As Australia opens up and we learn to live with COVID-19, rapid antigen testing could play an increasingly important role in limiting the spread of the virus.
So we can expect a growing demand for these tests, which can give results in minutes, and are already being used in other countries, including the United Kingdom.
Airline travel, accommodation, admission to ticketed programs and school attendance may depend on this type of test. Large-scale family gatherings and community events also want to ensure the safety of all attendees, especially if some, for whatever reason, are unconnected.
Read more: Rapid antigen test has long been used abroad for the detection of COVID. Here’s what Australia can learn
What are Rapid Antigen Tests?
Rapid antigen tests have several advantages over polymerase chain reaction (PCR) tests used in public testing centers. They are cheap, can be used anywhere at any time, and results are available in minutes. But they are also less reliable than PCR tests.
The Therapeutic Goods Administration (TGA) has approved dozens of these rapid antigen tests. But these are only available for use in health care, aged care, schools and workplaces.
These tests are not commercially available for home use, although this continues. Health Minister Greg Hunt expects home tests to be available from November 1.
Between now and then, here are four issues we need to consider whether individuals and families are expected to use these tests and if there is an effective and equitable access to rapid antigen testing activities and services. is the door.
1. Do they work?
The TGA will need to ensure that the tests, many of which were developed more than a year ago, perform well with the Delta version.
A Cochrane review recommends evaluation of tests in settings where they are used to fully establish how well they work in practice. Whether this research is being done in Australia is not clear.
Tests from different manufacturers vary in accuracy and are less accurate in people without symptoms and/or with low viral loads – when they would be most commonly used.
Read more: Rapid antigen test is not accurate. But it could be a useful part of Australia’s COVID response
Many home tests recommend testing twice over a three-day period, with at least 36 hours between tests; They work best when testing is done regularly.
Appropriate consumer information materials need to be included with tests to ensure that people are using and interpreting them correctly at home.
There is also a need for a back-up service (such as a telephone hotline) for those who are confused, get unexpected results, and for those who test positive and need a PCR test to confirm their status. it occurs.
2. Do we have enough tests?
There are already indications that supplying these tests could be a problem.
The largest Australian manufacturer of rapid antigen tests has a large government supply contract with the United States, where the supply of such tests cannot keep pace with demand.
India has also recently acted to restrict the export of rapid antigen tests.
There are indications that the federal government has supplies for distribution to aged-care facilities and local government areas as needed. However, the extent of the stockpile – and whether tests can be released from the stockpile for home use – is unknown.
3. What will be their cost?
Once approved for use at home, people will be able to purchase these tests at pharmacies. However, no suggestion has been made that these will be subsidized or that their prices will be controlled.
There are various international perspectives. In the UK, people can order two packs of seven tests for free from a government website and pick them up from places including pharmacies and libraries.
In Germany, people can buy the test in supermarkets for €25 (about AU$39) for a pack of five.
In the US, there are huge price variations with each test costing US$5-30 (approximately AU$6.80-$40.90).
In Australia, workplaces in Sydney can purchase tests directly from suppliers for AU$8.50-$12.50 (depending on quantity). But they also need to hire a health care professional to monitor their use.
Companies that provide rapid antigen tests are reportedly approaching schools, saying they can supply the tests at $15 each (with an additional cost for a nurse and administration).
Asking parents of school children and university students to pay such costs on an ongoing basis would not be sustainable.
Read more: Keeping workers COVID-safe requires more than just following public health orders
4. How do we ensure equity?
US survey results indicate that Americans’ willingness to regularly use home testing is price sensitive. It is certainly the same in Australia.
To date, all indications are that the federal government is taking a pragmatic approach to introducing rapid antigen testing for home use. But it is imperative that we have an effective delivery mechanism to cover the whole of Australia. We also need a regulated price structure and/or subsidy to make the cost of these tests affordable.
Failure to ensure the availability and affordability of home testing will further harm Australians already affected by the pandemic.
Read more: As lockdowns ease, vaccination disparities risk more harm