Millions of rapid at-home Covid tests are flying off pharmacy shelves across the United States, giving Americans an instant, if sometimes imperfect, read on whether they are infected with the coronavirus.
But the results are rarely reported to public health departments, exacerbating the longstanding challenges of maintaining an accurate count of cases at a time when the number of infections is surging because of the Omicron variant.
At the minimum, the widespread availability of at-home tests is wreaking havoc with the accuracy of official positivity rates and case counts. At the other extreme, it is one factor making some public health experts raise a question that once would have been unthinkable: Do counts of coronavirus cases serve a useful purpose, and if not, should they be continued?
“Our entire approach to the pandemic has been case-based surveillance: We have to count every case, and that’s just not accurate anymore,” said Dr. Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials, a national nonprofit organization representing public health agencies in the United States.
“It’s just becoming a time where we’ve got to think about doing things differently.”