Abstract
Objective: This paper motivates and justifies the use of antigen tests for epidemic control as distinct from a diagnostic test.
Study design and setting: We discuss the relative advantages of antigen and PCR tests, summarizing evidence from both the literature as well as Austrian schools, which conducted frequent, mass rapid antigen testing during the spring of 2021. While our report on testing predates Delta, we have updated the review with recent data on viral loads in breakthrough infections and more information about testing efficacy, especially in children.
Results: Rapid antigen tests detect proteins at the surface of virus particles, identifying the disease during its infectious phase. In contrast, PCR tests detect viral genomes: they can thus diagnose COVID-19 before the infectious phase but also react to remnants of the virus genome, even weeks after live virus ceases to be detectable in the respiratory tract. Furthermore, the logistics for administering the tests are different. Large-scale rapid antigen testing in Austrian schools showed low false-positive rates along with an approximately 10% lower effective reproduction number in the tested cohort.
Conclusion: Using antigen tests at least 2-3 times per week could become a powerful tool to suppress the COVID-19 pandemic.
Keywords: COVID-19; Large-scale testing; Lateral flow device; Public health; Repeat testing; SARS-CoV-2.
【저자키워드】 COVID-19, public health, SARS-CoV-2., Lateral flow device, Large-scale testing, Repeat testing, 【초록키워드】 public health, SARS-CoV-2, Efficacy, children, COVID-19 pandemic, diagnostic test, diagnostic, Delta, Antigen, Protein, Cohort, Rapid antigen tests, Schools, Epidemic, Lateral flow device, Viral load, Reproduction number, Rapid, viral genomes, breakthrough infections, Breakthrough infection, School, respiratory tract, antigen tests, PCR test, information, diagnose, Live virus, Evidence, Large-scale testing, Repeat, PCR tests, spring, viral loads, virus particles, powerful tool, logistics, while, virus genome, Public, effective, tested, detect, detectable, the disease, conducted, suppress, false-positive rate, Lateral, 【제목키워드】 SARS-CoV-2, Epidemic, rapid antigen test, School, observation, benefit,