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

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

JOURNAL=International Journal of Public Health

VOLUME=67

YEAR=2022

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2022.1604659

DOI=10.3389/ijph.2022.1604659

ISSN=1661-8564

ABSTRACT=<p><bold>Objective:</bold> To quantify the utility of RT-PCR and rapid antigen tests in preventing post-arrival transmission based on timing of the pre-departure test.</p><p><bold>Methods:</bold> 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.</p><p><bold>Results:</bold> 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.</p><p><bold>Conclusion:</bold> 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.</p>