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Coronavirus

Here’s how at-home COVID-19 tests could be impacting Maryland’s data

In the coming weeks, millions of Americans will receive a set of at-home COVID-19 tests by mail, after a federal government order form launched Tuesday. The tests, while extremely useful, are part of the reason why coronavirus case tallies only represent a fraction of the virus’s true toll, experts say.

As in many states, at-home rapid test results aren’t included in Maryland’s daily coronavirus data dumps. But that doesn’t mean Marylanders should stop using them.

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“Testing by itself isn’t going to solve the pandemic, but testing can help people make better decisions, and having people have that diagnosis … to be able to make those decisions is seen as more valuable than the loss of data,” said Gigi Gronvall, an immunologist and senior scholar at the Johns Hopkins Center for Health Security.

Only PCR test results are included in the Maryland Department of Health’s reporting due to their greater sensitivity, said Andy Owen, spokesman for the department. So, even if at-home test takers dutifully reported their results through manufacturers’ websites with perfect consistency, the data wouldn’t appear on Maryland’s official COVID-19 site.

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Experts say the dearth of at-home testing data, while vexing, may be yet another indication that an intense focus on coronavirus case counts is misguided. Other metrics, such as hospitalizations and deaths, may be far better at telling the story of COVID-19, especially as many vaccinated people contract the highly contagious omicron variant of the virus, but don’t suffer severe symptoms because of the antibodies they have on board.

“Now, we might need to abandon those case counts,” Gronvall said. “We know that we’re undercounting to such a degree that we need to get better information from elsewhere.”

Perhaps that means beginning to rely on “sentinel surveillance” studies typically used for the flu, wherein specific health centers and physicians report data that’s used to track the incidence rate of particular diseases, Gronvall said.

Throughout the pandemic, health experts have assumed coronavirus case counts to be undercounts, partially because of inadequate testing. With at-home tests growing more popular, additional cases could be slipping through the cracks — if sick individuals choose not to seek PCR results that will be recorded as part of the state’s official tally.

Even with the increasing focus on un-reportable at-home tests, Maryland’s case counts have repeatedly set all-time records this winter — evidence of the omicron variant’s rapid spread.

Hospitalizations have also shattered records. About 3,000 Marylanders are hospitalized with COVID-19 — far more than last winter’s peak, when no more than 2,000 people were hospitalized with the disease at any one time. But it’s a decline from last week, when as many as 3,462 Marylanders were hospitalized with COVID-19 at once, indicating that omicron infections could be slowing.

Of the 1 million at-home tests Maryland Gov. Larry Hogan announced the state would distribute in November, about 495,000 had been sent out as of last week. On Jan. 6, the governor announced that Maryland was on track to receive another 500,000 at-home rapid tests in the coming days.

Last week, President Joe Biden announced that private insurance companies would be required to reimburse Americans for eight at-home COVID tests each month.

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Prior to the holidays, at-home tests where in particularly high demand, as residents sought peace of mind before family gatherings. In Baltimore, Enoch Pratt Free Libraries began offering the tests, and on the very first day, lengthy queues formed outside branches before they even opened. The vast majority of the tests were gone within a half-hour.

For Bel Air resident Chuck White, 55, taking an at-home COVID-19 test meant he could notify his co-workers about his positive result more quickly.

After he started to feel ill in early January, White visited the UM Upper Chesapeake Medical Center testing site near his home and took a PCR test. Because officials said getting his result could take about 48 hours, White decided to stop by a Walgreens store close by and look for rapid at-home tests. He’d heard they could be difficult to find, but he had a different experience.

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“They were right there in the door when I walked in,” he said.

He grabbed two kits, each with two tests inside, for about $25 each. The first kit was for him to use. The second may be saved for later.

“Both my son and my wife work at a grocery store, so they’re out there in that field every day. So having this little kit at home gives a little peace of mind,” he said.

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After he tested positive, White did not report his result to the manufacturer, but he did try and report his result through Maryland’s COVID Alert app — and begin to call his close contacts — as he isolated in his home’s spare bedroom.

Maryland health care professionals are hopeful that an increasing supply of at-home tests, and a recent uptick in testing sites, will help relieve some of the pressure on hospitals, which have seen sizable numbers of patients heading to emergency departments seeking testing without severe symptoms.

“With at-home tests still in short supply, and with most of the National Guard supported testing sites just launching this week, it’s too soon to say hospitals are seeing less testing traffic in emergency departments,” said Bob Atlas, president and CEO of the Maryland Hospital Association, in a statement. ”However, we are hopeful that expansion of testing resources will help ensure that medical teams at the hospitals can focus on those in need of lifesaving care.”

Even with more tests available of late, “the omicron variant of the coronavirus is so highly contagious that the sheer volume of demand will outpace supply for some time to come,” Atlas wrote.


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