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The Case for LESS Sensitive COVID Tests

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Thanks to Brilliant for sponsoring this video – the first 200 people to click on https://www.brilliant.org/MinutePhysics will get 20% off a Premium subscription to Brilliant.

This video written & produced in collaboration with Aatish Bhatia, https://www.aatishb.com

This video is about how cheap, fast, and LESS sensitive rapid antigen tests might be better for screening (& maybe surveillance) than PCR COVID tests due to the nature of contagiousness/infectiveness at various points on the viral load trajectory of symptomatic and asymptomatic COVID sars-COV-2 carriers.

REFERENCES

Thanks to Daniel Larremore for feedback on early versions of this video https://larremorelab.github.io/

Rapid Antigen Testing:

COVID-19 testing: One size does not fit all. https://science.sciencemag.org/content/371/6525/126

Rethinking Covid-19 Test Sensitivity — A Strategy for Containment. https://www.nejm.org/doi/full/10.1056/NEJMp2025631

Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening. https://advances.sciencemag.org/content/7/1/eabd5393.abstract

The effectiveness of population-wide, rapid antigen test based screening in reducing SARS-CoV-2 infection prevalence in Slovakia. (pre-print, not yet peer reviewed) https://www.medrxiv.org/content/10.1101/2020.12.02.20240648v1

Effective Testing and Screening for Covid-19. https://www.rockefellerfoundation.org/wp-content/uploads/2020/09/A-National-Decision-Point-Effective-Testing-Screening-for-Covid-19-Full-Report.pdf

Brown University & Harvard University modeling of COVID-19 testing shortfall. https://globalepidemics.org/testing-targets/

Fast Coronavirus Tests are coming. https://media.nature.com/original/magazine-assets/d41586-020-02661-2/d41586-020-02661-2.pdf

Open letter signed by epidemiologists and infectious disease experts supporting widespread & frequent rapid antigen testing for COVID-19: https://www.rapidtests.org/expert-letter

More information on various COVID-19 tests: https://chs.asu.edu/diagnostics-commons/testing-commons

Field performance and public health response using the BinaxNOW Rapid SARS-CoV-2 antigen detection assay during community-based testing. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1890/6052342

Performance of an Antigen-Based Test for Asymptomatic and Symptomatic SARS-CoV-2 Testing at Two University Campuses. https://www.cdc.gov/mmwr/volumes/69/wr/mm695152a3.htm

Asymptomatic Spread:

People without symptoms spread virus in more than half of cases, CDC model finds https://www.washingtonpost.com/science/2021/01/07/covid-asymptomatic-spread/

(More than half of all) SARS-CoV-2 Transmission From People Without COVID-19 Symptoms. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707

Three Quarters of People with SARS-CoV-2 Infection are Asymptomatic: Analysis of English Household Survey Data. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549754/

Viral Load Curve:

SARS-CoV-2 viral dynamics in acute infections. (pre-print, not yet peer reviewed)
https://www.medrxiv.org/content/10.1101/2020.10.21.20217042v2

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