Originally published at: Ellume COVID-19 Home Test Goes High Tech - TidBITS
After suffering from uncontrollable shivers and a fever, Adam Engst (and his family) worried that he might have been infected with COVID-19, despite being fully vaccinated. He was able to use the Ellume COVID-19 Home Test—a rapid antigen test—to set everyone’s mind at ease. And the technology involved was a geek’s delight.
Nice review. Glad to hear the results were negative. Hopefully it was just a 24-48 hour bug, which we all get from time to time.
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I’d say this would have been great if it came out a few months ago, but with the delta variant on the rise, and less than 70% vaccinated, we might be needing this in bulk once again.
It is true individual tests must produce a lot of disposables, but this very same test could also be employed by clinics too. That’ll give a fast response, less consumables, cheaper costs, and help for those who are too technophobic or don’t own the right tech to do the test themselves.
Israel is about 80% vaccinated, and they’re having a surge of corona virus cases due to the delta variant. It’s mainly affecting the under vaccinated population — the extreme religious groups who insist it’s all a hoax and the Muslims who don’t trust the government (sounds familiar?).
Fortunately, we know the current Pfizer (and Moderna) vaccines are effective against the variant. Never the less, they’re looking towards another lockdown in Israel.
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I believe it’s 80% of their adult population that’s vaccinated. Many of their current cases however are among children and teenagers. We need to keep in mind that even today, there are no vaccines for younger children. And 12-15 was only recently approved. This would make us adults all getting vaccinated just that much more important.
The good news is that among children symptoms are often weak (or not present at all) and serious illness is very rare. Just this morning I learned that although Israel has recently seen incident rates grow, their hospitalization is still declining. The primary explanation is that hospitalization is usually only a risk for adults and seniors. Fortunately, vaccination among seniors is high and efficacy even against delta is very high for the mRNA vaccines.
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I’m glad it wasn’t more serious. Stories about long-haul survivors scare me more than stories about people dying. I know the vaccine is supposed to make any subsequent infection less severe, but does it also reduce the chance of a long-haul recovery? I understand that some long-haulers were never that sick to begin with, but just stayed the same or even got worse as weeks and months went by.
Thank you for that information.
I see that the Ellume web site tells me to go to the Azova web site to buy a kit for international travel, and the Azova web site offers to sell an at home antigen test “from $50”. No doubt the international virus has more expensive tastes than the domestic one.
More seriously, how large is the package? Is it so large as to make it unfeasible to carry one or two when traveling to avoid needing to purchase test kits at the destination?
Unrelated to the article, what does a poor traveler do when a test returns a false positive?
Sadly, after two days of feeling fine, and even running a 1500m race, I felt lousy on Sunday again. Today I was better in the morning but faded. Still no real fever or symptoms apart from fatigue. The go-to test for weird symptoms around here is Lyme disease (I’ve already pulled five or six deer ticks off this year, though they never, as far as I know, stay on long because they make me itch badly). My doctor didn’t even blink at calling in a referral for a tick-borne disease panel. I’ll know soon enough if I have a course of doxycycline in my future.
Indeed. Even if the vaccines protect you from serious cases of COVID-19, who in their right mind (yeah, yeah, I know) isn’t going to worry about any illness being COVID-19 at this point?
You and me both. I don’t think we have enough time with vaccines to know if breakthrough infections could result in long-haul COVID.
The Measure app tells me it’s 6.5 inches high by 4 inches wide by 2.5 inches deep. It’s light, and you could easily unpack the box and pack all the parts more efficiently. I see no issue with traveling with it, perhaps apart from the fact that the Analyzer has some sort of a battery.
If I were to get a positive, false or otherwise, I’d immediately get a PCR test. There is a false positive rate of either 4% if you have symptoms or 9% if you don’t. False-negative rates are lower: 0% for symptomatic cases and 4% for asymptomatic cases.
I think it’s just like a pregnancy test. If you get a negative result and you’re really worried, you take it again, and hopefully a second negative sets your mind at ease. If you ever get a positive result, you go see a doctor right away.
A rash is usually one of the warning signs of Lyme, as are circular or bulls’ eye marks where the tics bit a victim. But these symptoms vary, and some people don’t show them at all, so a test is a very good idea. I’ll keep my fingers crossed, and I hope whatever symptoms you have will vanish soon.
As @ace says above, you would be advised to get a PCR test right away. At least then you gain some clarity. Your travels, however, will most likely be delayed. Here in the States it’s very hard to find a PCR test with guaranteed <24 hr turn-around time unless you’re willing to lay out some serious dough.
I was wondering about exactly this case when I recently went on international travel. Usually, the requirement is the test is less than 3 days old prior to travel. So assuming your antigen test came back positive on day 3 before travel (it’s a quick test after all), even if you then right away get a PCR test (assuming slots open, no wait time), you’re looking at day 1 before travel at best. If you’re less lucky the negative PCR result will come in just after your original itinerary departed. Of course, a negative PCR result is still great news, but I would assume you will have to engage in some rebooking or at the very least some super last-minute nail-biting right up to the wire. ;)
I was pleasantly surprised when I ran into a testing opportunity two weeks ago at ZRH airport. The Swiss have a walk-in testing site there that guarantees PCR results within just 5-10 hours. It’s not cheap at about $170, but that’s still a factor 3 less than what I get quoted around the Bay Area for a PCR test with guaranteed 24-hr turn-around.
On a related note, it’s good to keep in mind that several countries will not accept antigen tests for entry, only PCR. The US is fine with antigen though for re-entry which is convenient because it’s a fast and cheap test. But as others have pointed out, it’s by far not as accurate as PCR which is why that is still considered the gold standard.
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Thanks for testing, and providing a review of, this product. I am pleased that the device has given you a negative result. Just as a check, maybe a comparison test at a clinic would have been advisable, particularly as you subsequently experienced flu-like symptoms.
Here in Australia, the rollout of the vaccines has been less than admirable with politics and idiots getting in the way. The value of vaccination was again proven in the last few days with the local example of a house party of about 30 people testing positive except for the six who had been vaccinated.
I’ve had my two jabs of the Astra Zeneca vaccine and played two good games of golf almost immediately after taking the shots. But Astra Zeneca vaccine is under a cloud due to the rare possibility of blood clots and so people are resisting taking this vaccine despite the statistics showing the higher likelihood of getting the virus and of women getting blood clots from contraceptive pills.
Home-testing applications for other symptoms is an interesting and potentially excellent development.
You stated that the test results are ‘accepted.’ PLEASE make clear to your readers that home testing is NOT accepted at airports, and, at least for an international flight, you would almost certainly be turned away and sent back home.
I’d be getting that antibiotic if there’s a slightest chance of Lyme. Early intervention being key, it too has a long term life. My wife suffers from it for the past five years, symptoms sporadically appearing all from initial tick bites in the forest upstate in New York. She had a quick set of antibiotics but it still became an issue.
Adam, thanks for this brave piece, so glad you’re COVID free — but (being a regular visitor to tick infested QLD in Australia) can I join others here in saying don’t take risks with Lyme!
It’s freezing out with a 70mph gale, but there are times when being in the S Island of NZ feels OK… 
Glad your immune system took care of you, Adam. Being ‘vaccinated’ will protect you even from variants so not sure about the ‘panic.’ Also, not sure where you live, but, Lyme Borreliosis is a real entity esp in states like Wisconsin and Pennsylvania. Erythema chronicum (migrans) is the red bullseye exanthem (rash) commonly seen, but the eruption may not be annular (a ring), it maybe circular (filled in circle). Also, STARI which is Southern Tick Associated Rash and Illness is tick related but NOT Lyme disease and not necessary to treat. It is seen in southern states but variants are spread across the US as well. So, a rash after a tick requires a medical differential diagnosis followed by reasonable and logical course of action to confirm or deny. To truly test for Lyme is not an easy process requiring two or more tests to CONFIRM each other, so to speak. Doxycycline is such an easy drug to take, but watch for photosensitivity and exaggerated sunburn if you get in the sun. (I’m a dermatologist). As well, children and teens do well with Coronavirus and are ‘sick’ for a short time, as all my grandkids revealed. These are generalities and not written in stone, not a treatment suggestion, and not medical care you should follow: these are my thoughts as a Medical Doctor, not a politician. 
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Agreed! Lyme is pretty much epidemic here in upstate New York, so I know many, many people who’ve had it, and Tonya had another tick-borne disease a few years ago (anaplasmosis). At this point, I think the bullseye rash is quite rare—if you get one, that might be indicative, but most people don’t. Most don’t even know they’ve been bitten by a tick. That’s not my problem because tick bites make me itch, so I notice them quickly.
I had been thinking that too, but my doctor doesn’t seem to think it’s at all likely, given that the only real symptoms I’ve had are fatigue and occasional temperatures slightly over normal. We’ll see as the tests come back this week.
No, I said: “The emailed test result may be useful as proof of a negative test (BinaxNOW essentially works on the honor system)”
I haven’t attempted to travel internationally nor did I try to figure out the various regulations from different countries. That’s left as an exercise for the reader.
Oh, I’m so sorry! One of Tonya’s cousins has suffered with symptoms that may have been the result of a case of Lyme for the last decade. My doctor said that if it were him, he’d wait until the tests came back to start the doxycycline because my initial labwork didn’t show any major indications of infection. But, he said, if it got worse in the next few days, take it! :-)
Thanks for the details and the suggestions—I appreciate the kind thoughts from everyone here!
United Airlines has worked out a deal for the BINAX test where UAL will accept the results for re-entry to the US. It’s not clear if the Ellume test would be accepted by airlines or TSA. Nor do I know if other airlines would accept BINAX.
Fortunately, Europe dropped their entrance test requirements for vaccinated people a couple weeks ago. So we cancelled the pre-flight test we had scheduled. We’re still scheduled for an airport pre-flight test coming home. (Test standards are strict, 48 hours for Antigen, 72 for PCR tests. Last I heard, Hawaii was only accepting PCR tests, not antigen. Check with your airline, but -good luck getting through to them-!.)
Of course, I wouldn’t know that a positive result was false, but my question was based on the assumption that it was. As @Simon said, it would be a significant inconvenience to a traveler.
By Europe, I assume you mean the EU or that my information is out-of-date. My understanding is that England requires a pre-flight negative test followed by quarantining on arrival with follow-up tests on day 2 and day 8. (There is an optional test on day 5, after which quarantine may be broken, but the day 8 test is still required.) Of course, all tests must be negative, and therein lies the problem.
If there is a false positive rate of 9%, then I have a 91% of not getting a false positive. But if I need three tests, now the chance of getting zero false positives is 0.91^3, or an almost 25% chance of getting one or more false positives. That’s bad odds when I want to go sightseeing. And if I take the optional test on day 5 to try to leave quarantine early, now I have a 31% of a false positive at some point. Sigh.
Yes, that’s right, sorry. From what I understand, UK was going to open up and then changed. Each EU country has adopted the EU -suggestion- at a different rate/different mechanism.
Interesting article, thanks for taking the time to write up your experience Adam, even as you weren’t feeling 100%. Question as I’m not sure about all the terminology… is this the same as a lateral flow test?
Over here, we have PCR tests (as discussed above) and lateral flow tests. Both are free, and I know people who keep a box of lateral flow tests (one box contains 7 tests I believe) handy in case they feel ill and want to check. In that context, $40 seems quite pricey, especially as you might need two or three on hand in case of multiple people in a household feeling ill. Is this a different type of test, or are test kits generally expensive in the US? Even $25 for lateral flow is more than I expected – I assumed retail price would be $5-$10/test. That’s why I’m wondering whether this is a different kind of test to the ones I’m familiar with.
I think the Ellume test is a lateral flow test, yes, although I hadn’t seen the term before.
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OK, I’m officially old now that I’m sharing my medical woes as general conversation, but since I started this whole discussion by taking a COVID-19 test after feeling sick, I feel I need to close the loop.
My tests came back from the Mayo Clinic yesterday and I tested positive for babesiosis, which is a tick-borne disease that often accompanies Lyme and does indeed have as its main symptoms fatigue and malaise with chills and fever too. Nevertheless, it’s unusual enough around here that my doctor had never treated a case.
Unlike Lyme, which just gets a course of doxycycline, babesiosis requires both the antibiotic azithromycin and atovaquone, an anti-malarial drug, since it’s actually a parasite. (And I have to say, atovaquone is disgusting—it’s bright yellow, is vaguely representative of banana cough syrup, so thick and chalky that it gloops rather than pours, and has to be taken using a spoon rather than a little measuring cup because it sticks to the side.)
Happily, even before I got the diagnosis and started the drugs yesterday, I was feeling normal again. With luck, it’s all upswing from here.
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