After a long lockdown, the mood is rising in Ireland as restrictions are being lifted and Covid-19 vaccines are being rolled out. However, in order to reopen society safely, we are still going to need fast, reliable testing. As part of our Well at Work blog series, Dr Shane Farrelly, a Senior Consultant with Cognate Health discusses the benefits of rapid antigen testing.

Rapid antigen testing, which can deliver results in 15 minutes, has been adopted in places like the United Kingdom and Denmark to allow people to enter crowded settings like workplaces safely. Ireland could easily do the same.

To date, Ireland has relied on polymerase chain reaction (PCR) testing to diagnosis Covid-19 cases, and for good reason. PCR testing is highly accurate and can identify the virus even when the patient has a low viral load. However, the drawback is the 24-48 hour waiting period for a result. If we want to reopen safely, frequency of testing is as important as accuracy, and PCR tests cannot provide that.

Antigen tests need a higher viral load to work — meaning a single test might miss a positive case. However, when used on a regular schedule, rapid antigen testing is an effective Covid-19 screening method.

The gold standard is three tests per week. This gives an accuracy rate of 96%. Even two tests per week, as adopted in the UK and by many companies in Europe, offers an accuracy rate of 88%. While two PCR tests per week offer 94% accuracy, the results aren’t known for 24-48 hours, meaning an asymptomatic person can still be a risk to others. Someone with a positive antigen test can immediately go into isolation and seek further medical attention quickly, protecting themselves and those around them.

Costs for antigen testing are relatively low, especially for settings like workplaces that can buy in bulk. In Ireland, 20 tests can be bought for approximately €220. Tests can be administered by the person themselves, though the best practice is that they are used under medical supervision as there are concerns about people choosing not to report a positive result. In Ireland, the license for such testing requires medical supervision, making this a must for any business considering implementing them. This can be facilitated through online consultations or observation in the workplace, which, while adding additional costs, can still be affordable. For a business in the UK to introduce two tests per week under the supervision of a GP, the cost per worker still only amounts to about £75 each week.

At a relatively low cost, rapid antigen testing could allow people to return to work and crowded places with confidence that they are at a low risk of getting infected with Covid-19 or infecting anyone else. It is possible for schools, sports, colleges, and workplaces to return to the ‘old normal’. New hotspots can also be identified and managed quickly, helping to prevent further breakouts.

After a more than a year of disruption, businesses are eager to open again. However, this needs to be done safely. The public, weary from months of a level five lockdown, are just as eager to get out living again. Rapid antigen testing, used correctly, offers an accurate way of making that a reality.

Cognate Health provide consultancy services and will assist any employer to initiate a fit for purpose and economically efficient antigen testing programme in their business. For more information, please contact our customer relationship team, led by Denis Weir at denis@cognatehealth.ie.

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