NYC's At-Home COVID Positives Go Unreported And Unsupported

 After a series of cases at his school, a sore throat and a feeling of tightness in his chest, Alex Jallot, a Manhattan special education teacher, was sure he’d contracted COVID-19. He took a rapid test at home in his Harlem apartment on Christmas Day, and sure enough, it was positive.

So, he called the city-run Test and Trace hotline, 212-COVID19, hoping to share the news with contact tracers. Of the many options the hotline offered—a directory of testing sites, resources for long COVID, help with isolation—none allowed him to report his positive test.

He called back a few more times and was never able to declare his case.

“I haven’t been able to get in contact with anybody,” he told WNYC/Gothamist. “It just feels like you’re very much on your own, which is super terrifying.”

About 100,000 New Yorkers are being officially screened for COVID each day at testing sites throughout the five boroughs, according to data from the New York City Department of Health and Mental Hygiene. That’s more than at any other time during the pandemic.

But long testing lines and turnaround times have prompted many people to opt for at-home antigen tests. The problem is those tests are not being counted in the city’s case and positivity data, obscuring an unknown number of infections. And this health care gap leaves those who test positive to largely fend for themselves at home.

While a positive result at a testing site triggers a cascade of responses from the city — calls from contact tracers, information on best isolation practices and links to medical services — those who test positive at home have to seek those out themselves.

“There are people who need help isolating, and it’s not easy to connect them to resources unless the system knows about them,” said Dr. Denis Nash, an epidemiology professor at the City University of New York. Nash noted that he didn’t expect the at-home tests to significantly affect the quality of the city’s COVID data, since it is likely already undercounting cases.

Other municipalities have approached the problem of tallying at-home tests differently. In Western New York, the Monroe County Department of Health provides an online form for self-reporting. Inhabitants of California’s Fresno County can simply call a hotline. And Washington, D.C. residents who test positive can choose between an online form and an add-on to the pre-existing mobile phone exposure notification system that allows them to report their results.

New Yorkers, meanwhile, have to try their luck on the hotline.

“I was kicked around like a soccer ball from one end of the field to the other,” said one Queens resident of their experience calling 212-COVID19 after testing positive at home. (They asked that their name not be shared because they are applying for jobs.) Between time spent waiting on hold and countless transfers, they spent about two hours on the phone, they said. The closest they got to concrete advice was the suggestion to report the test result to their doctor, who could then share it with the city.

Adam Shrier, a spokesperson for Test and Trace, said that the impact of at-home testing on COVID surveillance was “minimal” and that the convenience and accessibility of the tests outweigh any downsides.

“While the city will not be notified of every positive at-home test, New Yorkers will have the information they need to break chains of transmission,” he said.

Shrier confirmed that the best thing to do if you test positive at home is to let your doctor know, start isolating and inform anyone you’ve been in close contact with over the past two days. He added that people who test positive at home can still call 212-COVID19 (212-268-4319) to get food assistance or a free hotel room for their isolation period.

https://gothamist.com/news/nycs-home-covid-positives-go-unreported-and-unsupported