Few counties collect information on at-home COVID tests. How does that impact pandemic tracking?

Like most Iowans, Michelle Richardson has come to rely on at-home testing options to monitor for COVID-19.

So this past June, when her and her husband's rapid test kits came back positive, the 63-year-old from Norwalk attempted to notify public health officials. She had already discovered her primary care doctor would not be reporting her infection to the state.

Richardson called the Warren County Health Services and the Iowa Department of Public Health. People at both agencies said there was no way to tally residents' positive at-home coronavirus tests.

That fact alarmed Richardson, who said she's seen many friends and family members who have come back positive for COVID-19 through at-home test kits in recent months.

"So many of them had COVID-19 through June and July, and none of it was reported because there's no place to report it," she said. "Why are (state public health officials) not reporting that? Why are they not recording those numbers for those who do call?"

More: Iowa COVID-19 cases, hospitalizations drop to lowest points in over a month

Richardson's case highlights the reality of coronavirus tracking in Iowa. In the months since at-home testing options were made widely available, weekly surveillance data from the Iowa Department of Public Health has not captured those results. Instead, the report relies on data from health care providers, labs and county public health agencies.

Some local public health agencies have offered the option for residents to report positive at-home test results, but with few Iowans volunteering that information in a limited number of counties, public health officials say the full picture of the pandemic has become murky.

"We know more and more people have easy access to at-home test kits, and that throws off the numbers," said Nola Aigner Davis, public information officer at the Polk County Health Department.

National public health experts say the availability and convenience of at-home testing outweighs the loss of a more complete count of infections among the general public. Now that COVID-19 vaccines and treatment options are widely available, total case counts carry less importance in overall pandemic response, said Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, part of the Bloomberg School of Public Health.

"COVID-19 is not going to be eradicated," Adalja said. "There will always be cases. The goal was never to minimize cases. The goal was to minimize severe illness and death."

Some Iowa public health agencies attempt to collect at-home test data

The Polk County Health Department is among the few local public health agencies in the state that have created tools to collect at-home test results. The online survey that residents can use to report an infection, on the agency's website, has been live since February.

But among the more than 496,000 residents of Polk County, only a small portion have volunteered their positive at-home tests.

To date, 2,226 residents have self-reported positive coronavirus cases to the county health department. Aigner Davis said the county received 1,276 reports from July 1 to August 15 alone.

The public health agency in Johnson County also launched a self-reporting tool on its website in April. The survey was created after officials ended contact tracing efforts earlier this year, citing challenges to ongoing disease investigation following the dramatic increase in case counts in the area.

More: Nursing home cited for failing to provide COVID-19 treatment, staff levels and ‘disgusting’ food

An average of 20 to 30 cases is reported each week through the online survey, said Sam Jarvis, community health manager at Johnson County Public Health. However, residents usually report their infections days after they test positive, delaying officials' ability to accurately track community spread.

"The reality is that some folks are testing less. They’re vaccinated or they’re experiencing less symptoms, so the urgency to test is not there," Jarvis said.

With recent virus variants causing less severe disease overall, Adalja said hospital admissions, hospital capacity and deaths are better measurements of COVID-19's impact. He also said wastewater surveillance — which is conducted by Polk County and other counties across the state — is a more effective tool to gauge community spread.

Still, local public health officials say any data is helpful in tracking the movement of the coronavirus throughout their communities, especially after federal health officials loosened many guidelines to emphasize individual decision-making around the pandemic.

"As long as we know what’s going on in our county, it gives us a better picture of what’s around us," Aigner Davis said.

More: Only Iowa college to require COVID-19 vaccines drops mandate after state law bans them

How to self-report at-home COVID test results in Polk County

Polk County residents can report a positive at-home COVID-19 test directly to the Polk County Health Department's website.

Residents without access to a computer can call health officials at 515-323-5221.

To report a positive result, residents need to provide the date they took the at-home test and the type of test used.

Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm.

This article originally appeared on Des Moines Register: Can Iowans report at-home COVID-19 test results? Options are few