Positive COVID-19 Test Result... Now What?

A recent study published in The JAMA Internal Medicine shows that people using SARS-CoV-2 virus home test kits may fail to self-quarantine or quarantine unnecessarily because they misinterpret the implications of test results.

Researchers at Dartmouth, Carnegie Mellon University, the University of Pittsburgh, and the Lisa Schwartz Foundation for Truth in Medicine, revealed on January 31, 2022, that following a positive test result, the vast majority of participants appropriately said that they would follow the U.S. CDC's quarantine recommendations, regardless of which instructions they received.

But given a negative test result in the high-risk scenarios, a substantial proportion of participants said that they would not quarantine appropriately.

In the highest risk scenario, the people proportion inappropriately failing to quarantine was higher with the authorized instructions (36%) than with the intervention (4%) or with no instructions (21%).

In the low-risk scenario, the proportion choosing unnecessary quarantine was also higher with the authorized instructions (31%).

Although COVID-19 at-home test kits provide results within 30 minutes, they are less sensitive.

As a result, they have more false negatives than polymerase chain reaction (PCR) tests, with an estimated clinical sensitivity of 70%.

"I think our results show how fundamentally important it is to design and pilot-test instructions to ensure that they can be understood by as many users as possible—to increase the benefits and reduce the harms from at-home self-test kits," commented lead author Steven Woloshin, MD, MS, a professor of medicine, community and family medicine, and of The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine, in a related press statement issued on Jan. 31, 2022.

"In other cases, they may quarantine unnecessarily because they misinterpret the implications of their test results."

The research was funded by the Swedish Foundation for Social Sciences and Humanities, the Agency for Healthcare Research and Quality Comparative Health System Performance Initiative, and the S&R Foundation's Kuno Award for Applied Science for the Social Good. No industry conflicts of interest were disclosed.