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Validating and Modeling the Impact of High-Frequency Rapid Antigen Screening on COVID-19 Spread and Outcomes

Beatrice Nash, Anthony Badea, Ankita Reddy, Miguel Bosch, Nol Salcedo, Adam R. Gomez, Alice Versiani, Gislaine Celestino Dutra Silva, Thayza Maria Izabel Lopes dos Santos, Bruno H. G. A. Milhim, Marilia M Moraes, Guilherme Rodrigues Fernandes Campos, Flávia Quieroz, Andreia Francesli Negri Reis, Mauricio L. Nogueira, Elena N. Naumova, Irene Bosch, Bobby Brooke Herrera*

High frequency screening of populations has been proposed as a strategy in facilitating control of the COVID-19 pandemic. We use computational modeling, coupled with clinical data from rapid antigen tests, to predict the impact of frequent viral antigen rapid testing on COVID-19 spread and outcomes. Using patient nasal or nasopharyngeal swab specimens, we demonstrate that the sensitivity/specificity of two rapid antigen tests compared to quantitative real- time polymerase chain reaction (qRT-PCR) are 82.0%/100% and 84.7%/85.7%, respectively; moreover, sensitivity correlates directly with viral load. Based on COVID-19 data from three regions in the United States and São José do Rio Preto, Brazil, we show that high frequency, strategic population-wide rapid testing, even at varied accuracy levels,diminishes COVID-19 infections, hospitalizations, and deaths at a fraction of the cost of nucleic acid detection via qRT-PCR. We propose large-scale antigen-based surveillance as a viable strategy to control SARS-CoV-2 spread and to enable societal re-opening.