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Wed, 13 Jul 2022 09:51:00 -0500 en text/html https://ung.edu/learning-support/placement-test-practice.php
Killexams : How to Use practice exams to Study for the LSAT No result found, try new keyword!Likewise, it’s a bad idea to take the LSAT without first training with real practice tests. That said, very few athletes run daily marathons. Instead, they vary their training with shorter ... Tue, 01 Nov 2022 19:56:00 -0500 text/html https://www.usnews.com/education/blogs/law-admissions-lowdown/articles/how-to-use-practice-tests-to-study-for-the-lsat Killexams : Liver Function Test

SOURCES:

American Liver Foundation: “Liver Function Tests.”

KidsHealth: “Blood Test: (Liver) Hepatic Function Panel.”

Mayo Clinic: “Cirrhosis,” “Hepatitis B,” “Liver Function Tests.”

Royal Society of Chemistry: “Enzymes.”

World Health Organization: “What Is Hepatitis?”

Lab Tests Online: “Liver Panel,” “Tips on Blood Testing.”

University of Rochester Medical Center: “D-Dimer.”

American College of Gastroenterology: "ACG Practice Guideline: Evaluation of Abnormal Liver Chemistries."

Cleveland Clinic: “Tests to Diagnose Gallstone Disease.”

Thu, 17 Nov 2022 10:00:00 -0600 en text/html https://www.webmd.com/hepatitis/liver-function-test-lft
Killexams : A team of researchers goes through the most common questions about COVID-19 rapid tests

As fall temperatures set in, cold and flu season gets into full swing and holiday travel picks up, people will undoubtedly have questions about COVID-19 testing. Is this the year people can finally return to large gatherings for traditional celebrations? What role does testing play when deciding whether to go out or stay home?

Adding to the confusion are personal accounts of people who are experiencing confusing or seemingly contradictory test results.

We are part of a team that has developed and tested SARS-CoV-2 tests since the early days of the pandemic. Additionally, some of us are infectious disease specialists with decades of experience.

Our insights from both the cutting edge of rapid testing research as well as our clinical perspectives from working directly with patients can help people figure out how to make the best use of rapid tests.

Multiple negative tests, then a positive — why?

SARS-CoV-2, the virus that causes COVID-19, takes time to build up in the body, like many other viruses and bacteria that cause respiratory illness. Typically it takes two to three days to test positive after exposure. Our research group has demonstrated this, as have others.

Rapid tests detect parts of the virus that are present in the sample collected from your nose or mouth. If the virus has not replicated to a high enough level in that part of your body, a test will be negative. Only when the amount of virus is high enough will a person's test become positive. For most omicron variants in circulation today, this is one to three days, depending on the initial amount of virus you get exposed to.

Why do some people test positive for extended periods of time?

It's important to clarify which type of test we're talking about in this situation. Studies have shown that some people can test positive for a month or more with a PCR test. The reason for this is twofold: PCR tests are capable of detecting extremely small amounts of genetic material, and fragments of the virus can remain in the respiratory system for a long time before being cleared.

When it comes to rapid tests, there are reports that some people test positive for an extended period of time with the current strains of the omicron variant compared with earlier variants. Several studies show that most people no longer test positive after five to seven days from their first positive test, but between 10% to 20% of people continue to test positive for 10 to 14 days.

But why it takes longer for some people to clear the virus than others is still unknown. Possible explanations include a person's vaccination status or the ability of one's immune system to clear the virus.

In addition, a small number of people who have been treated with the oral antiviral drug Paxlovid have tested negative on rapid antigen tests, with no symptoms, only to "rebound" seven to 14 days after their initial positive test. In these cases, people sometimes experience recurring or even occasionally worse symptoms than they had before, along with positive rapid test results. People who experience this should isolate again, as it has been shown that people with rebound cases can transmit the virus to others.

Why do I have COVID-19 symptoms but still test negative?

There are several possible explanations for why you might get negative rapid tests even when you have COVID-like symptoms. The most likely is that you have an infection of something other than SARS-CoV-2.

Many different viruses and bacteria can make us sick. Since mask mandates have been lifted in most settings, many viruses that didn't circulate widely during the pandemic, like influenza and Respiratory Syncytial Virus, or RSV, are becoming common once again and making people sick.

Second, a mild COVID-19 infection in a person that's been vaccinated and boosted may result in a viral level that's high enough to cause symptoms but too low to result in a positive rapid test.

Finally, the use of poor technique when sampling your nose or mouth may result in too little virus to yield a positive test. Many tests with nasal swabbing require you to swab for at least 15 seconds in each nostril. A failure to swab according to package instructions could result in a negative test.

Our previous studies show that if you are symptomatic and do two rapid antigen tests 48 hours apart rather than just one, you are more highly likely to test positive if you are infected with SARS-CoV-2.

Do rapid tests work against the current strains of SARS-CoV-2?

Multiple studies have examined the performance of rapid tests against the omicron variant.

Fortunately, these studies show that all the rapid tests that have been authorized for emergency use by the U.S. Food and Drug Administration detect the current omicron variants just as well as previous variants such as alpha and delta. If a symptomatic person tests positive on a rapid test, they likely have COVID-19. If you are exposed to someone who has COVID-19, or have symptoms but receive a negative test, you should take another test in 48 hours. If you then test positive or if your symptoms get worse, contact your health care provider.

What's the best way to use and interpret rapid tests before gatherings?

Testing remains an important tool to identify infected people and limit the spread of the virus. It's still a good idea to take a rapid test before visiting people, especially older people and those with weakened immune systems.

If you believe you may be infected, the FDA recently updated their testing guidance largely based on data our lab collected. The testing regimen most likely to identify if you're infected is to take two tests 48 hours apart if you have symptoms. If you don't have symptoms, take three tests, one every 48 hours.

Does a positive test mean you can spread COVID to others?

The Centers for Disease Control and Prevention recommends that if you test positive for COVID-19, you should stay home for at least five days from the date of your positive test and isolate from others. People are likely to be most infectious during these first five days. After you end isolation and feel better, consider taking a rapid test again.

If you have two negative tests 48 hours apart, you are most likely no longer infectious. If your rapid tests are positive, you may still be infectious, even if you are past day 10 after your positive test. If possible, you should wear a mask. Multiple studies have shown a correlation between the time an individual tests positive on a rapid test and when live virus can be collected from a person, which is a common way to determine if someone is infectious.

Testing is still an important tool to keep people safe from COVID-19 and to avoid spreading it to others. Knowing your status and deciding to test is a decision that individuals make based on their own tolerance for risk around contracting COVID-19.

People who are older or at higher risk of severe disease may want to test frequently after an exposure or if they have symptoms. Some people may also be thinking about having COVID-19 and transmitting it to others who may be at higher risk for hospitalization. When combined with other measures such as vaccination and staying home when you're sick, testing can reduce the impact of COVID-19 on all of our lives in the coming months.


Nathaniel Hafer, Assistant Professor of Molecular Medicine, UMass Chan Medical School; Apurv Soni, Assistant Professor of Medicine, UMass Chan Medical School, and Yukari Manabe, Associate Director of Global Health Research and Innovation Professor of Medicine, Johns Hopkins University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Fri, 11 Nov 2022 13:28:00 -0600 en text/html https://www.salon.com/2022/11/11/19-rapid-tests-can-breed-confusion--heres-how-to-make-sense-of-the-results-and-what-to-do/ Killexams : Do Covid-19 tests expire? Here’s the truth about the home kits

If you stocked up on at-home Covid-19 rapid antigen testing kits during one of the Omicron-variant surges, you could be in for a surprise when you bust them out for a pre-holiday test: an expiration date months in the past. According to the Food and Drug Administration, most at-home Covid-19 tests list an expiration date between four and six months from when they were manufactured.

Does that mean those expired tests no longer work? Here’s why the expiration date printed on the box isn’t as straightforward as you might expect.

When does my at-home, rapid test Covid test expire?

The reason the answer to “when does my at-home Covid test expire?” isn’t as straightforward as, say, when the yogurt in your fridge expires has to do with the tests’ relative novelty. The tests have only been approved for two years, and crucially, the testing they underwent before hitting the market happened in just one year. If the FDA wanted to determine the maximum length of time the test was effective before putting it on the market, it would have had to delay those tests for years.

What it did instead is take a more conservative approach: authorizing a shelf-life of four to six months and then extending the expiration date as real-world data was compiled.

In an email, a spokesperson for the California Department of Public Health told Inverse that “since initial approval, most tests have had specific extensions issued by the FDA because test companies have presented information to the FDA showing the tests work well for a longer period of time.”

How can you tell if your test still works? In January of this year, the FDA released a list of updated expiration dates for different at-home rapid Covid-19 tests.

For example, BinaxNOW rapid Covid-19 tests manufactured by Abbott have been given an updated shelf life of 15 months, as have iHealth rapid tests. FlowFlex rapid tests manufactured by ACON Laboratories have been given a shelf life of 19 months. You can find a full chart of the FDA’s updated shelf-life and expiration dates for different rapid tests here.

California’s Department of Public Health has gone even further, authorizing the use of at-home rapid tests past the FDA’s extended expiration date. Their guidance now says you can use the tests as long as the control line is “both easily visible and the color specified by the specific test instructions” after the 15-minute test-development window. In other words, if you take an expired test and the control line shows up clearly, you can consider that result as valid as an at-home rapid test that isn’t expired.

How to prolong the shelf-life of your at-home rapid Covid-19 test

A longer than initially anticipated shelf life of at-home Covid tests doesn’t mean your tests will necessarily last that long. Like medication, proper storage of Covid tests will prolong their shelf life.

If the test is exposed to very hot or cold temperatures, it will degrade faster than if it’s kept at more stable temperatures. According to the FDA, “test performance may be impacted if the test is used while it is still cold, such as being used outdoors in freezing temperatures or being used immediately after being brought inside from freezing temperatures, or in a hotter than expected environment, such as outside in the summer.”

To perform as expected, manufacturers assume the test is being performed in an environment that is roughly between 59 and 86 degrees Fahrenheit. If the test is delivered to you when it’s very hot or cold outside, the FDA advises bringing the test inside and leaving it at room temperature for at least two hours before using it.

If you’re not sure if the test is still good, the FDA suggests taking the test. “As long as the test line(s) appear as described in the instructions, you can be confident that the test is performing as it should. If the line(s) do not appear in the correct location(s) and within the correct time as shown in the test instructions when you perform the test, then the results may not be accurate, and a new test is needed to get an accurate result,” the FDA explains.

How rapid tests work and what goes bad when an at-home Covid-19 test degrades

Nate Hafer is the director of operations for the University of Massachusetts Center for Clinical and Translational Science and an assistant professor in molecular medicine at UMass Chan Medical School. He tells Inverse that the extended expiration dates make sense to him, especially in light of how the tests work.

After you swab your nostrils, you put the swab in a solution that breaks apart the sample so different proteins in the sample can be detected. In the case of rapid antigen tests, the protein they’re looking for is called the nucleocapsid protein, which is “one of the most abundant proteins in the SARS-CoV-2 virus,” Hafer says.

Once the solution has broken apart the genetic material, you put a few drops of the solution on the test strip. The strip has been painted with antibodies that, if they come into contact with the nucleocapsid protein, will change color. As the solution moves down the paper, the control line will appear regardless of whether it detects the nucleocapsid protein or not.

The various substances used in the test are fairly stable, Hafer says, which is why the tests last past the expiration date if stored properly. If they are exposed to prolonged heat or cold, Hafer says both the solution and the antibodies on the test paper could degrade.

“I would guess that the antibodies on the strip of paper are one of the more sensitive things that could be damaged by extreme heat or cold, but the solution probably has some chemicals in it that could also be influenced by extreme temperatures,” he says.

So if you come across an expired at-home test, don’t immediately throw it away. Hang on to it and the next time you need to test, make sure the control line shows up as it should. If it does, go ahead and treat it like a non-expired test. If that line looks funky, head to the store for a new one.

Mon, 14 Nov 2022 01:47:00 -0600 en text/html https://www.inverse.com/mind-body/covid-19-at-home-tests-expiration-date-science
Killexams : Do Expired COVID Tests Work? Here’s the Deal, According to Experts

We’ve gotten to the point in the COVID-19 pandemic where you’re probably not stressed every single day about getting the virus—the wide availability of COVID-19 vaccines and effective treatments have thankfully made that possible. And, with that, you likely have some tests around your place for the just-in-case that may have been sitting there for a while. Here’s the thing, though: They can expire. Yep, there is a COVID test expiration date printed on your package that you may not even realize is there.

Many COVID-19 tests last for just a year or so, but the odds are high that you’ll need to use your at some point. That may or may not be before the expiration date stamped on your package passes. So…do expired COVID tests work, or do you need to toss what you thought was a perfectly good test? It’s actually a little complicated. Here’s what you need to know.

So, do expired COVID tests work?

Yes and no. To fully understand that, it’s important to explain how COVID-19 tests get an expiration date in the first place. “When tests are developed, the company will assess the test over time to make sure it’s performing with the quality standards intended,” says Thomas Russo, M.D., a professor and the chief of infectious diseases at the University at Buffalo in New York. “Whatever time frame they assess it for is the expiration date that will go on that test.”

This “doesn’t necessarily mean that the test won’t perform for a longer period of time,” Dr. Russo says—it’s just the amount of time that the test has been assessed for and what is authorized or approved by the Food and Drug Administration (FDA).

Older tests are more likely to have shorter expiration dates because there were time pressures to get tests out earlier in the pandemic, when they were first developed, and only so much time since they had been created to test how long they were good for, Dr. Russo says. “However, companies kept assessing the tests over time,” he says.

As a result, “many manufacturers have received shelf life extensions by the FDA,” says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security.

The FDA has a list online of authorized home COVID-19 tests, along with links to “updated expiration dates” so you can check to see if your test’s expiration date has been extended.

“If you have a test and it’s ‘expired’ based on what the package says, it may or may not be the most correct expiration date,” Dr. Russo says.

What happens if you use an expired test?

Again, the expiration dates are a reflection of how long the company that manufactured the test found that it was good for—or the period of time in which they were able to assess the test. With that, there’s a chance that your test will still be good beyond the expiration date listed. “Most tests will still perform past their expiration date for several weeks,” Dr. Adalja says.

If the test has truly expired “you are more likely to get a false negative,” says Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University. “The test might be negative because the reagents or ‘ingredients’ are past their shelf life and are not working as they should,” she explains. “They are likely good past their expiration date, although how long I cannot say with any degree of certainty.”

If you have symptoms of COVID-19 and the only test you have at home is expired, Alan says you could try it. “If you get a positive, you are probably positive,” she says. “If you get a negative, it would be good to follow up with another test, either a PCR test or another rapid at-home test.”

Why do COVID tests expire?

COVID tests contain specific reagents (aka ingredients) that react with the virus, or lack thereof, from your swab, Alan explains. “These ingredients do not work forever,” she says. “This is true for medications, lab materials, and food.”

How do I know if my BinaxNOW is expired?

BinaxNOW is one of the most popular home tests out there, and it typically has an expiration date stamped on the back of the box. But, again, that may not be the most up-to-date expiration date for your test.

If you have a test with an expired date on the package, check out the FDA’s list of updated expiration dates for BinaxNOW tests to see if it’s been extended. Just keep in mind that you’ll need to have your box’s lot number handy.

But, if your test is expired—both on the box and per the FDA’s updated dating—and you want to be sure you’re getting an accurate reading, Dr. Russo says it’s “probably best to not use that test.”

This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.

Thu, 01 Dec 2022 20:10:00 -0600 en-us text/html https://www.prevention.com/health/a42086541/expired-covid-tests/
Killexams : Best DNA Test for 2022: AncestryDNA vs. 23andMe and More

You can learn all about your ancestry, medical predispositions, physical condition and more with a simple at-home DNA test. It's never been easier or more affordable to try one out if you're curious. There are multiple different DNA tests out there right now that can teach you all about your genetics without even having to go to a doctor's office. Below, we'll break down the best DNA test options on the market so you can find the one that will work best for you. 

Though it's a thorny and controversial topic, some tests also claim to reveal your "ethnicity." There are also DNA test services that can shed light on your genetic predisposition for diseases and physiological traits, ranging from your eye color to your tolerance for cilantro. 

While they used to cost about $1,000 back in the 2000s, you can now get a sophisticated DNA data analysis of your genetic makeup for a fraction of that price, thanks to trailblazers such as 23andMe and Ancestry, and upstarts like Living DNA

There are three types of DNA tests -- each with its own particular strengths, limitations and rationales.

  • An autosomal DNA test is the best investment for most beginners; it can identify relatives between five and seven generations back, across both maternal and paternal lines.
  • Only men can effectively use a Y-DNA test, which identifies male relatives on the paternal line reaching back 60,000 years. If you're looking to trace the history of your family's surname, this is the test to use.
  • Mitochondrial DNA testing, also known as mtDNA testing, can determine genetic relationships on a maternal line from up to 150,000 years ago; both men and women can take this type of test.

Each testing company will deliver you an analysis of your DNA test results. These results could include your geographical origin -- some claim to be able to pinpoint a specific country, town or even "tribe" -- as well as your genetic ancestry composition and your susceptibility to particular genetic diseases. We should note that these tests don't serve a diagnostic purpose. A doctor-administered genetic test and a follow-up with a genetic counselor is important if you think you have a genetic disease. No online testing company offering results from a saliva sample can substitute for a health test administered by your doctor. 

Certain companies will also serve up "matches" from their DNA databases, which will deliver you a head start on connecting with possible relatives and offer some degree of family-tree research support. AncestryDNA, for example, offers a subscription service that includes access to hundreds of databases containing birth, death and marriage announcements, census documents, newspaper archives and other historical records.

Some DNA companies sell tests designed for specific ethnicities or specialized kits that claim to shed light on your optimal skin care regimen or weight; others offer tests designed to identify the genetic makeup of your cat or dog. (Yes, you can get a dog DNA test.) The experts I spoke to were dubious of the efficacy and value of these tests, however, and recommended avoiding them.

Though there's no blood involved with modern DNA testing -- you either swab the inside of your cheek or fill a small test tube with your saliva -- there are plenty of reasons to be wary of the companies that sell these kits. Your success in DNA test genealogy is largely dependent on supplying highly personal information about yourself and your relatives, from your genetic data to your mother's maiden name (a traditional cornerstone of password security).

Concerns over data privacy and security are well-founded, and experts warn that regulation, especially in the US, lags far behind the technology. You should also know that some DNA testing companies may share data with pharmaceutical companies and law enforcement agencies. Bottom line: Think critically before volunteering information about your health history and familial connections to any DNA testing company or organization. 

Read more: In the Future, Not Even Your DNA Will be Sacred

DNA testing, and genealogy more broadly, involves a complicated mixture of genetics, probabilities and guesswork. The various DNA testing services use different labs, algorithms, equipment and criteria to analyze your genetic material. Although you should expect some degree of overlap between analyses from different companies, they may differ significantly. There's also an element of critical mass -- the larger the company's database, the larger the sample they use to analyze your results, and the more accurate your test result should be. 

We tried some of the top DNA testing services, assessing the breadth and depth of their offerings, methodologies, reputation and price. Take a look at our recommendations below.

23andMe

Founded in 2006, 23andMe is one of the pioneers of DNA testing for consumers. In 2017 it became the first such service to win the FDA's approval as a risk screener for diseases. It has become one of the most well-known DNA testing companies -- and well-funded, since taking in a $300 million stake from GlaxoSmithKline, which uses the company's customer data to research and design new drugs. Still, the company recently announced a round of layoffs, citing a slowdown in the DNA testing market likely caused by increasing concerns about privacy.

23andMe segments its analysis into three main categories -- health, ancestry and traits. The basic ancestry and traits test, which is now on sale for $79, includes an analysis of your genetic makeup including your regions of origin, maternal and paternal lineage and Neanderthal ancestry. Once you opt in, the company's match database -- which has more than 10 million profiles -- will identify and offer to connect you with people who share a DNA match with you.

The company's DNA health test, which is on sale for $129, adds information about your genetic predisposition for late-onset Alzheimer's, Parkinson's and other diseases. The service also includes analysis of your carrier status as a potential genetic carrier for disorders like Cystic Fibrosis and Sickle Cell Anemia as well as indicators for lactose intolerance and other "wellness" issues. The Premium Membership bundle, currently on sale for $159, provides priority lab processing, premium customer support and a personalized walkthrough of your results. 

I found 23andMe's website and mobile app very easy to navigate and brimming with interesting, comprehensible information about both my ancestry and health as well as the science of genetics and genealogy. The main dashboard offers intuitive links to exploring your ancestry, learning about the genetic risks for health conditions, building out a family tree and connecting with relatives. Among all of the DNA tests I tried, 23andMe delivered the best introduction to my latest and ancient genealogy along with an analysis of my genetic health. The only real drawback is that it does not offer integrated access to historical documents.

23andMe does provide easy access to a full range of privacy preferences and consent options, however. (That noted, 23andMe's terms of service and privacy statement is among the most extensive, exceeding 20,000 words.) You can ask the company to store your saliva sample indefinitely for future testing or have them discard it. Having signed off when I first signed up, I subsequently changed my mind about giving the company permission to share my data with researchers outside of 23andMe, and was able to retract my consent with the click of a button.

Read more: Ancestry vs. 23andMe: Which DNA testing kit is best for tracing your family history?

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Ian Knighton/CNET

Founded in Utah in the 1990s, Ancestry.com -- the parent company of AncestryDNA -- started out as a publishing and genealogy company. Since then, it has had a somewhat tumultuous corporate existence, having been bought, sold, publicly traded and then purchased by private equity groups.

The company's basic DNA kit service, currently on sale for $59, provides you with an "ethnicity estimate" derived from its proprietary sequencing techniques. It's noteworthy that the company's genetic testing, which is outsourced to Quest Diagnostics, is distinct from most other companies that use paternal Y chromosome and/or maternal mitochondrial DNA methodologies, and less is known about the particular criteria it uses. 

That noted, AncestryDNA says its database contains more than 18 million profiles, making it the largest of all of the DNA test kit services. The company also maintains a powerful tool for searching through hundreds of historical document databases -- but any substantive research will quickly bring you to a paywall. Ancestry's databases are further bolstered by its partnership with FamilySearch.org, a genealogical records site run by the Mormon church.

An entry-level membership, which provides access to more than 6 billion records in the US, costs $119 for six months or $25 per month, after a free two-week trial. The "World Explorer" membership, for $40 per month, broadens your access to the company's 27 billion international records, and the "All Access" tier, starting at $60 per month, includes unlimited access to Ancestry's historical and contemporary database of more than 15,000 newspapers and military records from around the world. 

AncestryDNA offers a personalized health report with "actionable insights," access to genetic counseling resources, an online tool to help you map your family's health over generations and a next-generation sequencing service for screening your genetic risk for heart disease, some cancers and blood disorders. Still, the results are not diagnostic -- though the test result must be approved by one of the company's physicians -- and the service does not have FDA approval. For now, 23andMe maintains the advantage when it comes to introductory DNA testing for health risks and genetic screening. But AncestryDNA's service is particularly well-suited for leveraging an introductory DNA analysis into deep historical research to build out a family tree.

AncestryDNA allows you to get your full DNA results profile and upload the raw data into other tools, and it provides reasonably good control over your privacy preferences, though the options are not as granular as others. 

Read more: What AncestryDNA taught me about DNA, privacy and the complex world of genetic testing

FamilyTreeDNA

Founded in 2000, FamilyTreeDNA offers a comprehensive suite of reports and interactive tools to analyze your DNA and build a family tree. With a credible claim to "the world's most comprehensive DNA matching database," FamilyTreeDNA offers all three types of tests -- autosomal DNA, Y-DNA and mtDNA. And it's the sole company to own and operate its own testing facility: The Gene-by-Gene genetic lab, located in Houston.

The company's entry-level "Family Finder" package usually costs $79, though its testing kit is currently on sale for less. The test results provide information about your ethnic and geographic origins, identifies potential relatives and offers access to the company's massive DNA database. I paid $275 for a broad DNA test that included analysis of my mtDNA and Y-DNA -- tests that currently cost $119 and $79, respectively, when you buy them individually -- as well as the "Family Finder," the company's $39 autosomal test.

Though the user interface is a bit more complicated than what you'll find on other sites, FamilyTreeDNA provides the most complete suite of introductory tools of any provider I tested. For each type of test, you are presented with matches -- I got more than 22,000 for my autosomal DNA test -- a chromosome browser, migration maps, haplogroups and connections to ancestral reference populations, information about mutations and a link that allows you to get your raw data. Suffice to say, there are numerous threads to pull on to learn about yourself, your family and your health. 

FamilyTree also offers a number of higher-end tests, for those interested in digging deeper, including a range of Y-DNA tests that will trace the path of your male ancestors and the history of your surname. The company also allows you to upload raw DNA data files from other services and transfer your autosomal information to its database to expand your universe of matches and relationships. 

From a data security and privacy perspective, there are several things I find appealing about FamilyTreeDNA. The company does its own DNA testing in house, processing and storing your sample in its lab. Posted prominently on the front page of its website is a promise that the company will never sell your DNA to third parties. Like most other companies, however, FamilyTreeDNA may use your aggregate genetic information for internal research and may comply with requests from law enforcement -- unless you opt out. 

Other DNA testing options

The three services above are our top choices for the best DNA test. But they weren't the only ones we tested. What follows are some additional options, none of which eclipsed the 23andMe, Ancestry or FamilyTreeDNA in any significant fashion. 

MyHeritage

MyHeritage DNA test kit box
MyHeritage

Based in Israel, MyHeritage was founded in 2003, and like a number of other services profiled here, started out as a genealogy software platform. Over time, it acquired a number of historical databases and eventually added DNA testing in 2016. (MyHeritage outsources its DNA analysis to FamilyTreeDNA.) In 2018, MyHeritage committed a security breach, exposing the email addresses and hashed passwords of more than 92 million users.

MyHeritage offers a free tier of service that includes some basic family tree-building and access to excerpts of historical documents. It won't get you too far. 

The basic DNA testing and analysis service, which is now on sale for $36, includes the usual fare -- a report of your genetic makeup across the company's 42 supported ethnicities, the identification of relatives and connections to them where possible. All things considered, I preferred FamilyTreeDNA's presentation of my DNA information. But MyHeritage highlighted a first cousin living in the US, with whom I shared about 15% of my DNA, and offered to show me her family tree -- if I paid a $209 annual subscription fee. 

Yes, that's expensive -- a free 14-day trial is available -- but the company maintains an impressive online database of historical documents that includes 3.5 billion profiles in addition to information about over 100 million subscribers and their collective 46 million family trees. This enormous database is powered by Geni.com, a genealogy social media site that's also MyHeritage's parent company. According to the New York Times, Geni.com has assembled "the world's largest, scientifically vetted family tree." 

In 2019, MyHeritage launched a health test similar to the one offered by 23andMe. As part of this effort, the company partnered with PWNHealth, a network of US physicians who oversee the process. I was required to complete a personal and family health history questionnaire -- it was 16 questions -- which was then ostensibly reviewed by a doctor. Though the company says it may recommend a "genetic counseling" session administered by PWNHealth, my health results were simply delivered along with my ancestry analysis.

On the plus side, I like MyHeritage's straightforward access to a range of comprehensible privacy preferences. Still, overall, I found MyHeritage's user interface far less intuitive and more difficult to navigate than others. Though the company's offering is broad -- it's one of the few to offer a comprehensive research database of historical documents, DNA analysis and health screening -- I found the integration among them to be a bit clumsy. 


Living DNA

The Living DNA test kit box
Living DNA

Living DNA describes itself as a "consumer genealogy DNA service that does not sell or share customers' DNA or data with third parties," which gives you a sense of its priorities -- or, at least, its sense of customers' concerns. LivingDNA's headquarters in the UK may also be a factor in its distinctive mission statement, as it is subject to the more stringent data and privacy regulations of the GDPR

LivingDNA divides its offerings in a different way than others. The $59 autosomal DNA kit provides an overview of your ancestry in 80 geographical regions and information about maternal and paternal haplogroups and access to the company's genetic matching tool. The $69 "wellbeing package" includes reports about your physiological compatibility with vitamins, foods and exercise. And the $89 DNA ancestry and well-being package gives you all of it.

Recent ancestry results are presented with a breakdown of percentage by country as well as the percentage attributable to more detailed regions, as well as the origin and migration path of haplogroups. In February 2020, LivingDNA introduced an African Ancestry DNA test report that features data on 72 regions in Africa and, according to the company, "five times the detail of any other test on the market." The report is available for free to existing customers. 

That noted, the company has a very limited family match database; a company representative declined to deliver me a specific number but said that it contained less than 1 million profiles. My wife, who took the test, returned exactly zero matches. So, if you're looking to identify and make connections with relatives, there are better choices in the market. That noted, LivingDNA has a very solid reputation for both the quality of its DNA analysis and privacy terms among experienced genealogists. 


For experts only: Whole genome sequencing

There are a number of companies -- including Full Genomes, Veritas Genetics, Nebula Genomics and Dante Labs -- that can sequence all of your DNA, otherwise known as your genome. This level of analysis is appropriate for advanced users only. Not only is it expensive -- these tests can run into the thousands of dollars, in some cases -- it requires a sophisticated understanding of both genetics and a range of technical tools required to explore and interpret your results. 

The least expensive whole genome tests cost about $300. (Though it is on sale for $99 right now.) For example, Full Genome's 30X test -- which scans every targeted location of your genome 30 times on average -- is considered the standard for a clinical analysis. It costs $799.

For most people, the main rationale for sequencing the whole genome is to dive deep into your genetic health outlook. You can glean your personal risk factors for diseases, drug sensitivities and your status as a carrier; that is, what you might pass on to your kids. But there are also plenty of applications for advanced genealogical projects. 

All of these efforts can also be undertaken -- to a less intense degree -- with some of the more affordable options outlined above. But whole genome sequencing provides a significantly more comprehensive, accurate and high-resolution analysis. 

If you want to dip your toe into this realm. you might want to start with Nebula Genomics. You can also upload an existing DNA sequence from Ancestry or 23andMe's DNA database and get Nebula's reports at a reduced price. 


DNA tests we'd avoid


HomeDNA

HomeDNA sells testing kits under a number of brands, including DNA Origins, and has a retail presence at Walmart, CVS, Rite Aid and Walgreens. The company's tests claim to combine genetic research and "ancestral tracking" techniques that can identify the town or village where your ancestors originated with a high degree of accuracy. Many experts dispute these claims.

The company offers a range of ancestry testing services starting at $69. That's the price for the maternal and paternal lineage kits and the "Starter Ancestry Test," which uses DNA markers to develop an estimate of your origins in Europe, Indigenous America, East Asia and Sub-Saharan Africa -- and shows you the modern population groups that share your DNA. The $124 "Advanced Ancestry Test" expands the analysis to 80,000 autosomal genetic markets, 1,000 reference populations and 41 gene pools. 

I'll note that the HomeDNA test kit contained no warning about not eating or drinking for any period of time prior to taking the test -- unlike every other kit I used. And of the four swabs the company sent, one broke. The test kit just didn't seem as rigorously hygienic as the others.

For $199, HomeDNA claims that the Asian Edition of its GPS Origins Ancestry Test can analyze 17 Asia-specific gene pools and hundreds of Asia-specific reference populations. In addition to a $164 paternity kit, the company also sells a variety of specific kits to determine your sensitivities to particular animals and foods, one to help you achieve a healthy weight, and another that promises to "unlock your skin's full potential." 

For $39, the company will allow you to upload a raw data file from another DNA testing service and pinpoint your origin to a particular town or city. There are also kits to help you screen your dog or cat for genetic diseases and traits. 

But this company doesn't have a sterling reputation in the genetic genealogy world. When we recently spoke with Debbie Kennett, a genetic genealogist from University College London, she referenced the company's notoriety for delivering "bizarre results" and expressed doubt about the efficacy of its specialized tests for particular ethnic groups. HomeDNA did not respond to CNET's inquiry about its testing process or results.

And the HomeDNA reports don't stack up particularly well against those returned by other companies. Results are summarized on a single webpage, though you also get a PDF that certifies that you've "undergone DNA testing" and shows the continents and countries where your DNA originates. The company also throws in a boilerplate 20-page explainer about DNA science and technology. HomeDNA does not offer access to any matching databases -- so there's no obvious next step or any actionable data that comes with your results. Given this, I'd recommend choosing a different DNA testing service. 

African Ancestry

Claiming to have the most comprehensive database of African lineages, African Ancestry promises to trace its customers' ancestry back to a specific country and identify their "ethnic group origin." But a number of experienced genealogists have cited issues with this company's marketing claims and science. 

Unlike most other companies, African Ancestry doesn't offer an autosomal DNA test. Instead, it offers an mtDNA test or a Y-DNA test (for males only). In contrast to your standard DNA analysis, African Ancestry's report doesn't provide the percentage of DNA that's likely to have originated across a range of regions. Instead, African Ancestry claims to trace your DNA to a specific region of Africa. 

According to experts, however, African Ancestry's DNA tests come up short. As explained in a blog post by African American genetic genealogist Shannon Christmas, the company's methodology simply doesn't analyze a sufficient number of DNA markers to deliver on its marketing promises. 

Furthermore, he writes, "Ethnicity is a complex concept, a concept not as rooted in genetics as it is in sociopolitical and cultural constructs. There is no DNA test that can assign anyone to an African ethnic group or what some refer to as an 'African tribe.'" African Ancestry isn't the only company that claims to be able to determine your ethnicity or "ethnic group of origin." But its claim to narrow things down to a single "tribe" of origin is overblown, as any African tribe would ostensibly contain multiple haplogroups. 

In an email to CNET, African Ancestry responded: "African Ancestry makes it clear that ethnic groups are social and cultural groupings, not genetic ones. However, based on extensive genetic research of African lineages performed by African Ancestry's co-founder and Scientific Director (who holds a Ph.D. in Biology and specializes in human genetics), we find that contrary to laymen's beliefs, there are ethnic groups that share genetic lineages. Our results pinpoint genetic lineages that share the same genetics as our test takers. Given the vast number of lineages in our African Lineage Database, we are able to provide the ethnic groups of the people with that shared lineage."

The company's PatriClan Test analyzes eight Y-chromosome STRs and the YAP, which it says is a critical identifier for African lineages; and the MatriClan Test analyzes three regions of the mitochondrial DNA: HVS1, HVS2 and HVS3. But though these tests offer lower-resolution results than others, African Ancestry's services are considerably more expensive. The company's Y-DNA test and mtDNA tests cost $299 each -- or you can take them both, and get an eight-pack of "certificates of ancestry" and a four-pack of t-shirts, for $729. 

On the plus side, African Ancestry says that it does not maintain a database of customer information and that it will not share or sell your DNA sequence or markers with any third party -- including law enforcement agencies. The company's terms and conditions run to just over 2,200 words, making them considerably more concise than the disclosure statements of most other companies we included in this roundup. And African Ancestry promises to destroy your DNA sample after your test results are delivered.

That said, even if you accept the company's take on tribal and ethnic genetic markers, African Ancestry remains too expensive to recommend at its current price.


What does a DNA test tell you?

If you're using a home DNA testing service, you're likely looking for one of three things:

Ancestry and family history: The first big draw of a full DNA test is that you'll get a detailed breakdown on ancestry and ethnicity, and the migration patterns of your common ancestors. Spoiler alert: Your ethnic background may be radically different than you think it is. You'll also find out what a haplogroup is.

Relative identification: With your permission, some DNA services will let you connect with relatives you never knew you had -- other folks with matching DNA who have used the service and likewise given their permission to connect to possible relations. 

Health and disease info: DNA testing can also indicate which conditions for which you may have a preponderance. It's a controversial feature, to be sure. Knowing that you have a genetic predisposition to a certain form of cancer may make you more vigilant for testing, but it may also lead to increased stress -- worrying about a potential health condition that may never develop, even if you're "genetically susceptible" to it. The possibility of false positives and false negatives abound -- any such information should be discussed with your doctor before you act upon it.

How DNA tests work

Afraid of needles and drawing blood? Good news: That's not an issue with these tests. All you need to do is spit into a vial or rub a swab in your mouth -- all the genetic data needed for these tests is present in your saliva -- and ship the DNA sample to the company for analysis. 

The reason that a saliva sample works as well as blood (or hair follicles or skin samples) is that your DNA -- which is short for deoxyribonucleic acid -- is present in all of them. It's the basic genetic code present in all of your cells that makes up your key attributes, from the color of your eyes to the shape of your ears to how susceptible you are to cholesterol.

The key terms you need to know when comparing DNA testing services are:

SNP (single nucleotide polymorphism): Genotyping is done by measuring genetic variation. One of the more common is SNP genotyping, which measures the variations of a single nucleotide polymorphism. The more of these a company measures, the more granular the analysis.

Autosomal DNA testing: An autosomal test that's effective for men and women, and which traces lineage back through both maternal and paternal bloodlines.

Y-DNA: The Y-DNA test can only be administered to men, and traces DNA back through the patrilineal ancestry -- basically from father to grandfather to great grandfather and so on.

mtDNA: The mtDNA is matrilineal and lets you trace your ancestry back through your mother, grandmother, great grandmother and so on. 


DNA testing FAQs


Can I use a DNA test to determine paternity?

Yes, DNA tests are the most accurate way to determine paternity of a child. Samples need to be collected from both the child and suspected parent to make a determination. For the best accuracy, you need a test that specifically checks for paternity not just ancestry.

Can I get a DNA test for my dog?

Yes. Several companies sell dog DNA tests with the goal of helping you determine the breed of your animal and screen for possible genetic health issues. 

Three popular brands are Wisdom Panel (for both dogs and cats), Embark (for dogs only), and Basepaws (for cats only).

More DNA advice

David Gewirtz contributed to this story. The current version is a major update of past revisions and includes hands-on impressions of most of the services listed.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

Wed, 12 Aug 2020 07:30:00 -0500 See full bio en text/html https://www.cnet.com/health/medical/best-dna-test/
Killexams : You Can Still Get Free COVID-19 Tests Through Insurance

November 21, 2022 4:12 PM EST

Planning to gather with loved ones over the holidays? Here’s a timely reminder that every member of your family enrolled in health insurance is eligible for eight free rapid at-home COVID-19 tests every month. That goes for whatever insurance you have—whether it’s through Medicare, the Affordable Care Act marketplace, Medicaid, or your employer—because rapid-test reimbursement is still required by the federal government.

There are two main ways to purchase these tests. The first is to pick them up at a pharmacy or store that your plan designates as “in-network.” If you’re on Medicare, there’s also a partial list of the pharmacies offering over-the-counter tests here. In many cases, the advantage is that you won’t have to pay for the tests; they’ll be immediately covered. Some pharmacies, including Walgreens and CVS, also offer online programs where you can locate tests, enter your insurance information, and then pick them up in person. However, insurance companies sometimes require people to purchase tests themselves and then apply to be reimbursed.

However, insurance companies sometimes require people to purchase tests themselves—online, at a pharmacy, or from other retailers—and then apply to be reimbursed. Your plan is required to reimburse you up to $12 per test (or $24 for a box of two). Before buying, you should check your individual insurer’s requirements for reimbursement—and plan to hang on to your receipt. There are some contexts in which insurers are not required to reimburse for testing. For example, they are not legally bound to pay for ongoing tests demanded by an employer as a condition of employment.

At this point in the pandemic, at-home rapid COVID-19 tests are indispensable tools. Experts recommend taking them before gathering with other people, especially if they’re at high risk of severe disease (including those over age 65) or are not up-to-date on their vaccines. You should also test whenever you have COVID-19 symptoms, like a fever, sore throat, or runny nose, or after coming into contact with someone who has had COVID-19 in the last five days.

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Contact us at letters@time.com.

Mon, 21 Nov 2022 10:34:00 -0600 en text/html https://time.com/6235791/free-covid-19-tests-monthly-insurance-reimbursement/
Killexams : Blood tests for Alzheimer's are here. Here's what you need to know.

Few illnesses instill as much fear as Alzheimer's, a fatal neurodegenerative disease that destroys memory and identity. The dread is compounded by the uncertainty that often surrounds the diagnosis of the most common form of dementia.

Brain autopsies remain the only way to know for sure whether someone had the disease, which the Centers for Disease Control and Prevention estimates affects 6.5 million people in the United States. Over the past several years, sophisticated tests such as spinal taps and specialized PET scans have become available - but they are invasive and costly and not routinely used.

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As a result, Alzheimer's is frequently misdiagnosed, especially in the early stages. Other illnesses, including depression, can have similar symptoms and require other treatments.

But simple blood tests designed to help doctors diagnose Alzheimer's now are on the market. More are on the way. The tests are seen as an important scientific advance, but have ignited debate about how and when they should be used.

Some experts say much more research is needed before the new tests can be widely deployed, especially in primary-care settings. Others say there already is sufficient information on the accuracy of some tests. All agree that no single test is perfect and physicians still should perform a complete clinical assessment.

Widespread use of the tests may be some time off in the future - after insurance coverage improves and even more accurate next-generation tests become available. For now, none is covered by Medicare, and private insurance coverage is patchy.

- - -

How do Alzheimer's blood tests work?

In the past few years, scientific and technological advances have made it possible to detect in the blood tiny fragments of brain proteins implicated in Alzheimer's.

That has prompted experts in academia and industry to develop blood tests for the disease. Some of the tests detect a sticky protein called amyloid beta, while others look for another protein called tau. Some search for both or other markers of disease. The abnormal accretions of amyloid plaques and tau tangles are the defining characteristics of Alzheimer's.

So far, the tests have been used mostly in clinical trials, but a few are being sold on the commercial market. They are designed to complement doctors' assessments based on symptoms and other tests, not replace them.

If you have concerns about memory or reasoning issues, you should talk to your family and doctor. Just because the tests are available does not mean people should try to get them, experts say.

- - -

Which tests are available? How much do they cost?

At least three tests - by C2N Diagnostics, Quest Diagnostics and Quanterix - are available in most states outside clinical trials.

Quest, which charges $500, said some health plans are paying for its test. C2N charges $1,250 and offers financial assistance for eligible patients. Quanterix declined to provide a price but said its test is much cheaper than amyloid PET scans, which can cost $5,000 or more. All the companies are working to secure broader insurance coverage.

Eli Lilly and Roche also have developed tests but for now are using them only in trials.

- - -

Who should get the tests?

There is a wide range of opinions on this.

Some experts say it is too early to use the tests in regular clinical care. Others say they can be used in memory centers with confirmatory tests such as PET scans or spinal taps. Some say the tests are a useful tool that can be used broadly once they are covered by insurance.

Still, many scientists agree on an important point: That the tests, which must be ordered by doctors, should be reserved for people with cognitive problems - persistent memory or logic issues, not just the occasional forgetfulness we all experience because of normal aging or stress.

Many researchers say it is too early to use the tests for people who do not have symptoms, because there isn't adequate research involving that group and the issue is rife with scientific uncertainty and ethical questions.

"The test results are intended to be used in adults presenting with cognitive impairment who are being evaluated for [Alzheimer's disease] and must be interpreted in conjunction with other diagnostic tools," Quanterix said in a statement in July when it launched its test.

C2N uses a similar description, and company officials stress that their test is not designed for the "worried well" group of people.

Quest says its test is for people with or without symptoms. Quest relies on physicians "to use their own discretion when ordering tests," said spokeswoman Kimberly Gorode, adding that the test's "clinical utility will increase once there is an FDA-approved treatment for Alzheimer's disease."

- - -

Why would I want to know if I have Alzheimer's?

Some patients with cognitive issues take a fatalistic approach toward Alzheimer's, saying an exact diagnosis is not necessary because little can be done. Currently available treatments target symptoms and often are not effective. They do not change the course of the disease.

Alzheimer's treatments may be improving. Recently reported results showed that an experimental drug called lecanemab, by Japanese drugmaker Eisai and its U.S. partner, Biogen, worked to modestly slow Alzheimer's disease. It was the first therapy to do so in a well-run trial. The Food and Drug Administration could decide whether to approve the drug as soon as January.

Recently, in a sign of the roller-coaster nature of Alzheimer's, a drug by Roche failed in clinical trials. A medication by Eli Lilly is in late-stage testing.

If a new treatment is approved by the FDA and gains Medicare coverage, blood tests could play a key role in determining who might benefit. Doctors will want to make sure patients have amyloid in their brains before prescribing the medications.

Down the road, after more research is conducted, the blood tests might be used to alert people, even those without symptoms, that they have elevated amyloid and tau in their brains, putting them at risk for Alzheimer's. Patients could start a preventive therapy early, if one exists. Or they could pursue healthier lifestyles.

"Knowing your risk can be a hugely positive motivator," said Leslie M. Shaw, a pathologist and Alzheimer's researcher at the University of Pennsylvania. "Make the changes we now know are important. Instead of being a classic couch potato, get off your duff and get going."

Even if new treatments for Alzheimer's are not cleared, many experts say, it is important for patients to know their diagnoses so they can plan for the future. Trying to hide such a diagnosis is an echo of the 1960s, when people were not told they had cancer.

"If people are having cognitive symptoms, they deserve to know their diagnosis," said Howard Fillit, co-founder and chief science officer at the Alzheimer's Drug Discovery Foundation, a nonprofit group that helps fund research into the disease. "If they test positive, they will get certainty. If they test negative, maybe they have depression or a different type of dementia that might be treated differently."

- - -

Do experts back use of the blood tests?

Many experts, even those enthusiastic about the tests, say that while they can be used carefully by certified in memory centers, there should be more research before they are used in primary-care settings. Some certified say they want more data on how the tests work for patients of different races, ethnic groups and genders.

"You want to know how the specific tests perform in different patients so you can really interpret them," said Matthew Schrag, a neurologist at the Vanderbilt University School of Medicine.

But other experts are eager to use the blood tests, saying they will help provide clarity to patients.

Demetrius M. Maraganore, chairman of the neurology department at Tulane University School of Medicine, who took part in a study sponsored by C2N, said he would start using that test immediately if it was covered by Medicare and insurance.

"The point is that patients seek an end to their diagnostic journey," Maraganore said. "This will help them to flip the page and start focusing on acceptance and getting the support they need."

- - -

Do the tests have FDA approval?

Not at this point. Under the FDA's current policy, agency approval is not required for laboratory-developed tests - which are developed and processed by a single laboratory. The current tests are those types of tests. They are regulated under the Clinical Laboratory Improvement Amendments program under the Centers for Medicare and Medicaid Services.

Still, some of the manufacturers are seeking the FDA's imprimatur, saying agency approval would assure health-care providers and insurers about the value of the tests.

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Thu, 17 Nov 2022 23:29:00 -0600 en-US text/html https://news.yahoo.com/blood-tests-alzheimers-heres-know-224815950.html
Killexams : How to get free or low-cost Covid tests this holiday season — and how best to use them

The third holiday season since the pandemic started is nearly here, and around 300 people are still dying of the coronavirus every day, on average, according to NBC News' tally.

At what was likely his final White House briefing, Dr. Anthony Fauci said on Tuesday that people shouldn’t underestimate the value of testing.

“When we’re gathering at a family gathering for Thanksgiving or for Christmas or for any other holiday as we get into the winter, it makes sense that you might want to get a test that day,” said Fauci, who directs the National Institute of Allergy and Infectious Diseases but is leaving that role next month.

But finding low-cost tests and interpreting the results aren't always simple.

Here's the latest guidance from the Centers for Disease Control and Prevention and the Food and Drug Administration, as well as expert advice, about how to get tests without paying out of pocket, check when an at-home test expires and interpret a negative result if you have symptoms or known exposure.

Private insurance and Medicare cover eight at-home tests a month

Since January, the Biden administration has required private insurers and Medicare to cover up to eight at-home tests per month. People with private insurance can order the tests at in-network pharmacies or submit claims to be reimbursed for tests they buy at other stores or out-of-network pharmacies. People with Medicare can search online for a list of providers that offer free tests.

PCR lab tests are also fully covered through private insurance and Medicare.

Free at-home tests from the government are no longer available

The federal program that distributed up to 16 free at-home tests to households through the mail ended Sept. 2 because of a lack of congressional funding.

How to find free testing sites near you

Some sites that provided free rapid or PCR tests earlier in the pandemic have closed, but the Department of Health and Human Services has an online search tool to find nearby sites still offering free or low-cost tests. Most are pharmacies like CVS and Walgreens, but the site can also direct you to your state health department's website, which may offer additional options.

Once the government's public health emergency declaration expires, testing costs will probably go up

The declaration was last renewed in October, and it could end sometime in 2023. After that, Medicare beneficiaries will most likely have to pay the full cost of at-home tests but should still get clinical diagnostic testing covered, according to KFF, a nonprofit health think tank. For people with private insurance, testing costs will be subject to the particulars of their plans, but they are unlikely to be covered in full.

Rapid tests can expire, but many shelf lives have been extended

Different tests have different shelf lives, but many of the original expiration dates have been extended since the tests were authorized.

In such cases, the manufacturer has provided evidence to the government that the tests deliver accurate results longer than was known when they were created. 

Abbott’s BinaxNOW at-home test, for example, says it has a shelf life of 15 months, but the expiration dates of many batches have been extended by three to six months. The government-distributed tests from iHealth Labs, meanwhile, last one year, but most of their shelf lives have been extended four to six months. Flowflex at-home tests have a shelf life of 19 months, with extensions of six months.

To check whether the expiration date of your particular test has been revised, click on the relevant link on the FDA's list and look up the lot number.

When to test if you've been exposed or feel ill

If you have symptoms, take a test immediately. If you were exposed to someone who tested positive but you feel healthy, test after five full days.

The FDA recommends that people with known exposures who test negative take second tests 48 hours later. If they are negative again, test a third time after another 48 hours.

"We know antigen-based tests, you have to repeat them. They're not a one-and-done test," said Dr. Susan Butler-Wu, an associate professor of clinical pathology at the University of Southern California.

If you are exposed within 30 days after having previously tested positive for Covid, you don’t need to test unless you develop symptoms, according to the CDC. If it has been less than 90 days since your last Covid infection, use a rapid test, because PCR results can stay positive for up to 12 weeks.

You can report your at-home test result to public health agencies at MakeMyTestCount.org, a site from the National Institutes of Health.

What to know about the accuracy of at-home tests

PCR tests are generally more sensitive and accurate than at-home tests, but the results can take at least 24 hours — and often several days. At-home tests (also known as antigen tests), meanwhile, rarely deliver false positives but can deliver false negatives, even if someone is symptomatic. That's especially likely in the early days of an infection.

Scientists aren't sure why that is, but one theory is that the immune response leads to symptoms before the virus has a chance to replicate to detectable levels. That may cause people to feel tired, achy or sniffly before they test positive.

For other people, Covid tests never come back positive even though they feel sick and were exposed to the virus. It's possible that those people have unrelated infections or their immune systems did a swift job of vanquishing the virus before it replicated widely enough to register on a test.

People who are elderly or immunocompromised should still seek out PCR tests if they feel sick or were exposed to Covid and get negative results on at-home tests, said Dr. Sheldon Campbell, an associate professor of laboratory medicine at the Yale School of Medicine. That's because those groups are eligible for treatments like Paxlovid in the days after they test positive.

"You don't want to wait two days, get a positive and realize you should have been treating for two days," he said.

Your test result could be a good indicator of contagiousness

Campbell said testing positive on an at-home test is a pretty good indicator you're infectious. But Butler-Wu cautioned that it’s still possible to be contagious and test negative on an at-home test or to test positive and not spread the virus to others.

"At the end of the day, there is no infectiousness test for Covid. There has never been, and there still isn't," she said.

It is well established, however, that people are more likely to be infectious at the start of their illnesses. An August study found that 65% of people with Covid shed infectious virus five days after their symptoms started but that just 24% were still doing so after a week.

How long you're likely to test positive

If you are mildly ill, the CDC recommends isolating for at least five days after your positive test or the start of symptoms, then ending isolation if you test negative or if symptoms have resolved or are clearing up. If your symptoms haven’t improved much or you still have a fever on day five, the agency advises continuing isolation until you are fever-free for 24 hours without medication.

People with moderate or severe illness — characterized by shortness of breath or hospitalization — should isolate through day 10.

"Typically, people are positive for about seven days after their symptoms" start, Campbell said. "Some people can go longer — rarely more than two weeks."

In one small study, just 25% of people with Covid were negative on rapid tests on day six of their illnesses, but all the participants tested negative after two weeks. In a study of college athletes with Covid, meanwhile, 27% still tested positive one week after their first positive tests.

Campbell said scientists are still investigating why some people test positive for more than two weeks.

"People who are antigen test-positive beyond two weeks are in some fashion not having good immunity to the virus," he said.

Tue, 15 Nov 2022 01:34:00 -0600 en text/html https://www.nbcnews.com/health/health-news/get-free-covid-tests-check-expiration-date-rcna56482
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