Home-based SARS-CoV-2 antigen tests could help pandemic control

Frequent, inexpensive, and incomplete home SARS-CoV-2 antigen testing could help pandemic control and be useful as part of a containment strategy. These results were reported in a preprint article published on medRxiv.

Investigators adapted a simple compartment epidemic model to simulate the spread, death, and associated costs of SARS-CoV-2 in the United States. The model included traits such as COVID-19 infection epidemiology, behavioral response to test availability, and test results based on officially published data on the disease. The financial consequences of SARS-CoV-2 and illness-related costs were also taken into account.

Without testing, investigators predicted there would be 15 million infections, 125,000 deaths, inpatient stresses of $ 6.5 billion and productivity losses of $ 3.9 billion over a 60-day period.

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If tested weekly at home over the same period, those numbers would drop to 11 million infections, 106,000 deaths, and inpatient costs of $ 5.9 billion. However, weekly testing would increase lost work days due to the isolation of positive results equivalent to $ 13.9 billion, and partially offset the lower costs for inpatients.

Overall, weekly testing would avoid a cost per infection of $ 5,400 and a cost per death of $ 1.1 million, indicating an exceptional cost value.

In order to assess whether tests at home are still beneficial in the worst case, investigators changed the input parameters. With poor compliance (25% participation; 25% isolation of positives; 33% daily dropout rate) 900,000 infections would still be prevented over 60 days. More expensive tests would still save $ 1.8 million per death. In the poor test performance scenario, an average member of the population would only spend 1.1 days in unnecessary isolation due to a false positive result.

This model may have been constrained by its input parameters, as the researchers reported that their results were based on assumptions.

These results suggest that introducing low-cost SARS-CoV-2 tests at home nationwide would help reduce the spread and mortality of disease. In addition, even in scenarios where the compliance was poor, the tests were more expensive, and the results relatively inaccurate, the tests would result in large cost savings.


Paltiel AD, Zheng A, Sax P E. Clinical and economic effects of widely used rapid tests to reduce SARS-CoV-2 transmission. medRxiv. Published online on February 8, 2021. doi: 10.1101 / 2021.02.06.21251270

This article originally appeared on Infectious Disease Advisor

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