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State’s COVID-19 cases lower than actual number as at-home tests go unreported

When someone does a coronavirus test at home, it's not usually reported to the state.

INDIANAPOLIS — At-home COVID-19 tests are a hot ticket item, and major retailers like CVS and Walgreens can’t keep them on their shelves lately.  

“Right now, we are limiting one test per person,” said Julie Acra at Blue River Pharmacy.  

Testing sites aren’t any different. Every day, hundreds of cars line up to wait for an appointment.  

“I can tell you we’ve been busier than we have ever been. We’ve been conducting about 500 tests a day,” said Monica Heltz, director of Fishers Health Department.  

Heltz said when a test is done through a health department, pharmacy or a proctored home test with a lab, those results are reported to the state. 

But when someone does their own test at home, it isn't usually reported. 

“You are responsible for reporting it yourself, and most people don’t do that,” Heltz said.  

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Some states have started online forums or websites for people to submit positive results, but right now, Indiana doesn’t have anything set up.  

“Even if results were reported, there is no way to confirm that each test was performed correctly and provided an accurate result," a state department of health spokesperson said. "Given the increased number of at-home tests being used, we know our number of reported cases is lower than the actual number.” 

That means COVID cases are likely higher than what’s being reported, especially after the recent demand for rapid tests around the holidays - but it is difficult to determine by how much.  

RELATED: Indiana State Health Department discusses new CDC guidelines for schools

“That will probably skew our numbers a little bit here, both this week and into next week,” said Dr. Brian Dixon with the Regenstrief Institute.  

Since there is no way to self-report, Dixon said it helps when people get a follow-up PCR test, which he expects will happen more often when people get back to work after the holidays.  

“If you go in to get a PCR test as a follow-up to that at-home antigen test, at that point if you are positive, it will be reported to the state health department,” Dixon said.  

As home tests continue to gain popularity, health departments are still encouraging quick results, but are also rethinking how they measure the virus. 

“The more that COVID becomes endemic and the more accessible these home tests are, the more we are going to have to use some extrapolating to guess at the true burden of infections,” Heltz said.  

On Tuesday, data from the Food and Drug Administration suggested at-home antigen tests might not be great at detecting the omicron variant. The early data suggest the tests can still detect the new strain but are less sensitive to it. That’s because the antigen tests work best when someone is most contagious, and omicron is known to have milder symptoms.  

“So that might be another reason to select the PCR test. Most of the labs are turning those around in a day or two,” Heltz said.  

Heltz said if you have symptoms and tests negative at home, it’s a good idea to test yourself again a day or two later to be sure.

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