As respiratory virus season arrives in the U.S., a new tool could be a game-changer for families: over-the-counter combination tests that can detect both flu and COVID-19 with a single sample. These tests became available last year, but this is the first flu season where this type of test will be widely available.
The combination tests offer a convenient way to quickly check for both viruses at home, but how reliable are they and how should they be used?
Here in Atlanta, researchers at Emory University, Children's Healthcare of Atlanta, Georgia Institute of Technology, and Grady Health System have played a pivotal role in evaluating these combination tests through the National Institutes of Health's (NIH) Rapid Acceleration of Diagnostics (RADx) and Independent Test Assessment Programs (ITAP), which select and test the most promising diagnostic tools and then help them move quickly through the development, approval, and commercialization pipeline.
Greg Martin, MD, MSc
The Atlanta Center for Microsystems Engineered Point-of-Care Technologies (ACME POCT), led by researchers at Emory University, helped test seven of the eight combination tests for flu and COVID-19 that are now available on store shelves. Almost every test on the market went through Emory channels, making the university a key contributor in bringing these products to the public.
Greg Martin, MD, MSc, a principal investigator in the ACME/RADx initiative at Emory and director of pulmonary and critical care medicine, shares insights into how these tests work, their reliability, and what to expect as respiratory viruses circulate. Having directly evaluated these combination tests, Dr. Martin offers valuable firsthand knowledge that families can use to prepare.
Q: What can we expect from this year's respiratory virus season?
Dr. Martin: It's difficult to predict exactly how the season will play out, but we do know that the flu will circulate starting this fall, as it does every year. On average, the flu causes 30,000 to 50,000 deaths in the U.S. annually, so it's important to remember that it's not just a mild illness — it can be deadly. Here in Atlanta, we can expect that tens of thousands of people will get the flu. Some may have mild cases, especially if they've been vaccinated, but it will still impact a significant portion of our community.
Q: Can I test myself for COVID-19 and the flu at the same time?
Dr. Martin: For the first time this flu season, you'll have access to eight different over-the-counter (OTC) combination tests that you can use to test yourself and your family for both COVID-19 and the flu at home. These tests can differentiate between influenza A, influenza B, and COVID-19, all from a single nasal swab. It's a convenient way to get quick results and determine which virus you or your family members may have.
Q: Can you explain why the new combination tests are significant for consumers, especially during respiratory virus season?
Dr. Martin: The significance of these tests lies in their ability to help you differentiate what's causing your illness. This is especially valuable during cold and flu season, when many respiratory viruses have similar symptoms. Once you know the cause of your illness, you can take the appropriate next steps, like contacting your doctor for treatment options. Both COVID-19 and flu have antiviral treatments that work best when started early, so finding out early which virus you have can help you get the right care quickly.
It's also important to follow the instructions closely for the most accurate results. Depending on the test, results are typically ready for interpretation within 10-30 minutes, so make sure you check the timing guidelines provided in the instructions.
Q: Who can use these combination tests?
Dr. Martin: These tests are designed for both kids and adults. Parents can perform the test on children as young as two years old, while anyone 14 and older can test themselves. It's important to refer to the specific instructions provided with the test to ensure proper use, as instructions and applicable ages will vary slightly by manufacturer.
Q: Where can I get the tests, and how much do they cost?
Dr. Martin: The combination tests are readily available at common places like CVS, Walgreens, and other local pharmacies. You can also find them online at retailers like Amazon or Walmart.
The Healgen Rapid Check COVID-19/Flu A&B Antigen Test is one of eight combination tests currently available.
Healgen
In terms of cost, most of these tests are priced similarly, around $10 to $12 per test. Some may be sold in packs of two or four, but when you break it down, it averages about $10 to $12 per individual test. They are typically purchased out-of-pocket, however, if you have a health savings account (HSA) or a flexible spending account (FSA), you can use those to reimburse the cost, as these are considered health-related expenses.
Q: How accurate are the combination tests?
Dr. Martin: All these tests have gone through the same rigorous approval process, which means they meet a certain threshold for accuracy that is established by the Food and Drug Administration (FDA). They are all held to the same standards, so their effectiveness is similar across the board. Over the past few years, the performance of these types of tests has improved, so you can feel confident that they provide reliable results for both COVID-19 and flu detection.
Q: When should I use the combination test?
Dr. Martin: The best time to use a combination test is during cold and flu season, when multiple viruses like COVID-19, influenza A, and influenza B are circulating. If you have respiratory symptoms, it's a good idea to use a combo test to determine whether you have COVID-19 or the flu, especially since the symptoms can overlap.
However, there are some situations where a single COVID-19 test might make sense, like if you've been directly exposed to someone with known COVID-19 and you start developing symptoms. That said, the cost difference between combination tests and single COVID-19 tests is usually minimal, so I tend to favor having the combination test on hand.
It's important to use these tests early in the course of your symptoms, ideally within the first few days, because treatments for both COVID-19 and the flu are most effective when started early.
Q: What should I do if I test positive for COVID-19 or the flu?
Dr. Martin: If you test positive for either COVID-19 or the flu, the first thing to do is take precautions to prevent spreading it to others. Practice good hygiene, isolate as much as possible from others in your home, and follow general cleaning practices to reduce the risk of transmission to your family.
It's also important to contact your healthcare provider, especially if you have risk factors for severe illness. Conditions like chronic lung disease, heart disease, cancer, diabetes, high blood pressure, being overweight, or simply being older can increase your risk, so it's important to let your healthcare provider know you've tested positive. They can guide you on next steps, which may include antiviral treatments that are most effective when started early.
I also recommend checking the latest CDC guidelines for specific recommendations, as they can change depending on current data.
If you test negative, the FDA recommends repeat testing 48 hours following a negative result whether or not you have COVID-19 symptoms. A follow-up test can give you extra reassurance that it's not COVID-19 or the flu, reducing the risk of missing someone who may be positive for COVID-19 or flu.
Q: What types of testing and resources are available at Emory, and how can people access these services?
Dr. Martin: As a national test verification center, Emory offers both the Atlanta community and surrounding areas access to valuable testing resources. We validate and verify the performance of new diagnostic tests, but we also provide free testing services to the public for COVID-19, flu, and RSV.
If you're interested in getting tested, you can visit our website and sign up for an appointment. We'll test you for these viruses, or if you're curious about using the latest at-home tests, you can even help evaluate those new tests. This is a free service, and we often compensate people for their time when they participate in our project to validate the latest tests.
To participate or learn more about these services, you can sign up at our website: Emory RADx COVID-19, Flu, and RSV Test Research Study.
