COVID: 1/5 (⭐☆☆☆☆)
COVID: 1/5 (⭐☆☆☆☆)
What do our online reviews of at-home COVID tests say about us?
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9 min read
Our family, like much of the country, spent the past two weeks in the midst of COVID recovery and decision-making. My husband had it, thankfully mild. My son and I had symptoms, which, many tests later, turned out to be colds.1 During the various stages and configurations of quarantine, we spent a lot of time on the Internet, Googling things like “incubation period,” “time from exposure to positive test,” and “new CDC guidance.” Some of us also enjoyed a lot of Goodnight Moon, animal noises, and watching TV as a diversion from the dreaded Snot Sucker. But for most of us, it was a lot of reading and thinking about COVID.
It was during my daily (hourly) online trawl for at-home tests that I came across the customer reviews: thousands of reviews across Amazon, Target, Walmart, and CVS, commenting on the tests we’ve all come to recognize, like BinaxNOW (the one with the droplets), QuickVue At-Home (the one with the test tube), and On/Go (the one with the app).
As someone who studies psychology and the Internet, I couldn’t look away.
A Deep Dive Into At-Home COVID Test Reviews
The reviews cover a lot of ground2.
Some are enthusiastic, like this one, concluding with the analogy that we’ve all been thinking:
Finally! It's a long time coming but finally we have an accurate, at-home rapid antigen test […] At just under $10 per test (it comes as a 2-pack) it's totally worth it. If you can figure out an at-home pregnancy test, you can do this. - OmahaMom
Some (many) are angry:
Do Not Buy!!! worst tests! my husband took a flowflex first and it was positive so to make sure he took this test TWICE and was negative. went to Urgent care and tested POSITIVE! NOT reliable at all! Do NOT BUY!! - Unsterbliche78
There are those that keep it brief (and bitter):
I thought it was for multiple uses not one use. It’s too expensive. I don’t want it. I haven’t used it. - Vladimira
And those that blur the line between review and memoir. My comments embedded:
I purchased this for my family because it was affordable, convenient, and authorized by the FDA for emergency use. [introduction is clear, to the point]
After my nephew was exposed to a major COVID outbreak at his school and he began experiencing symptoms (nasal congestion, vomiting, nausea, and lethargy), my mother performed one of the tests in the middle of the night. [excellent use of narrative detail; setting the scene, introducing characters]
We watched an instructional video on YouTube (highly recommended), and she completed the test step-by-step. Upon sealing the test for the 15-minute wait, two purple lines began to appear almost instantly. [building suspense for the reader, creating tension]
After the instructed wait time, it showed a very clear positive result. [climax of the story]
Since this was our first experience with an at-home COVID test, we weren't sure how reliable it was, but we immediately isolated my nephew from others in the home and began disinfecting. The next day, his father took him to a local wellness center for a rapid test, and it was confirmed that he was, indeed, positive for COVID…[conflict is resolved for the reader; good use of the word “indeed.”] - RainBallerina
There are, as expected, the doubters—not just of the tests, but of other things, too:
What I think is that people have gone insane. Stop listening to the lies and false information. That so called Dr. Fraudci [sic?] should be tried and prosecuted.
I was previously infected exactly 1 year ago and seem to still be protected. I am still unvaccinated but I believe in natural immunity. I don't know why natural immunity is being ignored. My only conclusion is profits over decades of proven science. I was in close contact with many (8 people) who have tested positive in the past few weeks and I am still tested negative […]
There is some confusion about the tests:
I have been vaccinated and no anti bodies show wtf!!! -Pamala
This is not a test for Covid!!!! This is an antigen test NOT A VIRAL load test. this test will not tell you if you have Covid 19. This test will tell you if antigens are present from a previous infection. If you had a Covid infection this test can tell you if your one of the 45% of people who developed antigens from the infection. - Richard
And confusion about the shift key:
THIS IS A SIMPLE TO USE TEST. HOWEVER, IT IS WAY TOO EXPENSIVE!! – TexasGranny
But many of the reviews just look something like this:
COVID HIT US!
[…] My husband picked up COVID about a month after I got my booster shot (and he “wanted to wait”). He started with congestion and then a dry cough (overall pretty mild symptoms). Then all of a sudden couldn’t smell our son’s dirty diapers the next day, and I made him go get tested at our local CVS. Lo and behold the next evening we got his results back from CVS and he tested positive. I went and got tested myself at CVS the following day and these kits arrived in the mail almost as soon as I got home. I took one and made my husband do the other. His read positive and mine negative, which was confirmed by my CVS results the next day […].
This is an accurate at home Covid test. I gave it to my daughter to test before she came home from college this week […] She had been exposed to Covid over the weekend and we wanted to make sure she did not have it prior to coming back home with me, her mother, and her younger siblings. Well she did both tests and they showed she was positive. the next day, 12/14 she had a PCR test done which was also positive. She’s feeling good, few symptoms (she was vaccinated but not boosted yet )and now in her 10 day quarantine at her dads where she has her own bathroom a floor to herself.
People providing details on the minutiae of their experiences: testing dates, symptoms, courses of illness, quarantines. People simply telling their stories.
Web 2.0: Where everyone has a say
Online product reviews—like social media—fit squarely within Web 2.0: the Internet ecosystem in which people can both consume content (read what’s out there) and create content (post their own stuff). Web 2.0 was originally described in comparison to Web 1.0, the dominating model in the early days of the Internet, where we spent a lot of time sitting at (large) computers, reading static webpages that other people had created.3
The power of Web 2.0 was, and continues to be, the contribution of users. The Internet is a big place, and it’s a place where everyone now gets a say. Every site has a comment section. Every platform is built for social interaction. Every product has room for reviews. The benefit is that each person, no matter who they are, has a voice. It doesn’t matter whether you’re an infectious disease specialist, a distributor of antigen tests4, or a guy in Nebraska whose friend once had a stuffy nose.
Of course, the downside of all these voices is the resulting chorus. It’s hard to sort through, to know what to listen to and who to believe, in the onslaught of information and, just as commonly, misinformation.
Sometimes the volume of conflicting information is overwhelming. Linda writes:
I like that the directions were straight forward and not complicated. I purchased it because it gives the result in 15 minutes. However, our local health department told me that home tests are not reliable. There's a lot of double talk in the literature provided with it - it's approved for this but not approved for that.
It's hard to know what to believe.
Why do people write online reviews?
Online reviews are a central component of the Internet as we currently know it. But why do people write them?
Researchers have identified a number of factors that influence people’s likelihood of writing reviews. People are motivated by such things as ego, altruism, and vengeance. In one fascinating study of Amazon’s “top reviewer” community5, researchers asked 280 people about the reasons they write reviews. The researchers argue there are three types of reviewers. About a third of people (37%) are “Challenge Seekers.” These people are motivated to improve their “ranking” as “top reviewers” on the site, but don’t care much about being part of the reviewing community. A smaller group (25%) is “Indifferent Independents.” These people post simply to provide their opinions on the products they choose.
But the majority of people (38%) are “Community Collaborators.” These are the people who derive personal value from the reviewing experience. For them, online reviewing fulfills certain psychological needs—for social connection, competence, independent thinking, and self-expression.
Reviewing provides them with a deeper purpose.6
Across the at-home COVID test reviews, the details of each reviewer’s story are unique. Sometimes a positive result, sometimes a negative. Sometimes a seemingly accurate test, sometimes not. Sometimes a husband, sometimes a child.
Yet the arc of these stories is remarkably similar. A loved one developed symptoms or was exposed. A decision point of when and how to test. A test, often followed by another (and another). And through it all, an attempt to navigate the complexity of a global pandemic as it touches individual lives.
Voices of the pandemic, online
As the baby and I waited—with worsening symptoms—for test results, my husband and I spent the days (separately) buried in data, news, information, digging for facts we could trust. I furiously Googled testing sites, repeatedly called the pediatrician, checked various pharmacy websites, read articles about incubation periods and viral loads and days from exposure to a positive test.
One night, I had a dream that we took the baby with us to some kind of party, and then put him in a parade of unsafe situations. We turned into caricatures of irresponsible parents—leaving him in the bath alone with rising water levels, failing to feed him for hours, forgetting we’d even brought him with us. What is wrong with us? My dream-self was thinking. How are we letting this happen?
Surely this was just a coincidence.
This pandemic is, of course, a global crisis of public health. It is science and data and case rates and sensitivity and specificity and false positives. But it is also deeply personal. It is fear and disappointment and uncertainty and guilt. It is anger and mistrust. It is sadness and grief. It is exhaustion and a desperate readiness to move on.
It is, often, the feeling that you are alone. That you are buried beneath a growing pile of information: of opinions and false claims, of news reports, and CDC guidance, and that article you read in the New York Times, and that study your friend sent you, and those statistics you saw somewhere, and that label you read on your BinaxNOW test. And from the bottom of the information pile you are shouting, because you just want someone to listen to you, to cut through all the information and hear your story.
There is something disheartening about reading online COVID test reviews. When everyone is an expert, the information continues to pile up. The facts are buried. The science gets lost.
And yet, the beauty of this information age is that we, too, are a voice in the pile. Whether we’re an OmahaMom, a TexasGranny, a critic of Dr. Fraudci, or an aunt trying to test our nephew in the middle of the night, we’re all simply trying to live our lives, questioning what to do, trying to make sense of a reality that is complicated and scary and uncertain.
As we clamor though the information pile, we can share our story. And in that, we can feel a little less alone.
I’m not sure which of us spread the cold to the other. For a few days, I assumed it was me, spreading it to the baby. But given that his symptoms started first, and that I have a distinct memory of him drooling directly into one of my eyes, this assumption might be wrong.
Searching “COVID” on Amazon is a rollercoaster that goes far beyond at-home tests. There is COVID-19 and the Global Predators: We Are the Prey, for example, a book that “discloses for the first time the actual blueprint and master plan that that [sic] was ten years in the making by global predators before the pandemic.” There’s also A Mom’s Guide to the COVID Shot, which took me down a Wikipedia rabbit hole on Christiane Northrup, who, apparently, argues that vaccines are unnecessary because they “only boost the first chakra” and is one of only twelve people responsible for 65% of the anti-vaccine content on Twitter and Facebook. Thankfully, to cheer us up, there’s this plush COVID microbe toy, about which reviewer Lynn notes “playing catch with COVID over the holidays was worth the cost.”
Web 3.0, which savvy Twitter enthusiasts pronounce without the “point oh,” is where we’re headed now. The basic idea of Web3 is an even more decentralized, peer-to-peer Internet built on the blockchain. If Web 1.0 is “read,” Web 2.0 is “read and write,” and Web3 is “read, write, and own.” I am still wrapping my head around Web3—stay tuned for another post once I get the basics down.
In an interesting strategic move, Abbott (i.e., the maker of the BinaxNOW test) has dutifully responded to each negative review on the CVS website. For example, a one-star review from someone named Jamey titled Junk Covid Test reads simply: Never worked for 2 positive persons. Waste of money! Directly below this is Abbott’s paragraph-long response, in which they cite clinical data on the test’s sensitivity and specificity: Hi Jamey, thank you for sharing. Based on the results of a clinical study where the BinaxNOW™ COVID-19 Antigen Self Test was compared to an FDA authorized high sensitivity SARS-CoV-2 test, BinaxNOW COVID-19 Antigen Self Test correctly identified 84.6% of positive specimens and 98.5% of negative specimens […] I have a feeling Jamey is unlikely to change his opinion based on these data, but I have to applaud Abbott for the effort.
To incentivize reviews, Amazon has created a complex system that gamifies the review process. Reviewers are ranked based on the number of reviews they’ve written, the recency of reviews, and how “helpful” others have rated their reviews. The current Top 10 reviewers have written anywhere from 2,000 to 11,000 (!) reviews. Part of the appeal is an invitation to the exclusive Amazon Vine program, where reviewers receive free products in exchange for helpful reviews. Apparently, the community is tight-knit, with reviewers becoming close friends online and off, but the competition is fierce, with people “down-voting” others’ reviews to gain advantage. Says Joanna D., Amazon’s #1 Top Reviewer: So, negative votes really did count against you. Well, once that news got out it was like, “Oh I have a competitor who’s near me in the rank and I could be in the top 10? Downvote that sucker!”
Many apps have followed the Amazon model, gamifying the user contribution process to ensure adequate reviewer participation. These apps rely on the (free) contributions of extremely dedicated users, many of whom devote hours of their time for a chance to improve their ranking and gain community status. Waze has its Map Editors, for example, Yelp has Yelp Elite, and GoodReads has its Librarians.
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