A new examine raises vital doubts about whether or not at-home fast antigen checks can detect the Omicron variant earlier than contaminated folks can transmit the virus to others.
The study looks at 30 people from settings together with Broadway theaters and workplaces in New York and San Francisco the place some employees weren’t solely being examined day by day however had been, due to guidelines at their workplaces, receiving each the antigen checks and a day by day take a look at that used the polymerase chain response, or PCR, which is believed to be extra dependable.
On days 0 and 1 following a constructive PCR take a look at, the entire antigen checks used produced false-negative outcomes, though in 28 of the 30 instances, ranges of virus detected by the PCR take a look at had been excessive sufficient to contaminate different folks. In 4 instances, researchers had been in a position to verify that contaminated folks transmitted the virus to others throughout the interval earlier than they’d a constructive consequence on the fast antigen take a look at.
“I believe that with each new variant that comes, scientists should query whether or not the issues that had been beforehand true are nonetheless true,” mentioned Blythe Adamson, the lead creator of the paper and the principal epidemiologist at Infectious Economics in New York. “This one has a special method it travels, a special mechanism of motion of signs, it has completely different home windows of transmission.”
Adamson, who can be an worker of Flatiron Well being, a unit of Roche, mentioned that it was additionally doable there have been extra instances of transmission than the authors had been in a position to verify.
“It’s completely doubtless there have been many greater than 4 transmissions,” Adamson mentioned. “We named 4 as a result of there have been 4 that had been confirmed via contact tracing and epidemiology investigation. There have been doubtless many extra.”
The examine included each the Abbott BinaxNOW and Quidel QuickVue fast antigen checks, each of that are licensed by the Meals and Drug Administration.
The outcomes had been printed in a preprint, that means they haven’t but been reviewed by outdoors researchers.
Different knowledge from the group point out that viral masses peaked in saliva one to 2 days earlier than they peaked in checks taken from nasal swabs, including to proof that swabs taken from the mouth or throat could detect the SARS-CoV-2 that causes Covid higher than the nasal swabs used for a lot of PCR and antigen checks.
“This group of specialists who’ve been doing sequential testing is elevating the uncomfortable chance that antigen testing is lacking folks that may infect others,” mentioned Harlan Krumholz, director of the Heart for Outcomes Analysis and Analysis at Yale. “They’re utilizing state-of-the-art strategies and sound epidemiologic approaches leveraging a well-designed occupational well being program.”
Whereas he was not concerned within the analysis, Krumholz is thanked in acknowledgements part of the paper.
Regardless of its small dimension, the leads to the examine are remarkably constant. Not a single fast antigen take a look at detected the virus till practically two days after the preliminary constructive PCR consequence. Moreover, the instances of an infection from individuals who had acquired false destructive outcomes might increase alarm bells.
Nonetheless, the researchers emphasize, this doesn’t imply that fast antigen checks usually are not helpful. The checks additionally detected the virus in each case – it simply took longer than with PCR. So whereas the checks could not work as an early warning, a constructive take a look at consequence at residence does doubtless imply that the particular person taking the take a look at has Covid-19.
Anne Wyllie, a researcher on the Yale College of Public Well being and a co-author on the paper, mentioned that the reviews she is seeing from most of the people on social media additionally increase her stage of concern.
“If most of the people is seeing this and reporting on it, you realize, that is additionally plenty of proof for me,” Wyllie mentioned. “Like they’re really seeing it. This can be a lot extra widespread than simply this one outbreak that we had been observing.”
Through the pandemic, Adamson and Infectious Economics grew to become consultants to many Broadway productions that had been making an attempt to maintain their staffs protected from Covid. The chance to audiences was comparatively straightforward to manage, however forged and crew members labored in cramped quarters the place a lot of security precautions, together with vaccination, masking, and the usage of fast checks had been all essential to preserve folks protected.
She mentioned that as quickly as Omicron hit, there have been anecdotes about fast antigen checks remaining destructive till days after the contaminated folks had already developed signs. She mentioned she began to really feel anxiousness about whether or not precautions to maintain forged members protected can be sufficient. Since then, quite a few Broadway exhibits, including “Waitress” and “Jagged Little Pill,” have introduced Covid-related closures.