Health
How accurate are the COVID-19 rapid antigen tests and when is the best time to use them?
Rapid antigen testing, commonly known as RAT, has become an important tool in the Australian arsenal for COVID-19.
PCR testing is still available and continues to be the “gold standard” for testing, but many of us have made rapid testing either for convenience or as part of the requirements for returning to work or school. I’m looking.
RAT provides results within minutes, does not require medical personnel or laboratory treatment, and helps capture cases of COVID-19 that were not otherwise detected.
However, there are some restrictions. It is less accurate, more costly (unlike free PCR), and can give false-negative or false-positive results.
Therefore, the next time you reach RAT, keep the following in mind:
When is rapid antigen testing most effective?
Rapid antigen testing is designed to detect antigens found on the surface of the virus (while PCR testing looks for the presence of the viral genetic material).
They are Most accurate when people have symptomsAnd commonly used optimally Within the first 7 days after the onset of symptoms.
“If people are symptomatic, they often have more viruses present in their nose or mouth … and very quick tests work better,” said an infectious disease doctor and microbiologist. Paul Griffin said.
Dr. Griffin, RAT Picking up illness when people are in the infectious stage, that is, when they are likely to shed the virus, is why they can be a useful screening tool.
However, he said testing negative for RAT is not a guarantee that COVID-19 cannot be spread, but “it is certainly unlikely that it can be transmitted.”
Rapid antigen testing works most effectively at the highest viral load, making it less reliable in detecting COVID-19 very early or very late in infection.
“It will take some time before the viral load becomes detectable,” said Thea van de Mortel, a registered nurse and disease management expert at Griffith University.
Preliminary investigation RAT suggests that SARS-CoV-2 cannot be detected until at least 2 days after someone is exposed to the virus, and it takes an average of 3 days to test positive.
Professor van de Mortel recommends waiting a few days before undergoing a rapid test if you are known to be exposed to SARS-CoV-2.
“The other thing you can do is test for a couple of days in a row after you start the test, which increases your chances of starting the test,” she says.
Which rapid test is the most effective?
In order for rapid antigen testing to be approved in Australia, it must meet certain conditions. Performance requirements outlined by drug regulatory agencies in our countryTherapeutic Goods Department (TGA).
This includes at least 80% clinical sensitivity and at least 98% clinical specificity.
To understand what that really means, This example from Dr. Ashwin Swaminasan:
“Imagine arguably lining up 100 people with COVID infections. Applying the RAT kit with 80% sensitivity results in 80 positives and 20” false negatives “. increase.
“If you line up 100 people who are definitely free of COVID infection, using the RAT test with 98% specificity will result in a negative 98 and 2″ false positives. ” “
TGA classifies rapid antigen testing into three categories: Acceptable sensitivity (> 80%), high sensitivity (over 90%), and very high sensitivity (95% or more).
In Australia 40 Rapid Antigen Tests (Home) Approved by TGA..
Dr. Griffin said that although there was “a lot of volatility,” RATs that require a nasal swab tend to be a little more sensitive than RATs that test saliva because “usually a large amount of virus is found in the nose.” Said.
“Of course, there are benefits to having a variety of tests. For example, saliva-based tests are often suitable for children because they are easy to manage,” he said.
Regardless of which test you use, it is important for Professor van de Mortel to follow the instructions carefully, and for saliva swabs, eat, drink, smoke and brush your teeth 10 to 30 minutes in advance. Please do not smoke.
Does Rapid Antigen Test Detect Omicron?
When Omicron appeared in late 2021 There is also concern that rapid antigen testing may reduce sensitivity. When discovering a new variant.
This is because mutations in the virus can change the structure of viral proteins, making them undetectable by test kits.
However, Dr. Griffin said these early concerns were not substantiated by quality evidence.
“Recently, we’ve found that many rapid antigen tests are positive for BA1 and BA2 … so they’re likely to function as well as previous mutants,” he said.
TGA We are currently reviewing and reporting evidence provided for rapid inspection. And how sensitive they are to the new COVID-19 mutants, including Omicron.
“As each variant of concern emerges, manufacturers are expected to perform an analysis … to verify that their tests continue to run as intended,” says TGA.
“There are many mutations in the viral pesplomer, not the nucleocapsid protein, which is the main target of these types of tests.”
As of mid-March, 85% of antigen and rapid antigen tests “Evidence of performance” for Omicron was shown, one test (a point of care test performed by healthcare professionals) was interrupted, and a few were still under consideration.
Preliminary investigation Australian scientists announced in December that the 10 off-the-shelf RAT kits were equally sensitive to detecting delta and omicron variants.
My RAT says I’m negative, do you feel sick?
If you feel sick and have a negative rapid antigen test, we recommend that you isolate for another 24 hours and perform another RAT or PCR.
“At this point, the infection rate is so high that if you have compatible symptoms … you have to treat yourself as positive until the PCR is negative,” said Dr. Griffin.
“Rapid antigen testing involves a significant proportion of false negatives.”
The sample may be collected too early or incorrectly, the immune system may be working hard to keep the viral load very low (even if it is infected), or the test may not be sensitive enough. You may also have another illness.
If the PCR test is negative, it is unlikely that you are infected with COVID-19.
However, Professor Van de Mortel said that in order to protect others no matter what illness you have, you should remain isolated until your symptoms are resolved.
“One of the interesting things about this time is that, like most upper respiratory tract viruses, influenza cases have passed the floor because of the precautions people are taking,” she said.
“Personally, if you feel sick, you should try to stay at home, even if you’re not a COVID. If you absolutely need to go out, wear it. Others around me Mask to protect people. “
you Thick contactRegardless of the test result, it should be quarantined for 7 days.
My RAT says I’m positive, how are I?
The risk of a “false positive” result is much lower than a “false negative” result. Remember that the specificity of the approved RAT must be 98%.
It is also not uncommon for people to have very mild or no symptoms when infected with COVID-19.
However, if you haven’t left home for a few weeks, or if you have a very unexpected positive result, it’s a good idea to repeat the test after 24-48 hours or run a PCR test. However, there are negative consequences.
For COVID-positive individuals who have completed a 7-day quarantine period, it is not necessary to complete the RAT test, but the chances of getting infected are small, but it is worth remembering.
If you have symptoms such as sore throat, runny nose, cough, or shortness of breath (last 24 hours), you should keep them isolated until 24 hours after the symptoms disappear.
Even in the absence of symptoms, Dr. Griffin recommends wearing a mask to avoid high-risk settings for a few more days.
“In some states, there is a rule to wear masks for an additional period of time after quarantine. This is another very less likely to give masks to people who may still be slightly infected. It’s a good way, “he said.
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