Evidence suggests that SARS-CoV-2 rapid antigen tests provide benefits for epidemic control -- observations from Austrian schools

TL;DR

Rapid antigen tests, especially when used 2-3 times weekly, can significantly aid in controlling COVID-19 spread, as evidenced by large-scale Austrian school testing and their advantages over PCR tests.

Contribution

This paper provides updated evidence on the effectiveness of frequent rapid antigen testing in epidemic control, particularly in school settings, comparing it to PCR testing.

Findings

Frequent antigen testing helps suppress COVID-19 transmission.

Antigen tests are easier to administer at scale than PCR.

Recent data shows efficacy in children and breakthrough cases.

Abstract

Rapid antigen tests detect proteins at the surface of virus particles, identifying the disease during its infectious phase. In contrast, PCR tests detect viral genomes; they can thus diagnose COVID-19 before the infectious phase but also react to remnants of the virus genome, even weeks after live virus ceases to be detectable in the respiratory tract. Furthermore, the logistics for administering the tests are different, with rapid antigen tests being much easier to administer at-scale. In this article, we discuss the relative advantages of the different testing procedures and summarise evidence that shows that using antigen tests 2-3 times per week could become a powerful tool to suppress the COVID-19 pandemic. We also discuss the results of recent large-scale rapid antigen testing in Austrian schools. While our report on testing predates Delta, we have updated the review with recent data on viral loads in breakthrough infections and more information about testing efficacy, especially in children.