International Journal of Public Health (Jul 2022)

Testing for COVID-19 is Much More Effective When Performed Immediately Prior to Social Mixing

  • Chad R. Wells,
  • Senay Gokcebel,
  • Senay Gokcebel,
  • Abhishek Pandey,
  • Alison P. Galvani,
  • Jeffrey P. Townsend,
  • Jeffrey P. Townsend,
  • Jeffrey P. Townsend

DOI
https://doi.org/10.3389/ijph.2022.1604659
Journal volume & issue
Vol. 67

Abstract

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Objective: To quantify the utility of RT-PCR and rapid antigen tests in preventing post-arrival transmission based on timing of the pre-departure test.Methods: We derived analytical expressions to compute post-arrival transmission when no test is performed, and when either an RT-PCR or any of 18 rapid antigen tests is performed at specified times before arrival. We determined the diagnostic sensitivity of the rapid antigen tests by propagating their RT-PCR percent positive agreement onto known RT-PCR diagnostic sensitivity.Results: Depending on the rapid antigen test used, conducting a rapid antigen test immediately before departure reduces post-arrival transmission between 37.4% (95% CrI: 28.2%–40.7%) and 46.7% (95% CrI:40.0%–49.3%), compared to a 31.1% (95% CrI: 26.3%–33.5%) reduction using an RT-PCR 12 h before arrival. Performance of each rapid antigen test differed by diagnostic sensitivity over the course of disease. However, these differences were smaller than those engendered by testing too early.Conclusion: Testing closer to arrival—ideally on the day of arrival—is more effective at reducing post-arrival transmission than testing earlier. Rapid antigen tests perform the best in this application due to their short turnaround time.

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