Could free rapid antigen tests cause more harm than good?

As Omicron numbers soar and Australia pivots towards large-scale use of rapid antigen tests (RAT), constituents are screaming for them to be provided free of charge.

The political response from the states has been a scramble to secure and offer supplies, hoping to avoid the backlash that has accompanied their Covid-related decisions to date.

Fortunately, however, Australia has strict pharmaceutical protections in place and the only rapid antigen tests available for distribution are listed by the Therapeutic Goods Administration (TGA).

The TGA has listed 15 different rapid antigen tests and categorised them according to their clinical sensitivity. The judgment is based on studies done by the manufacturer that show the positive percent agreement (PPA) – the percentage of individuals that produced a positive test result using a rapid antigen test, in comparison with a positive test result by PCR test.

The minimum clinical sensitivity a testing kit must achieve before it is listed is 80 per cent, which it labels as “acceptable sensitivity”. A kit with 90 per cent PPA is labelled “high sensitivity” and a kit that records clinical sensitivity greater than 95 per cent is considered to have “very high sensitivity”.

There are only five kits that have been given the “very high sensitivity” label:

• All Test Sars-CoV-2 Antigen Rapid Test (Nasal Swab)

• Panbio Covid-19 Antigen Self-Test (Nasal Swab)

• OnSite Covid-19 Ag Self Test (Nasal Swab)

• Lyher Novel Coronavirus Antigen Test Kit (Nasal Swab)

• V-Chek Covid-19 Antigen Test (Saliva)

Adding to the confusion however, there are some tests that reportedly, don’t detect the Omicron variant or need to be used in conjunction with LED torches to interpret the results – and not unlike the burgeoning waste issue with masks, the latter brings with them significant concerns for Australian landfills and possible battery consumption by children.

The onus, therefore, is on the local supplier - whether organisation, supermarket or pharmacy - and the purchaser to do their homework and to select tests of high or very high sensitivity and specificity.

As federal government commit another $375m to buy rapid tests for the national stockpile, there is criticism that once again the issue has “fallen to the states”. Victorian health minister, Martin Foley, has announced that they have bought 34m tests and hope to start handing them out next week, joining NSW which has now ordered 50m and will distribute them from the end of January.

The real issue, however, is whether these states are merely playing politics, appeasing constituents without considering the critical issue of collecting crucial data so that they may better understand community transmission and respond to the pandemic more effectively.

If, for instance, there are 30 million tests issued at a wholesale cost of $6 a piece, that’s an initial spend of $180 million. To spend that amount of money and likely not be able to monitor the results or identify and assist the end user that has a positive result, means that the government is not making effective decisions regarding the protection of communities.

Worse still, indiscriminate distribution without appropriate reporting opens the very real potential of arbitrage – where millions of tests are never used for their intended purpose – instead being amassed and sold on the black market or shipped overseas for sale. Already we are seeing rapid antigen tests double in price due to price-gouging.

We only have to look at the UK Governments’ experience with its initial tranche of free RAT handouts to see ‘what not to do’. Approximately 1.8bn Pounds was wasted in the first provision of tests, when the government could only identify 17 per cent of end users having completed a test. That is 83 per cent potentially having headed offshore.

By spending just a fraction more than the cost of a RAT test, authorities could link each test to a proven mobile app and robust management system that effectively records consent and identification of the test user, the location of where the test is taken and access to every result.

Speaking of the current situation, Graham Gordon, CEO and founder of Gardian, and the developer of the Gardian Self Check app believes the answer lies somewhere in the middle.

“The government is already supplying rapid antigen tests to Commonwealth-subsidised residential aged care facilities, multi-purpose services and national Aboriginal and Torres Strait Islander flexible aged care program services in areas of high prevalence of COVID-19, with additional kits to NSW, QLD, ACT, VIC and SA expected to commence in early 2022. 

“Perhaps a more comprehensive solution – one that would meet the health and continuity requirements of business and the general public, would be to implement a rebate system based upon tests taken in conjunction with an official app that is linked to a Medicare card. This would ensure that the results could be tracked, and support provided to ‘positive’ individuals, while the ‘cost’ of the test is rebated,” said Gordon.

How difficult have you found it to find RATs?

7 comments

impossible.

I agree.

Ask my chemist today and his answer could be a week, a month or who knows.

 

Humblest apologies Leon but I don't know any other successful way to bring a burning issue to the notice of YLC. The following members have expressed a desire to return to the old system where the forum was busy and the to and fro was interesting to say the least.

Margaret Thompson posted:

I like YourLifeChoices: no, really-despite the click-baitiness of the stories, the dearth of helpful information in those stories, and the utter lack of suggested solutions to the issues that are addressed in some stories.

I have noticed that fewer and fewer comments are left on story pages (actually, no comments at all) and wonder if the readership is declining, or like me, just no longer willing to comment on no-news bad-news. A many years ago, when I first subscribed, some people just wouldn't stop putting forward their 'insights' into the stories they had just read.

Anyway, the real reason I'm commenting is the subject line of the latest YLC email, which is:

Shaming the unvaccinated | Putting healthy options first | Good deeds in 2022 | Salted Caramel Pavlova

Is giving its readers a recipe for salted caramel pavlova the best that can be offered when asking readers to also peruse at an article about putting health options first? I think not.

In a big lie world where clear communication is essential, can we not do better, editors? If we expect the younger generations to age well - be thoughtful and empathetic - can we not furnish a better example? I think we can.

Responses include Milly: I admit I was absent from YLC for a couple of months but was surprised when I came back to find no comments under the articles. I have to admit I often didn't read the article just the comments as I thought they were more fun and informative. Today I thought I would actually post which is something I normally don't do as I am more of a lurker and sponge of information and opinions and find out why there are no comments anymore where last year there were comments by the dozen. I actually thought I had missed something like a change in format that disallowed them. 

RnR: I can never find any comments under the main YLC articles ... been happening a long time now for me. 

Celia: 

There is an easy answer for me at least!

I don't belong to 'D'  'F' Twitter and Google and do not wish to change or add to my already selections.

Pity I have often wanted to make a comment on those sites but I cannot, it is not for trying as I have mentioned this to Management and they ignore me. 

I guess the same applies to others?

Lets have a chat about this problem.

I have even copy and pasted this issue into a new Chat here and nothing happened so I guess management could not care less either.

Why cannot we use the system we do here?

Horace Cope: I agree with those who can't see posts on articles that YLC posts. I have added posts from time to time but no more as a friend who is also on YLC has told me that he has never seen any of my posts. I sent a link to an article I posted and he said that the link showed no posts were there. I used to enjoy the banter, the back and forth of the original site and it would be nice if this could return. Regardless of what I have been told, no posts are appearing on the YLC posted articles although those added by members in the Forum are accessible and it seems that responses are all accepted and posted. Over to you Admin. 

When you're bored.....

Borrow Books From Library

I too find this disappointing as I used to love reading the comments as it helps to process information gaining a cross section of peoples views on any subject.

I have tried everything to see if it's an issue on my part but still have no comments. 

Maybe people have just given up trying now and we may never go back to the fun interactive banter that we enjoyed so much in the past.

There has been a response from Leon at Admin about comments at 

https://forums.yourlifechoices.com.au/the_meeting_place/post/comments-not-welcomed

"Hi Hobbit and Suze,

We're still working through the glitches in the comments system. Should be sorted soon. Your comments aren't being deleted on purpose. We apologise for the hassle, too. Hopefully we'll have it back on track soon."

I've purchased 10 nasal swab tests with high sensitivity from Amcal Pharmacy under $10 each, before all this drama began.

For me the Government and our health officials move too slowly - it pays to read what is happening overseas.

'The judgment is based  on studies done by the manufacturer'. This statement alone makes me suspicious! Judgment should be based on independent studies completed by competent and qualified experts with no financial or organisational ties to the manufacturers, otherwise they are always going to be questionable at the very least.

Yes, they can cause more harm than good.

Rapid antigen tests aren't accurate... they may produce false positive and negative results. To be more effective they have to be used over multiple days.

Good luck to anyone trying to get the RAT tests near me, absolutely none available to the public due to shortages.

A friend had a RAT tester and put some orange juice in and it showed up positive

7 comments



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