Error Rates in SARS-CoV-2 Testing Examined with Bayesian Inference

Abstract

A literature review on SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) is used to construct a clinical test confusion matrix, including false positives and false negatives. This allows the simple correction of bulk test data results to estimate the actual infection rate, as demonstrated with examples. Then, the required sensitivity and specificity of a test are explored for the societal needs. It is indicated that many of the people with mild symptoms and positive test results are unlikely to be infected with SARS-CoV-2 in some regions. It is also concluded that current and foreseen alternative tests cannot be used to “clear” people as being non-infected. Recommendations are given that regional authorities must establish a programme to monitor operational test characteristics before launching large scale testing; and that large scale testing for tracing infection networks in some regions is not viable, but may be possible in a focused way that does not exceed the working capacity of the laboratories staffed by competent experts. At scale RT-PCR tests cannot be relied upon as the gold standard for SARS-CoV-2 diagnosis, instead clinical assessment supported by a range of expert diagnostic tests should be used.

SARS-CoV-2 and Liver Transplant: How Has It Behaved in This Sixth Wave?

“…These findings together with those reported from South Africa, United Kingdom, and Canada, are consistent with experimental animal infection that Omicron causes less severe disease in mice and hamsters. 4,10…”

Comparing the Diagnostic Accuracy of Point-of-Care Lateral Flow Antigen Testing for SARS-CoV-2 with RT-PCR in Primary Care (REAP-2)

“…Sensitivity was higher when conducted by lab scientists (70.2%) or trained health care workers (73%) when compared to self-swabbing by self-trained members of the public (57.5%) [26]. To rule out infection in a high prevalence setting, high test sensitivity (true positive value) is more important than high specificity (true negative value) as a highly sensitive test means there are fewer false negative results and thus fewer cases of infection are missed [27]. In our study, sensitivity was 95.4% suggesting that LFT could rule out infection with more than 95% confidence among those 4.9% of suspected cases who tested LFT non-reactive.…”