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Recently, before a date, I asked my partner to take a COVID test using one of my rapid molecular test kits. Despite feeling completely fine, he tested positive. The next day, he became severely ill. Interestingly, the rapid antigen test he took that same evening showed a negative result.
No matter your perspective on the health risks of COVID, it remains a significant inconvenience, often resulting in missed workdays. Using a home molecular test spared me from this hassle—and potentially worse outcomes. Relying solely on a rapid antigen test or skipping testing altogether could have left me ill.
Despite efforts to move past COVID, this summer recorded the highest case numbers since 2022, with a winter surge imminent. In the US alone, nearly 10,000 people lost their lives to COVID in the last three months. While the pandemic has shifted to an endemic phase, the CDC warns that risks persist. Globally, approximately 400 million people suffer from long COVID, with symptoms varying from mild to severely disabling, regardless of age or prior health. Long COVID cases are also overwhelming healthcare systems. Masking and testing remain the most effective tools to prevent COVID. However, with the closure of local PCR testing centers, accessing PCR tests has become costly and challenging. This underscores the importance of at-home testing kits.
Although many consider COVID tests to be similar, there’s a significant distinction between standard at-home antigen tests and PCR or other molecular tests. Nearly five years into the pandemic, it’s crucial to recognize why molecular tests are the preferred choice for accurate results.
Understanding the Difference Between Molecular ("PCR") and Rapid Antigen Tests
The typical at-home COVID test—such as those you can request for free from the government—is a rapid antigen test. When these tests first became available, they were a game-changer, helping individuals identify infections and isolate to prevent spreading. Most at-home tests are lateral flow tests, or rapid antigen tests (RATs), which detect proteins on the surface of SARS-CoV-2. However, they have a critical limitation: they only identify active virus. If you’re asymptomatic or have a low viral load, a RAT might return a negative result even if you’re infected and contagious.
This is why a negative antigen test isn’t definitive if you’re already showing symptoms. You might need to test multiple times to confirm a COVID diagnosis. In the early stages of illness, it can take up to five days for the viral load to reach levels detectable by a RAT. These tests are designed for repeated use over several days.
Molecular tests, however, detect RNA and can identify even trace amounts of the virus. Lab-conducted PCR tests are a form of molecular testing and are regarded as the “gold standard” for COVID detection. The at-home tests I’m referring to are also molecular but use a different technology, known as NAAT (nucleic acid amplification tests). Their process and accuracy are comparable to PCR, which is why they’re often labeled as "home PCR tests."
These tests are typically reliable starting one to three days before symptoms appear. Until recently, PCR tests required a visit to a testing center, but advancements in home NAAT tests have introduced four rapid, at-home molecular COVID tests that deliver results within 30 minutes.
The Ongoing Importance of COVID Testing
Society is now split between those who treat COVID as a routine part of life and those who, due to chronic conditions, weakened immunity, prior infections, or age, cannot risk exposure. For years, COVID testing was seen as a personal health measure, but home molecular testing offers a simple way to safeguard vulnerable individuals without isolating them from society.
Even if you’re not worried about others, protecting yourself from repeated infections is essential. While the risk of dying from COVID has decreased significantly thanks to vaccines, treatments, and natural immunity, the media has largely overlooked the dangers of long COVID. With multiple infections, the odds of developing long COVID increase, with estimates ranging from one in 10 to one in five cases. COVID is now recognized as a vascular disease, affecting blood vessels throughout the body. This explains why long COVID symptoms vary widely, from severe fatigue and migraines to numbness, loss of taste and smell, and even neurological and cardiovascular issues.
Although many no longer bother testing for COVID, there are compelling reasons to confirm an infection. First, treatments like Paxlovid are only effective if taken within the first five days of symptoms. Antivirals like Paxlovid reduce viral load, which may help prevent long COVID. Second, since long COVID can affect anyone, a positive test result may be necessary for insurance claims, benefits, or validating sick leave in the future.
Finally, testing is essential because identifying COVID can be challenging. Symptoms range from headaches, body aches, and fever to congestion, fatigue, sore throat, vomiting, diarrhea, and loss of taste or smell—essentially any unusual health change. While rapid antigen tests (RATs) are unreliable for safe social interactions, molecular tests can confidently determine if someone is safe to enter your home or be in close contact. This makes molecular tests a valuable tool for helping immunocompromised individuals reintegrate into society and ensuring safer multigenerational gatherings.
How to Access Molecular/PCR Testing
Beyond home testing, your primary options are urgent care clinics and travel testing centers, both of which can be costly. Urgent care facilities may expose you to other sick individuals, and with masking no longer mandatory in healthcare settings, you risk contracting COVID there if you don’t already have it. Thankfully, molecular (PCR-quality) tests are now available for at-home use.
Rapid molecular tests are as easy to use as RATs. You’ll swab yourself and insert the sample into a device that provides results. Currently, only four brands offer these tests: Lucira, Metrix, 3EO, and PlusLife. Unlike RATs, these tests must be ordered, though Metrix and Lucira are available on Amazon, and Walgreens carries Lucira tests in select locations. Initially, their high cost limited their use to movie sets, law firms, and tech companies, but prices have dropped, making them more affordable—now as low as $10 per test. Here’s a breakdown of your options.
Lucira Check It COVID-19/Flu A&B Test
Cost: $39.99 for a single-use testAvailability: Amazon and WalgreensAccuracy on positive samples: 97%Accuracy on negative samples: 99%Pros: A major advantage of the Lucira test is its disposable hub, which comes with the test, making it perfect for group settings where everyone can test simultaneously. It also detects flu alongside COVID. Cons: Its specificity and sensitivity (accuracy) are slightly lower compared to other tests, and at $39.99, it’s pricier than alternatives.
Lucira was among the first at-home molecular tests and was updated last year to include flu detection. It’s user-friendly, requiring only a few steps. First, insert the provided batteries into the disposable testing hub immediately before starting the test to avoid errors. Like other tests, you’ll swab your nose, mix the sample in a liquid vial, and then snap the vial’s lid shut. After 30 minutes, the hub’s lights indicate a positive or negative result.
Aptitude Metrix COVID-19 Test and Reader
Cost: $24.99 per test, plus a one-time $49.99 fee for the reusable readerAvailability: Amazon (tests are in stock, reader is out of stock) and Aptitude WebsiteAccuracy on positive samples: 97%Accuracy on negative samples: 99%Pros: A dependable test with excellent accuracy, often available for quick restocking via two-day shipping on Amazon. Cons: Assembling the test components can be challenging for individuals with mobility issues or arthritis. Only one person can be tested at a time, with 30-minute intervals between tests, and the reader requires a power source.
The Metrix test consists of two components: a reusable hub purchased separately and a disposable test cartridge. After collecting a nasal sample with the provided swab, you break off the swab’s end and attach it to a liquid-filled compartment. This assembly is then connected to a test slide and inserted into the hub, which must remain plugged in during the 30-minute testing process. Results are displayed once the test is complete.
While the Metrix test can technically use saliva instead of a nasal swab, its accuracy significantly decreases with saliva. Most reported errors occur when saliva is used as the sample.
3EO COVID-19 Test
Cost: $195 for the reusable reader and 2 tests; additional tests cost $20 eachAvailability: 3EO WebsiteAccuracy on positive samples: 95%Accuracy on negative samples: 100%Pros: One of the simplest tests to use, especially for individuals with mobility issues or arthritis, offering accuracy comparable to Metrix and PlusLife. Cons: Only available directly from the manufacturer, the reader cannot be purchased separately, and the overall cost is higher than other options. The reader requires power and can only test one person at a time, with 30-minute intervals between tests.
The 3EO test uses a reader similar to other tests but simplifies the process with fewer components. After collecting a nasal sample with a shorter, more manageable swab, you place the swab into a small vial, insert the vial into the reader, and push until it snaps. Press the reader’s button and wait 30 minutes for the result.
PlusLife COVID-19 Test
Cost: $310 for the reusable reader; tests are sold in packs of 10 for $79.20. Discounts are available for immunocompromised individuals.Availability: Altruan WebsiteAccuracy on positive samples: 99%Accuracy on negative samples: 100%Pros: With a cost of $10 or less per test over time, it’s the most affordable option for long-term use. Offers high accuracy and a reader that connects to a website for real-time, detailed results. Cons: Only available through Altruan, and it hasn’t received U.S. authorization. The initial cost of the hub is high, and the testing process is one of the most complex. Only one person can be tested at a time (a more expensive eight-person reader is available), and the reader requires power.
It might seem unusual to recommend a test purchased from Europe with a costly reader and a complicated process. However, due to its exceptional accuracy, the ability to verify results online, and the low cost per test (under $10 when buying in bulk, even with shipping), PlusLife has developed a significant following in the U.S., especially among frequent testers. European countries prioritized affordable and accessible testing, and while this test isn’t officially authorized in the U.S., it’s approved in Europe, can be imported, and has been used in several U.S.-based studies.
To perform the test, insert a plastic card with a screw-top lid into a dock and place a vial of liquid beside it. After collecting a sample with a swab, immerse it in the liquid and remove it. Attach a dropper lid to the vial and carefully fill the card, ensuring the liquid stays between two marked lines. Secure the cap, press it down, shake the card, and insert it into the reader. You can then connect to the accompanying website via Bluetooth or USB using your phone or laptop to view real-time results.
An earlier version of this article described these at-home tests as PCR tests. This article was updated on 11/12/2024 to clarify that these are molecular tests, not necessarily PCR tests, though they share similar methods and accuracy levels with true PCR tests.
