals who test positive using the home testing kit may be considered as true positives, and no-repeat testing is required. All symptomatic individuals who test negative must get tested by RT-PCR, as RATs are likely to miss few positive cases. Md. Shakeel Ahmed, Head-Emergency Medicine, Fortis Hiranandani Hospital, Vashi, answers to IANSlife the commonly asked questions about home testing kits:

How does the home testing kit work?

Each kit provides all testing materials, instructions to use (IFU) leaflet and a biohazard bag to be safely disposed of after testing. The test is designed to be done using a nasal swab (not the deep nasopharyngeal swab) to reduce the discomfort. The kit is supposed to provide results in 15 minutes and people who test positive should immediately isolate so that they do not infect others, and quickly contact the local municipal bodies and their healthcare provider. Those who test negative and continue to experience Covid-like symptoms should seek follow-up care from their healthcare provider and conduct an RT-PCR test.

How do you when the result is positive?

The kit has a control line and a test line that will indicate the result. If both Control Line C and the Test Line T appear in the cartridge, the presence of novel coronavirus antigen is confirmed, and the result is positive. This takes up to around 15 minutes for results to appear.

How do you know when the result is negative?

If only quality Control Line C appears but the Test Line T does not appear, this indicates that novel coronavirus antigen has not been detected and the result is negative.

How do you know when the result is invalid?

For invalid results, if the quality control line C is not observed, it will be invalid regardless of whether there is a test line T. In this case, the test shall be conducted again.

What do positive results indicate?

Positive results indicate the presence of viral antigens. People who test positive with the home COVID-19 Antigen Test should self-isolate and seek to follow up care with their physician or healthcare provider for further action.

What are the possible disadvantages of these tests?

There could a possible discomfort while sample collection, if you do not do it correctly. Also, RATs have the tendency to interpret incorrect results. The other possibility is that people may test positive and resort to self-medication which could be harmful to them.

Are there any preparations to do before the test?

Firstly, it is important that you find a clean place to do the test.

• Identify a table and sanitise the surface thoroughly
• Wash your hands with soap, and make sure that your hands are dry before you perform the test
• Tear the pouch and lay the contents of the kit on the table
• Before you proceed with the test, please download the app mentioned in the testing kit, fill in the credentials and then proceed with the test. This is important so that no positive case is missed

Always remember that there are many factors that come into play when it comes to home test kits. These tests work best with people who have symptoms of COVID-19. If you test a little early or say if you are asymptomatic, most likely your test may show negative and that might give you a false sense of reassurance that this negative test means you are not transmissible, when you really could be. So, if you are sick, it is important to seek medical aid from your healthcare provider, and report the findings of the test to the local municipal body.