The Biden administration is distributing 500 million home test kits now, and another 500 million later this spring. (KCAW image capture)

Order four free COVID home test kits per household from the US Postal Service online, or call 1-800-232-0233.

As of Wednesday (1-19-22), every household in the US can order four home test kits for COVID-19 from the Postal Service.

The program was launched by the Biden Administration, which purchased 1 billion kits for use by Americans, and is distributing them in two phases.

Alaskan health officials say the kits work exceptionally well to detect positive COVID cases: What they’d like people to understand is that the kits can also produce false negatives.

With home test kits, context is everything: Someone in your child’s classroom comes down with COVID; soon your child isn’t feeling well.

Dr. Coleman Cutchins, the state’s chief pharmacist, says a home test kit will produce a reliable positive test for your child, if used correctly.

“For the most part, home tests are really good,” Cutchins said. “We’re using them in our household with with kids in school and with people with symptoms that could be COVID. I think it’s also important to remember most kits require two tests. So when you get the first test and it’s negative, it’s important to follow the directions on test and do the second one 24-to-48 hours later, depending on the test and what the instructions say, and get that second negative.”

Coleman, along with other state health experts, spoke at a Department of Health and Social Services media teleconference on January 13.

But home test kits are not always a slam dunk. There are variables in testing that tend to favor false negatives, and it can be confusing.

“So the most important things with home tests is to follow the directions,” said Cutchins. “These tests are meant to be done exactly as the direction say. So, in that instance, when you test positive on a home test, you can really trust that positive.”

But Cutchins continued with this caveat: “All of these tests require a certain amount of virus on the swab to detect a positive,” he explained. “And you know, we get a lot more false negatives, even when we have two people living in the same household with the same symptoms. One could test positive and the other test negative — likely they both have COVID. Just the one who tested negative wasn’t caught in that window. Some people can test positive for a very long period of time. Some people have a very narrow window where they test positive. And it’s hard to tell who’s going to be which.”

Dr. Anne Zink, the state’s chief medical officer, says doctors will put a COVID test in context. The omicron variant, especially, is highly transmissible. If you’ve had a significant exposure – like, someone coming down with COVID in your household – doctors may connect the dots, even if your home test kit shows a negative.

“I think clinically, we see this all the time where one person will test positive or negative,” said Zink. “In making that decision, if someone really has COVID or not, in that clinical setting where we’re seeing a family or group of people, it has to do with what’s circulating, as well as who’s tested positive. So if people are both symptomatic and in the family they’ve had similar symptoms,and one or two of them have tested positive for COVID — particularly if the other people are not up to date on their immunizations and have similar symptoms — and there’s nothing else that tests positive, it is probably COVID, and will be treated in the same sort of way.”

In a nutshell, with any one of the many varieties of home test kits now being distributed across the country, a positive is likely a positive; a negative, however, might just be a positive, if you didn’t use the test correctly, or if you took it at a time when you weren’t shedding virus. Your healthcare provider will look at all these factors – including your immunization status – to confirm if you have COVID, or perhaps one of the other pathogens circulating this time of year, like the common cold, RSV (Respiratory Syncytial Virus, particularly prevalent in children), or influenza.

Monoclonal treatments give way to oral medications for COVID

If you do happen to come down with COVID during the current spike in the omicron variant, chances are that you may not receive one of the monoclonal antibody treatments that proved so effective during the delta surge last fall.

Two out of the three antibody treatments* used during that time don’t work against omicron, and the third that does work** is in limited supply.

Instead, state pharmacist Dr. Coleman Cutchins says you’ll likely get oral medication – in other words, a pill.

“With vaccines and monoclonal, we saw this linear steady increase in supply,” said Cutchins. “With the orals, I really think it’s going to be more like an exponential curve straight up. We’re going to get more and more of these orals. And I think it’s important to remember that these are much better options to give to a lot of people, because they’re easier to deliver. And I think we all would rather take an oral med than have to go somewhere and get infused with an IV.”

There are two types of oral medications for COVID***, one of which has come on the market so rapidly that the Alaska Department of Health has been able to double the availability of the drug.

And although vaccination remains the best of all tools against COVID-19, the state’s chief medical officer, Dr. Anne Zink, says outcomes are generally improving for COVID patients.

“The good thing is that most people who get COVID-19 are going to do very well,” said Zink. “Well, at this point on most people have either been vaccinated or previously had COVID-19. And particularly the younger and healthier you are, the more likely the Omicron variant looks to cause less of your illness. You might feel miserable, but you may not need treatment and your body may recover well with just supportive care.”

DHSS officials are encouraged by recent downturns in cases in South Africa, where the omicron variant first emerged, and by recent dips in major urban centers in the US. In Alaska, however, cases are continuing an upward trend.

*Bamlanivimab plus etesevimab, and casirivimab plus imdevimab, aka Regeneron.

**Sotrovimab, available at 13 sites in Alaska, with 6 courses of treatment each. A fourth product,  Evushield, is a different type of monoclonal antibody, administered to only the most high-risk COVID patients.

***Paxlovid (limited), molnupiravir (available, 45 allocations of 20 doses each, allowing DHSS to double the sites and add seven new regions).