Answers to your questions about COVID-19 self-tests

As more self-test kits become available in our community, it’s getting easier to test for COVID-19 quickly at home. Tests are important tools to help us detect infections and isolate from others, if necessary, to control the spread of the virus.

Here are answers to some of your most frequently asked questions about self-tests:

When should I use a self-test?

Consider testing yourself and your family in the following situations:

  • If you have symptoms of COVID-19 like a cough, fever, or sore throat
  • If you have been near someone who ended up having COVID, even if you don’t have symptoms. In this case it is good to test 5-7 days after exposure.
  • Before returning to work or school in person after an extended absence or school break, according to the organization’s guidelines
  • Before family gatherings, parties or events, especially if there will be unvaccinated children, older individuals, or people who are immunocompromised or at risk of severe disease
  • After large events like sporting events and faith-based services
  • After travel

Self-tests are most accurate when you test twice if you get a negative result. Take a second test 24-72 hours after the first. If either test is positive you should consider yourself infected.

How do I use a COVID self-test?

Self-tests are easy and convenient to do at home. For accurate results, follow the box instructions carefully, which may vary by brand. Click on the name of the self-test below to see a video demonstrating how to use it:

BinaxNOW

A video demonstration of a BinaxNOW COVID-19 self-test. This video is available in other languages here.

FlowFlex

A video demonstration of a FlowFlex COVID-19 self-test. Video available in multiple languages here.

iHealth

A video demonstration of an iHealth COVID-19 self-test. Video available in Spanish here.

How accurate are self-test results?

When testing instructions are followed correctly, self-tests are very good at detecting a high viral load of COVID-19, which is when someone is likely contagious. If you receive a positive result, you can be very confident in that result and should isolate.

Self-tests are most accurate when used serially. So if you get a negative result, we recommend taking a second test 24-72 hours after your first test. That’s because the accuracy of a negative result depends on many factors, such as how long after exposure you take the test and how much virus is in your system at that time. Make sure you test at least 5 days after exposure and follow instructions on the box to get the best chance of an accurate reading.

More questions on COVID self-tests:

You can buy self-tests from many retail stores and pharmacies. Some local community health centers, community based organizations or libraries in your area may also be providing kits at no cost.  

As of January 15, 2022, private insurance companies are required to cover the cost of up to 8 self-tests per person, per month. Contact your insurance company to understand the process. Washington Apple Health (Medicaid) patients can receive up to 12 free self-tests per month. Make sure the pharmacy you go to accepts Apple Health coverage as no reimbursements are allowed. 

Some federal and state programs are also offering households free self-test kits. Availability comes and goes, so check back if the tests have run out: 

  • COVIDtests.gov - a federal program offering 4 free tests, shipped directly to your home 
  • Say Yes! COVID Test - a state program through Washington's Department of Health 

If you test positive, you should isolate at home, away from others, for at least 5 days, even if you don't have any symptoms. Inform your healthcare provider as well as close contacts. Follow isolation and quarantine guidance to learn when it’s safe to be around others again and consider reporting your result to the self-test report line at 1-800-525-0127 (Language assistance is available, just speak the language you need when the call is answered). If you absolutely have to be in contact with others, including other people living with you at home, make sure you wear a well-fitting mask of the highest quality you can find.

If you test negative, that means that the test did not currently detect the virus in your system. However, this doesn't mean that you don't have COVID-19. If you swab too soon after an exposure, you may test negative even though you do have the virus - you just don't have enough for the test to be able to detect it. Swabbing on day 5 after exposure will give you the most likelihood of accurate results.

You should repeat the test within 24-72 hours if this is indicated by the package instructions for your test. Flowflex tests are approved for single use and so follow up tests are not required. However, regardless of which test you are using, taking tests serially increases the accuracy of the tests and reduces your risk of transmitting COVID to others.

There are two possibilities: you may have something else that is giving you similar symptoms, such as a cold or flu. Or you may have COVID but you don't have enough virus in your system yet to be detected by a self-test.

Take another self-test within 24-72 hours. You can also choose to get a PCR test done, which is more sensitive. If you get a negative self-test result and a subsequent test is positive (whether it’s a PCR or a self-test), trust the positive result and follow isolation guidelines.

You are not required to report your positive result, but we strongly encourage you to do so. WA state residents can report their results confidentially by calling the state's COVID hotline at 1-800-525-0127. Language assistance is available; speak the language you need when the call is answered.

Make sure you tell your close contacts that you tested positive so that they can get tested, too. If you are reporting to work onsite or in an office, you should let your manager and human resources representative know. If you have a child test positive who normally goes to school or daycare, you should let the institution know.

You can throw away used self-tests in your regular garbage. Just make sure no one else touches the testing materials, especially if you have tested positive. To be safe, you can wrap the used test in another bag before throwing it in the trash.

Self-tests are usually antigen tests, while most testing sites use PCR tests. They are both useful in different ways.

PCR tests are performed in a lab or clinic and can take 1-3 days for results to be available.

They are more sensitive because they can detect even very small amounts of virus. That means a PCR test may be able to tell if you're infected earlier than a self-test, but it is also more likely to say you are positive well after you are no longer infectious.

Antigen tests (such as self-tests) are cheaper and faster - they usually take about 15 minutes to perform, and can be done at home. They are less sensitive, so you need a larger amount of the virus to test positive. That means you may test negative on a self-test even if you have COVID-19, such as at the beginning of your illness when you don't yet have a lot of virus in your body. Self-tests are most accurate when used serially, such as taking a second test 24-72 hours after the first.

An antigen test is your best bet at telling you when it's safe to come out of isolation. PCR tests can give positive results for up to 12 weeks or more and may detect virus particles long after your infection has passed.

This varies and you should check with your employer, school or child care. The Washington State Department of Health and Public Health - Seattle & King County are currently advising schools, child cares, and employers to accept both PCR and self-tests due to access issues.

Self-tests are not currently acceptable as proof of negative COVID status for travel. They also can’t be used for entry to restaurants and events.

For travel, look for rapid testing options that specialize in travel testing, as Public Health testing sites can’t guarantee results back in time for your trip. Check with your country of entry and airline to understand the policy for submitting documentation. If you've recently recovered from COVID, your test result may still come back positive and you should instead submit a document certifying a previous infection.

For more information on self-testing, visit kingcounty.gov/selftest.

Originally published on February 9, 2022.