Validating and modeling the impact of high-frequency rapid antigen screening on COVID-19 spread and outcomes

Nash, Beatrice; Badea, Anthony; Reddy, Ankita; Bosch, Miguel; Salcedo, Nol; Gómez, Antonio; Versiani, Alice F.; Dutra, Gislaine; Santos, Thayza dos; Milhim, Bruno Henrique Gonçalves de Aguiar; Moraes, Marília Mazzi; Campos, Guilherme Rodrigues Fernandes; Quieroz, Flávia; Reis, Andréia Francesli Negri; Nogueira, Maurício Lacerda; Naumova, Elena N.; Bosch, Irene; Herrera, Bobby Brooke

doi:10.21203/rs.3.rs-104765/v1

Cited by 14 publications

(11 citation statements)

References 59 publications

(36 reference statements)

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“…We show that it can, demonstrating this result within a individual-based network model that can be expected to provide qualitative insight. Our work supports the idea that population-level coverage is more important than test sensitivity, also pointing to a non-linear synergy between non-pharmaceutical interventions such as mandatory mask wearing, with testing accompanied by isolation and quarantine [57].…”

Section: Plos Computational Biologysupporting

confidence: 83%

Optimizing testing for COVID-19 in India

2021

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COVID-19 testing across India uses a mix of two types of tests. Rapid Antigen Tests (RATs) are relatively inexpensive point-of-care lateral-flow-assay tests, but they are also less sensitive. The reverse-transcriptase polymerase-chain-reaction (RT-PCR) test has close to 100% sensitivity and specificity in a laboratory setting, but delays in returning results, as well as increased costs relative to RATs, may vitiate this advantage. India-wide, about 49% of COVID-19 tests are RATs, but some Indian states, including the large states of Uttar Pradesh (pop. 227.9 million) and Bihar (pop. 121.3 million) use a much higher proportion of such tests. Here we show, using simulations based on epidemiological network models, that the judicious use of RATs can yield epidemiological outcomes comparable to those obtained through RT-PCR-based testing and isolation of positives, provided a few conditions are met. These are (a) that RAT test sensitivity is not too low, (b) that a reasonably large fraction of the population, of order 0.5% per day, can be tested, (c) that those testing positive are isolated for a sufficient duration, and that (d) testing is accompanied by other non-pharmaceutical interventions for increased effectiveness. We assess optimal testing regimes, taking into account test sensitivity and specificity, background seroprevalence and current test pricing. We find, surprisingly, that even 100% RAT test regimes should be acceptable, from both an epidemiological as well as a economic standpoint, provided the conditions outlined above are met.

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Section: Plos Computational Biologysupporting

confidence: 83%

Optimizing testing for COVID-19 in India

2021

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“…Thus, antigenbased testing has a relatively small window of detection during the incubation period of infected individuals. RT-PCR is more sensitive because its LoD is as low as 10 2 genomic copies/mL, while that of rapid antigen tests is ∼10 5 genomic copies/mL when correlating the amount of viral proteins to viral nucleic acid quantity (Nash et al, 2020;Vogels et al, 2020b).…”

Section: Antigen-based Assays For Sars-cov-2 Detectionmentioning

confidence: 99%

COVID-19 in-vitro Diagnostics: State-of-the-Art and Challenges for Rapid, Scalable, and High-Accuracy Screening

Habli

Saleh

Zaraket

et al. 2021

Front. Bioeng. Biotechnol.

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The world continues to grapple with the devastating effects of the current COVID-19 pandemic. The highly contagious nature of this respiratory disease challenges advanced viral diagnostic technologies for rapid, scalable, affordable, and high accuracy testing. Molecular assays have been the gold standard for direct detection of the presence of the viral RNA in suspected individuals, while immunoassays have been used in the surveillance of individuals by detecting antibodies against SARS-CoV-2. Unlike molecular testing, immunoassays are indirect testing of the viral infection. More than 140 diagnostic assays have been developed as of this date and have received the Food and Drug Administration (FDA) emergency use authorization (EUA). Given the differences in assasy format and/or design as well as the lack of rigorous verification studies, the performance and accuracy of these testing modalities remain unclear. In this review, we aim to carefully examine commercialized and FDA approved molecular-based and serology-based diagnostic assays, analyze their performance characteristics and shed the light on their utility and limitations in dealing with the COVID-19 global public health crisis.

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“…Breaks in transmission chains can be most effectively achieved when screening testing is applied frequently and serially using self-administered rapid tests (18)(19)(20).…”

Section: (Which Was Not Certified By Peer Review) Preprintmentioning

confidence: 99%

Comparative evaluation of rapid isothermal amplification and antigen assays for screening testing of SARS-CoV-2

Salcedo¹,

Sena²,

Qu³

et al. 2021

Preprint

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Human transmission of SARS-CoV-2 and emergent variants of concern has continued to occur globally, despite mass vaccination campaigns. Public health strategies to reduce virus spread should therefore rely, in part, on frequent screening with rapid, inexpensive, and sensitive tests. We evaluated two digitally integrated rapid tests and assessed their performance using stored nasal swab specimens collected from individuals with or without COVID-19. An isothermal amplification assay combined with a lateral flow test had a limit of detection of 10 RNA copies per reaction, and a positive percent agreement (PPA)/negative percent agreement (NPA) during the asymptomatic and symptomatic phases of 100%/100% and 95.83/100%, respectively. Comparatively, an antigen-based lateral flow test, had a limit of detection of 30,000 copies, and a PPA/NPA during the asymptomatic and symptomatic phases of 82.86%/98.68% and 91.67/100%, respectively. Both the isothermal amplification and antigen-based lateral flow tests had optimized detection of SARS-CoV-2 during the peak period of transmission; however, the antigen-based test had reduced sensitivity in clinical samples with qPCR Ct values greater than 29.8. Low-cost, high-throughput screening enabled by isothermal amplification or antigen-based techniques have value for outbreak control.

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Validating and modeling the impact of high-frequency rapid antigen screening on COVID-19 spread and outcomes

Cited by 14 publications

References 59 publications

Optimizing testing for COVID-19 in India

Optimizing testing for COVID-19 in India

COVID-19 in-vitro Diagnostics: State-of-the-Art and Challenges for Rapid, Scalable, and High-Accuracy Screening

Comparative evaluation of rapid isothermal amplification and antigen assays for screening testing of SARS-CoV-2

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