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The impact of high frequency rapid viral antigen screening on COVID-19 spread and outcomes: a validation and modeling study

Nash, B.; Badea, A.; Reddy, A.; Bosch, M.; Salcedo, N.; Gomez, A. R.; Versiani, A.; Dutra, G. C.; Lopes dos Santos, T. M. I.; Milhim, B. H. G. A.; Moraes, M. M.; Campos, G. R. F.; Quieroz, F.; Reis, A. F. N.; Nogueira, M. L.; Naumova, E. N.; Bosch, I.; Herrera, B. B.

2020-09-28 epidemiology
10.1101/2020.09.01.20184713 medRxiv
Show abstract

High frequency screening of populations has been proposed as a strategy in facilitating control of the COVID-19 pandemic. We use computational modeling, coupled with clinical data from rapid antigen tests, to predict the impact of frequent viral antigen rapid testing on COVID-19 spread and outcomes. Using patient nasal or nasopharyngeal swab specimens, we demonstrate that the sensitivity/specificity of two rapid antigen tests compared to quantitative real-time polymerase chain reaction (qRT-PCR) are 82.0%/100% and 84.7%/85.7%, respectively; moreover, sensitivity correlates directly with viral load. Based on COVID-19 data from three regions in the United States and Sao Jose do Rio Preto, Brazil, we show that high frequency, strategic population-wide rapid testing, even at varied accuracy levels, diminishes COVID-19 infections, hospitalizations, and deaths at a fraction of the cost of nucleic acid detection via qRT-PCR. We propose large-scale antigen-based surveillance as a viable strategy to control SARS-CoV-2 spread and to enable societal re-opening.

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