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Home COVID-19 Testing Could Prevent Infections and Reduce Deaths

The analysis highlights the importance of high-frequency testing as a complement to social distancing, vaccination, and other mitigation strategies.

Recent data published in the journal Annals of Internal Medicine has found that using a SARS-COV-2 test at home once a week could greatly reduce total infections and mortality at a justifiable cost. The study was conducted by investigators from the Yale School of Public Health.

Rapid antigen tests have the capability to warn people in real-time that they could potentially be infected with COVID-19 and be contagious. This could allow them to self-isolate before they are able to spread the virus further to other people.

However, many critics have suggested that testing at home could suffer from poor uptake, imperfect adherence, frequent false-negative results and frequent false-positive findings.

The investigators behind the study employed a mathematical model to estimate the number of infections, hospitalizations and death that could be avoided by supplying households with a test to self-identify and self-isolate before they infect others. The model also took into account how much it would cost.

To do this, they assumed that as many as 75% of households would elect to discard the package without opening it, that as many as 75% of the people would ignore a positive result, and that fewer than 25% of persons who elected to self-isolate would do so for a full week, as recommended.

Findings from the study demonstrated that over a 60 day period, 2.8 million infections and 15,700 deaths in the US could be avoided with the availability of weekly testing. Additionally, the cost would be just $68 per person. This includes $38 for testing, $32 in additional workday productivity losses, and savings of $2 in inpatient hospitalization. The cost-effectiveness ratio worked out to be $1.43 million per death averted.

In the interview with Contagion below, Paul Sax, MD, said that “The bottom line is that if you do this kind of strategy, where you kind of flood the market with rapid tests that are readily available and can be used regularly, what you can then do is have people periodically do them and with a positive result, self-isolate and not transmit to others.”