New research shows the value of antigen testing in the home to slow the spread of COVID-19
New research shows the value of antigen testing in the home to slow the spread of COVID-19

New research shows the value of antigen testing in the home to slow the spread of COVID-19

Two recent studies supported by the National Institutes of Health Rapid Acceleration of Diagnostics (RADx) Tech program show how widespread distribution of COVID-19 antigen tests in the home can be used as an effective public health strategy to reduce the spread of the disease.

Cases dropped by an average of 40 a day in communities
who received the free tests, according to one of the studies.

Both surveys were placed on the preprint server medRxiv and has not yet been peer reviewed.

“Obviously, fast antigen tests at home are useful and they have a huge value on an individual level in terms of how people decide to live their lives in the pandemic, but they also provide invaluable information to experts at a public health level,” Apurv said. Soni, MD, PhD’21, assistant professor of medicine and chief investigator of the studies.

The first examination assessed the effect of Say yes! COVID test program in Michigan, where 500,000 free rapid antigen tests in the home were distributed in the summer of 2021 to residents of Ann Arbor and Ypsilanti, two municipalities in Washtenaw County. Each household that participated received 25 home tests.

Researchers compared trends in COVID-19 infection rates during and after the distribution period in the two cities versus the rest of the county, which did not receive free home tests.

The COVID-19 infection rate was similar between the two cities and the county during the intervention period, but two months later, when the delta variant rose sharply, the infection was significantly lower in the cities that had received the free home tests, according to data provided by Washtenaw County Health Department director and study co-author Juan Marquez, MD, MPH.

“The number of cases that were reduced in communities that received the free tests is on average 40 cases a day, which is quite significant,” said Dr. Soni.

Soni said the trend was consistent in the two intervention communities, even though Ann Arbor had a higher than average vaccination rate and Ypsilanti’s vaccination rate was lower than the county average.

Researchers found that households receiving the 25 free trials used a handful of them during the June-August intervention period, but stuck to the rest and began using them more as the delta increase began.

“Overall, we see that people are responsible users,” Soni said. “They have a stockpile of rapid antigen tests, and they know to use them when cases increase, and not to use them when COVID-19 cases are low.”

That second study, which analyzed data from Say Yes! The COVID testing program in six communities across the country found that people were more likely to report the results of their home antigen testing to local health departments if they were given a financial incentive to do so.

It also found in all cases that negative test results were more likely to be reported than positive test results, a conclusion that Soni said researchers investigated further.

The study looked at the use of a digital assistant developed by the company CareEvolution, through which people could order quick antigen tests at home and have the option to log their results on the app or report them to the health department.

Most Communities in Say Yes! The COVID test program was strategically selected by the National Institutes of Health and the U.S. Centers for Disease Control and Prevention among those with lower vaccination rates and socioeconomic status. The six included in the study of optional digital assistant use and reporting of results were: Louisville, Kentucky; Marion County, Indiana; Fulton County, Georgia; O’Ahu, Hawaii; Ann Arbor / Ypsilanti, Michigan; and Hamilton County, Tennessee.

A $ 25 gift card incentive was offered throughout the intervention in Indiana and Kentucky if participants reported at least one test result through the digital assistant. The incentive was also offered in Georgia and Hawaii, but was not implemented until halfway through the intervention.

The survey showed that of the 178,785 households that ordered test kits through the digital assistant, a total of 8.5 percent chose to log their test results on the platform. In addition, 75 percent of these logged tests were also reported to the State Department of Health.

Reporting test results differed significantly from state to state and were highest in Kentucky and Indiana (more than 90 percent of the recorded tests were reported to public health officials), which were the states with full incentives for reporting.

“We need to do better in terms of incentives or campaigns to report test results, especially when they are positive,” Soni said.

“It’s people at home doing their normal routine,” said Nathaniel Hafer, PhD, assistant professor of molecular medicine and lead investigator of the RADx Tech Clinical Studies Core Logistics Team. “There are many strengths in these real-world studies, as opposed to the highly controlled studies that do not necessarily give us a real picture of people’s behavior.”

The project is made possible with federal funding from the National Institute of Biomedical Imaging and Bioengineering and the National Heart, Lung and Blood Institute, National Institutes of Health, Department of Health and Human Services.

Related reporting in New York Times:
Many virus cases do not count: Are there better ways to track the pandemic?
Mass distribution of coronavirus tests may have helped slow the Delta rise in two Michigan cities, a study suggests

Related news from UMass Chan:
Home COVID-19 antigen test detects omicron and delta variants in the same way, the study shows
New studies to test the performance of COVID-19 home tests for omicron
Rapid testing plays a crucial role in curbing COVID-19 infections – especially when people gather for the holidays


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