At-Home Respiratory Tests: What to Know This Cold and Flu Season
This winter, hospitals across the country, including emergency departments and urgent care clinics are seeing higher-than-usual numbers of patients with respiratory symptoms. Influenza (flu), COVID-19 and other seasonal viruses are driving a surge in illness, with national health data showing flu-like visits at levels not seen in decades and hospitalizations continuing to rise.
As a result, many patients and families are turning to at-home respiratory tests as a first step in understanding their symptoms. With more testing options available than ever before, it's natural to wonder how accurate these tests are and how best to use them.
To help answer these questions, we spoke with Frank Osborn, MD, primary care physician and Chief Medical Officer, Tufts Medicine Integrated Network, who shares what you need to know as respiratory illnesses spread.
What kinds of at-home tests are available?
There are two main types of at-home respiratory tests:
- Rapid antigen tests: These tests detect proteins from viruses such as SARS-CoV-2 (COVID-19), influenza (flu) or other respiratory viruses. Results are typically available within 10–30 minutes.
- Molecular tests: These tests detect the virus's genetic material and are generally more sensitive. Some molecular tests now provide results at home, while others require mailing a sample to a lab.
Some kits test for a single virus, while combination tests can check for multiple infections such as COVID-19 and flu using one nasal swab.
Where can I buy at-home tests?
At-home tests are widely available through:
- Pharmacies and drug stores
- Big-box retailers
- Online retailers
- Some health system or insurance programs
COVID-19 and flu tests are sold without a prescription. In addition, some public health programs offer free COVID-19 testing kits that can be mailed to your home. Check official sources like COVIDTests.gov for current availability.
How do I know if the test I'm buying is credible?
Choose a test that is:
- Authorized by the FDA for home use
- Clearly labeled with instructions and an expiration date
- Made by a reputable manufacturer
Avoid expired tests as accuracy may decline over time. If you're unsure, the FDA maintains a searchable list of authorized at-home tests.
How accurate are at-home tests?
Accuracy depends on the type of test, how it's used and when during the illness it's taken.
- Rapid antigen tests provide quick results but are less sensitive than lab tests and may miss infections, especially early on or in people without symptoms.
- Molecular tests, including some at-home versions, are more accurate and closer to lab-quality results.
- Newer combination tests that detect both flu and COVID-19 are highly accurate when used correctly.
Tip: If an antigen test is negative but symptoms continue, repeating the test about 48 hours later can improve accuracy.
How do I use an at-home test?
Each kit includes detailed instructions, but general steps include:
- Wash your hands thoroughly.
- Use the nasal swab to collect a sample from inside your nose.
- Insert the swab into the test device or solution as directed.
- Wait the specified amount of time, usually 10–30 minutes, for results.
Tip: Read all instructions before starting. Improper sample collection can lead to unreliable results.
How long does it take to get results?
- Rapid antigen tests: About 10–30 minutes
- Home molecular tests: Some provide results in under an hour, while others require mailing the sample to a lab with results taking one to several days.
What should I do with the results?
If your test is positive:
- Assume you likely have the virus detected.
- Stay home and avoid contact with others to reduce spread.
- Contact your doctor for guidance, especially if you're at higher risk for complications.
If your test is negative but you have symptoms:
- A negative result does not always rule out infection.
- Consider repeat testing or talk with your doctor about whether lab-based testing is needed.
Do I need to follow up with a doctor?
Yes, especially if:
- Your symptoms worsen or don't improve
- You have chronic medical conditions
- You're pregnant, immunocompromised or over age 65
Your clinician can recommend further testing, treatment options or supportive care.
When should I seek urgent care or visit the Emergency Department?
Seek immediate medical attention if you experience:
- Trouble breathing or shortness of breath
- Persistent chest pain or pressure
- New confusion or difficulty waking up
- Bluish lips or face
- Severe dehydration or dizziness
These symptoms may signal a serious complication that requires emergency care
Are there limitations to at-home testing?
Yes. At-home tests:
- Do not detect all respiratory viruses such as RSV, which often requires clinic-based testing
- May miss infection early in the course of illness
Bottom line
At-home respiratory tests are convenient and useful tools especially when used correctly and combined with medical guidance. They can help you make early decisions about isolation, care and next steps during cold and flu season. However, they should not replace professional medical evaluation when symptoms are severe, persistent or worsening.
Think your sniffles might be something more? Tufts Medicine's Symptom Checker can help you find out what's causing your symptoms and help you get the right care.
