![]() ![]() The program includes community-led provision of education and supplies for low-income households with new COVID-19 diagnoses. We have been operating a walk-up COVID-19 rapid test-and-respond site in the Mission District of San Francisco through an academic, community, and public health partnership that provides low-barrier services that extend the reach of traditional health systems and conducts ongoing molecular surveillance for SARS-CoV-2. Given that delay times for the return of PCR test results are often over 24 hours, rapid antigen tests could play an important role in identifying persons who could benefit from treatment however, it remains unclear to what extent this advantage outweighs the limitations of sensitivity in early infection. ![]() Both treatments require initiation within 5 days of COVID-19 symptom onset. There are now 2 oral treatments-nirmatrelvir/ritonavir (Paxlovid TM) and molnupiravir (Lagevrio TM)-for persons with COVID-19 deemed at high risk for progression to serious disease. For this reason, repeat rapid antigen testing is recommended for persons with suspected infection but a negative rapid antigen test. One limitation of these assays is that during the upswing of virus after initial infection, they detect fewer cases compared to RT-PCR testing. Rapid antigen tests have the advantage of providing results quickly and outside of medical clinics or in the home. Rapid antigen tests are used as a surrogate for infectiousness based on their correlation to in vitro cultures, although this application is imperfect with gaps in existing data. They effectively detect high levels of virus but are less sensitive than reverse transcriptase polymerase chain reaction (RT-PCR) assays at lower viral levels. SARS-CoV-2 rapid antigen tests are public health tools that can be used for COVID-19 diagnosis, to identify persons most at risk for transmission, and as mileposts for isolation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. The BinaxNOW cards were provided by the California Department of Health. The work is made available under the Creative Commons CC0 public domain dedication.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files.įunding: The funding for this study was provided by University of California, San Francisco, the Chan-Zuckerberg Biohub, the San Francisco Department of Public Health, the California Department of Health, and the McGovern Foundation. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. Received: NovemAccepted: MaPublished: March 24, 2023 PLoS ONE 18(3):Įditor: Etsuro Ito, Waseda University: Waseda Daigaku, JAPAN (2023) Field assessment of BinaxNOW antigen tests as COVID-19 treatment entry point at a community testing site in San Francisco during evolving omicron surges. Simulations support BinaxNOW as an entry point for COVID-19 treatment in a community field setting.Ĭitation: Schrom J, Marquez C, Wang C-Y, Saxena A, Mitchell AM, Ribeiro S, et al. BinaxNOW detected high viral load from anterior nasal swabs consistently across omicron sublineages emerging between January and June of 2022. In analyses to evaluate entry to treatment, BinaxNOW detected 81.7% (361/442, 95% CI: 77–85%) of persons with COVID-19 within 5 days of symptom onset. BinaxNOW detection was consistent over lineages. Among 1,137 RT-PCR positive samples, 788/1137 (69%) were detected by BinaxNOW 94% (669/711) of those with Ct value <30 were detected by BinaxNOW. We identified waves of predominant omicron BA.1, BA.2, BA.2.12, BA.4, and BA.5 among 720 sequenced samples. Among 25,309 persons tested with BinaxNOW, 2,799 had concomitant RT-PCR. Monte Carlo simulations were conducted to estimate the expected proportion of SARS-CoV-2 infected persons who would have been diagnosed within 5 days of symptom onset using RT-PCR versus BinaxNOW testing. SARS-CoV-2 genomic sequences were generated from positive samples and classified according to subtype and variant. We collected anterior nasal swabs for BinaxNOW and RT-PCR testing and clinical data at a walk-up, community site in San Francisco, California between January and June 2022. Although antigen tests are less sensitive than RT-PCR, rapid results could facilitate entry to treatment. COVID-19 oral treatments require initiation within 5 days of symptom onset. ![]()
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