I'm glad they're offering these again, but in my experience covid tests have been pretty useless. I'm pretty sure I've had covid twice and despite daily testing I never actually tested positive, and talking to others they've had similar experiences.

I had been doing a poor job swabbing too shallow, and I wonder if that's also a significant contributor to false negatives. This video helped me a lot [0]. In brief: don't swab just the shallow, hairy skin of the nose, and don't swab upwards. Instead, go slow and go straight back perpendicular to your face about 2-3cm to get to the mucosa of the respiratory lining, twirl for 15 seconds. It helped to see this ENT surgeon do it slowly and calmly, while talking through it. He goes much deeper than I had ever done on my own.

0. https://twitter.com/DrEricLevi/status/1477057391212449793

Both times I've had it I did it pretty shallow in the front of my nose and it was really dark for me on the peak day, unmistakable, much darker whan the C stripe. The other 2-3 days I had it it was about the same color as the C stripe.

When you’re very infected then even the most casual of swabs will pick it up. The OP is instead addressing that doing it in the very front of your nose may not get sufficient viral load to detect lower levels of infection. This is doubly problematic when combined with different newer strains (omicron for example was a big step down in test sensitivity), for which tests are not as sensitive towards by virtue of being designed for the OG strain.

My technique is to actually swab the back of my throat, then as deep in my nose as I can tolerate - I’m usually actually running out of stick on the swab before it’s too deep for me. I figure I want to grab any possible trace of virus if it’s there and I’d far prefer a false positive that disappears a day later than a false negative.

Ever get a positive test like that? I've avoided jamming them in my throat because I don't want to get saliva up my nose, and have a nagging feeling that it'll mess with results.

I've usually blown my nose, spun the thing around the suggested distance up my nose, pull it out because I'm about to sneeze, then repeat that process until it has been up both sides for the suggested time. Usually needing to blow my nose out 2-6 times total, with a bell-curve amount of snot coming out across each time. Had it one time, and the first time I did it was the darkest I've ever seen a line on one of those tests.

I wish there were more cheap at home tests like these, for other stuff. The last tests I picked up were 2 for €4 in Lidl. I tried about as many different branded ones as I came across throughout the pandemic. Was neat to see the different approaches they used for packaging/documenting/labelling what amounted to a long swab, some buffer solution, and a tiny test strip.

The antigen tests definitely seem to be much less effective than they used to be. There are so many false negatives, it's not clear that the test has any value. Many people have covid symptoms, test negative, and then figure they're good to go visit grandma in the nursing home or whatever, when the symptoms alone are probably a more reliable guide.

We use molecular (Lucira) home tests, which are much more sensitive, and even those have given us very inconsistent and confusing results on two separate occasions.

One thing that has helped anecdotally among my family and friends of mine is to do use a throat swab, and first thing in the morning before you eat or drink anything. A number of times, many other tests were negative, but that one was positive.

Antigen tests, on their box, usually say that if you test positive (there's enough virus to turn the strip, it's most likely correct.

But if you test negative, it doesn't guarantee it's actually negative -- since there are so many factors that could have led to that negative result (insufficient virus, early in the infection, incorrect swabbing, reagent expired).

This is explicitly stated on the box, so it's not "useless". During the early days of COVID, the antigen test is also a cheaper, faster "statistical" filter since full PCR tests are more expensive and less scalable. It's actually doing what it's meant to do.

The negatives can't really be trusted, but if they say you've got it, you've got it.

The home tests are still useful, if for no other reason than because a lot of people cannot get a test at all, or can't get one unless they have symptoms.

My insurance company is like that. At one point in the last year I'd recently been with someone who tested positive two days later, and while I felt fine, I wanted a test before visiting a highly vulnerable relative and was told the test would be entirely out of pocket since I wasn't feeling sick. People who can't afford a PCR out of pocket can at least try several at home tests for some piece of mind.

> The negatives can't really be trusted, but if they say you've got it, you've got it.

All of these tests have a non-zero false positive rate, they're not definitive proof that you have COVID.

It is vanishingly small relative to the false negative rate. It’s safe enough to say that if a test says you have it, you can act as if you it.

The "act as if you [have] it" really depended on your government's policy at the time.

I live in the Netherlands, and during the height of the COVID scare here and in the EU you needed e.g. a negative test taken days before every flight, before attending a concert etc.

So even if the false positive rate was say 0.05% that's for each individual test.

But that quickly adds up. I think I did on the order of 50 tests during COVID.

If your spouse needs the same that's a 0.05 * 50 * 2 = 5% chance that one test during that period was a false positive.

Which could be a relatively life-changing event, e.g. the difference between a nice holiday, and being locked up in a quarantine hotel for weeks on arrival.

There were other ways those relatively small false positive numbers could cascade upwards, e.g. policies recommending that if anyone you've recently met had COVID, you should also quarantine.

Why would you act differently when you're experiencing symptoms but the test is negative, if you know the negative is (relatively) highly likely to be "false"? And why would you test if you're having no symptoms? To me it is a very definition of useless test - neither positive nor negative add anything to decision making.

> And why would you test if you're having no symptoms?

It's useful in cases where you know you've been recently exposed to the virus. You can test yourself and avoid becoming an asymptomatic spreader.

If you, feeling fine, test positive for the virus then you know to stay away from everybody. You may be able to get a PCR to confirm at that point, but even if you can't, you can be confident (especially if multiple at home tests come back positive) that you're infected and act accordingly. You can contact your doctor, you can watch yourself closely for developing symptoms, you can isolate.

If you test negative after repeated tests in that situation, it's still not super comforting because false negatives are so high, but if you can't get a proper test due to your lack of symptoms the at home tests are the best indication that you've dogged a bullet that you're going to get. Maybe be careful to mask up when you go out just to be safe, but at that point you can be somewhat sure (as sure you can be) that you aren't going to get everyone around you infected.

That's pretty far from ideal. Ideally, anyone could just get a free PCR test, but it's way better than nothing and nowhere near useless.

I agree through, if you have symptoms it's best to assume the worst even if the home test is negative and see a doctor for a PCR in case it is covid or for a diagnosis and treatment in the event that it isn't.

Lots of people will do a covid test, or more than one, if they know they spent significant time close to someone with covid. If positive, they can then take measures to keep their family and others from getting sick.

I'm in the same boat I think. I never had COVID, even after taking PCR tests when I was feeling ill. (I have CF, so respiratory infections are common, so entirely possible it was something else)

Best one was the day my wife was diagnosed just before a minor surgical procedure. That day we went and received 15-minute PCR tests (the kind you'd get if you were traveling): I was negative and she was confirmed as positive. I can only assume I had it at one point and still had "natural" immunity. (We were both previously vaccinated, and her COVID case was very mild)

Every single human on earth has had COVID, multiple times. Its just that 90% of the people who "have COVID" never even know they have it, it's THAT MILD of a disease. I wonder how many years/generations it will take for people to accept the truth around COVID.

The whole reason it was such a difficult disease to contain was because so many people were asymptomatic. That doesn't mean it's a "mild" illness overall. Plenty of people with tuberculosis don't have symptoms, would you call that a mild disease?

What are your sources for this?

This paper[0] suggests 94% at the end of 2022. At this point it’s probably closer to a 100%. Technically it’s “at least once” though not “multiple times”. Other papers only cite 25-50% asymptomatic cases since Omicron so not quite 90% but still quite high

[0] https://www.medrxiv.org/content/10.1101/2022.11.19.22282525v...

Thanks for sharing. I’m admittedly very bad at reading papers like this, but I can’t determine how they are getting to that figure.

I’ve never tested positive, despite having been repeatedly tested (at home and PCR), due to the nature of my situation. I do believe, though, that I have probably had it, even if the tests never showed it, because how could I not have?

They modeled it mathematically using something called “Bayesian evidence synthesis”. It’s a popular method assessing disease rates, war casualties, etc when there’s limited “hard data” available

The VAST majority of people who have/had covid have no idea they have/had it. For 3 years it seems we were all trying to ignore this one simple fact. People still even joke about, "not knowing how I've avoided COVID this long". We have ALL "had COVID" multiple times. Testing at all is at best security theater but is literally a fools errand. COVID testing has not and will not ever save a single life.

Back in 2020, the US Navy published a study that told us everything we needed to know about covid: They found that over 90% of sailors who tested positive were asymptomatic. With only 1% testing positive in random checks, a mere 10% of those showed ANY symptoms and none had any major complications.

It's clear now that the mass hysteria was baseless. We had the facts, but it seems some people just wanted a reason to freak out for a couple years.

1. [Source](https://www.google.com/amp/s/amp.cnn.com/cnn/2020/11/11/heal...)

I’m sure plenty of people had it with no symptoms, but over a million people in the US died from it. I don’t think baseless is the right term here.

In my experience: when I had COVID symptoms and took one of these it was positive. So was my partner.

I think at the end of the day these aren't going to be perfect but if you combine it with a personal evaluation (do I feel sick, are people that were near me sick) it gives you better decision making than just playing dumb.

Pretty useful if you get a positive though

Complete waste of taxpayer money to line the pockets of big pharma.

Hug disservice to Americans as the false negatives actually are fueling a new wave! So many people around me are with COVID-19 and it's not symptomless "thanks" to the new variants. Yet, PCR tests now don't seem to be covered by insurance... unless you have HMO, I guess.

Why for goodness sakes would I ever take a COVID test again much less because I have the sniffles. It's a contagious disease much like the flu. It's part of life, the vast majority of people get over it, and it will probably always be with us now.

Why? Because it's not the flu! You don't have to die immediately from COVID-19 - you can die 2-3 years later from a heart attack, a stroke, kidney failure, and God knows what else. SARS-CoV-2 infects cells in various organs and tissues unlike the influenza virus. It damages your immune system, which could lead to cancer, autoimmune disease, and so on. There's no long-flu, but there's long covid, which is affecting more and more people. I have long covid and it's no joke - massive hair loss, palpitations up to several per minute, poor sleep, headaches, etc. I had no symptoms when I had covid back in April. In fact, I did a few PCR and antibody tests, and they were all negative, but I caught I had it when I did a antibody tests for the entire family. Then I realize what those problems were caused by! 99.9% of people do no test, do no do antibody tests, and worse of all - do not care. Suddenly they say "oh, I suddenly got a heart problem." Yeah, suddenly. Not! Every reinfection accumulates damage. Again and again, this is not the flu and stop comparing it only because it has respiratory symptoms! Many, many, many other diseases have flu-like symptoms! It's the long-term damage that's important, not if you die immediately or not!

USPS has mailed me countless tests and I have thrown them in dustbin. Not sure why taxpayer money is being wasted on this crap. As long as tests are available at reasonable price in the market, only poor people should be getting them from government and even there relying on local city administration is ideal.

This USPS business looks like scam to me.

I don't understand, I thought you had to take initiative to order them? At least that's what I've done... I've never received them unprompted.

I, too, have never received them unprompted. And, at least in my experience, they don’t eventually send them unprompted, because I never requested them and never received them, as I had another source.

I never wanted this tests and never requested them, in fact I have no idea how to tell USPS to send me those. It is possible that is a simple form ? Good chance that either someone entered my address incrorrectly or local USPS has some target they need to meet.

> countless

Maximum allotment was 4

> USPS has mailed me countless tests

You only received them by explicitly filling out and submitting a request form.

> Maximum allotment was 4

I have lost the count already because it is not worth my mental cycles to actually wont them. This is 4 tests one time or several boxes 4 times ?

> You only received them by explicitly filling out and submitting a request form.

Never did such a thing. In fact HN is the first time I am finding out such form exists.

I am glad that the postal service has chosen to release commemorative post-pandemic covid tests, it will be nice to display on my mantle as a reminder of the time past in which covid was a serious health concern for the country.

There is a note saying the tests may be expired, but it's ok because the FDA extended the expiry date. I wonder who lobbied to have that date extended, in my experience it is incredibly difficult to get the FDA to revisit things like this. Someone (Maybe USPS?) must have over ordered and didn't want to throw the extras away.

No this is normal. When you introduce a new diagnostic test, part of the approval process is that you have to run an aging study on the reagents/test cartridge.

The normal procedure is to set some of the tests aside when they first come off the production line. Typically every six months, you run a new study to validate that the tests you set aside still work. If they do, you can file an amendment to your approval to extend the expiration date. If this weren't allowed, you'd have to wait to bring your test on the market for two years or however long you wanted the shelf life to be.

The US military has a program to grade the efficacy of "expired" medication.

The generous version is that it's only feasible for a company to make a guarantee of efficacy to a point and the cynical version is that people will buy more as long as the expiration is some economically tolerable length. The .MIL has enough to make the efficacy tests worthwhile.

https://www.fda.gov/emergency-preparedness-and-response/mcm-...

> I wonder who lobbied to have that date extended

According to the FDA, the manufacturers are doing ongoing stability testing, and as they find the tests are still effective after the date they initially estimated, they can contact the FDA to share their results and request that the FDA authorize a longer shelf life. This actually costs the manufacturer money since they'd be paid when people replaced the "expired" product they threw away, but they're doing it anyway because not everything is a weird conspiracy (and maybe also because the most shelf stable products have an advantage when it comes to what people order for their stockpiles)

Is it any more serious than flu/rhino/other corona/strep/RSV/noto/rota/adeno/etc?

Why are there no tests being offered for all the other airborne viruses?

There are plenty of Flu Type A, Flu Type B, and COVID-19 combo tests, but they are useless for COVID-19 based on my experience.

My testing facility offers optional RSV testing as well.

I meant offered for free. All the other tests cost $150 to $250 at an urgent care, and I am not sure you can get them without the blessing of a doctor/NP/PA.

It's really pathetic how expensive the tests are here in America with the same equipment and materials! In Bulgaria, for example, I paid 80 BGN, which is less than $60, for a less-than-24-hours PCR test. Quantified antibody tests (for both IgM and IgG) using Abbott's latest equipment are less than $20. There's also a T-cell test, showing previous infection without the presence of antibodies, which costs around $100. First, you can't get decent antibody tests in America even if the tests are American-made. Also, no T-cell tests are available either and I'm sure the equipment is also American-made!

Yeah it still is unfortunately. Also good question.

> What are you gonna do with a positive anyway, call out of work? They don't have sick leave.

This is why I don't do indoor dining when community spread is high/climbing. I'd love to give local businesses more money, but since they don't let their workers stay home when they're sick, I can't trust that the restaurant workers aren't diseased. If I had faith that employees could call in sick without risking losing their job and/or getting evicted I'd feel a lot more comfortable having a night out.

> Most of the people I know with "real jobs" don't test anymore.

Just curious what you consider a “real job”?

A job you don't do from the computer. It's not a value judgement just a covid-risk one.

Useless tests - PCR only works for the new variants. Even Lucira [0], which got acquired by Pfizer and kinda discontinued, is still useless.

[0]: https://www.lucirapfizer.com/

Nonsense. I am currently positive as a result of a lateral flow test. It was a useful means of confirming what I had was indeed Covid (the dry cough was pretty tell-take) and so to take appropriate actions.

They are absolutely not without significant fault and there doubtlessly countless false negatives giving people ideas they can go out when sick (stay home, Covid or not!). However it’s not fair to say that “PCR only works”.

I did what CDC and the tests mandates - 3 consecutive days of tests. We had 1 person, got 3 negative tests, then other people got it from her relying on the triple-negative result. We thought she had tonsillitis as she had no other symptoms, but then after she infected 2 other older people, their symptoms were worse. A couple weeks later, the antibody tests showed BAUs up to the roof!

So, yeah, if you really want a meaningful and actionable test, which can limit the spread, it's the PCR. The rest could work after the fact being spread to everybody around you already. At the end of the day, this is the most contagious virus known to science!

May I ask, what are the appropriate actions which would be different or not appropriate at presence of the same symptoms sans positive test result?

I have several coworkers sick with Covid who showed positive on the at-home tests, this is simply false.

Which brands? You can't put all tests in one bucket. I'm talking about Lucira and the one supplied by the government. We had 3 people in the family with COVID this summer, later proven by an antibody test showing 9,000 BAUs, all tests during first, second, and third day of symptoms were negative and, trust me, we get very good samples, so, it can't be blamed on poor sample-taking!

Lucira used to work on first day of symptoms with Delta and the first Omicron variant. After that, it stopped working! For Omicron, I was doing a PCR test for my wife every other day. And daily antibody test. Her antibody test was positive on a the third day of symptoms for just 1 day!!! Useless crap! When you're symptomatic, and recovered, what's the point of this test?! You've already spread the virus to everybody around you!