Rapid antigen tests are on sale at pharmacies, supermarkets and online from anywhere between $10 and $17 a test. RATs are best used several times a week to make sure the virus can be adequately screened, meaning that to use them properly households could be forking out hundreds of dollars a week.
New South Wales Health Minister Brad Hazzard wants the tests flying off the shelves: “Forget the ham,” he said. “A RAT test is the best Christmas present you can give your family.”
Many places have sold out as families snatch them up before Christmas gatherings.
For many, $15 for a test doesn’t break the bank. But for others — single parents, those in low socioeconomic areas, or those using the tests as a preventive measure, such as people with disabilities or those working in retail or hospitality — the cost is too much.
As Australia records the highest number of active COVID-19 cases since the pandemic began, and with health experts urging people to continue wearing masks, why are at-home testing kits not being given out free?
How good are the tests?
This morning, NSW recorded 2501 new daily cases after 144,368 people came forward for testing. Victoria recorded 1240 new cases yesterday, Queensland recorded 42 — double the number from Saturday — and South Australia recorded 80.
PCR tests are still free but in NSW many have waited in queues over an hour long. Crikey has heard of one woman waiting 72 hours for her test result, only to learn it had been lost. She later tested positive. NSW Health has said it can extend testing hours and add testing clinics “should the need arise”.
RAT tests aren’t as good as PCR tests. RAT tests involve a nasal or saliva swab and take about 15 minutes for a result. They don’t require lab analysis like PRC tests. But they also can’t pick up the virus when in its early or late stages as the viral load decreases.
One study found RAT picked up 77% of the cases PCR tests picked up, although this rate increased to 100% when the person was tested within a week of the onset of symptoms. False positives and false negatives are more common with RAT.
But they are good for fast, frequent testing — a few times a week in high-risk settings like healthcare — to screen for the virus, and have been approved by the Therapeutic Goods Administration.
In South Australia and Western Australia, using rapid antigen tests to screen healthcare workers, for example, is illegal, slowing the screening rate for COVID.
Where are the tests free?
Free RATs are federally available to healthcare workers, disability and aged care workers, and businesses that hire health practitioners to oversee the tests in Australia. In Victoria, schoolchildren — many of whom won’t be vaccinated until next month — can access free RATs if they’re deemed close contacts.
But that leaves a huge gap in the general public who either have to pay for the test themselves, or queue and isolate for days for a PCR test.
Ontario, in Canada, is giving free tests to citizens in high-risk areas, and the Biden administration in the US also has plans to distribute free tests to uninsured Americans. The UK allows households to order free tests, and Germany has 15,000 free RAT sites.
Wouldn’t this ease the burden?
As Australians pack their bags for Christmas travel, many are getting precautionary tests before visiting their families — despite not showing any symptoms. In these cases, RATs could ease the burden on state testing clinics and allow them to focus on those who have returned a positive RAT reading or those who have cold-like symptoms.
Federal Health Minister Greg Hunt didn’t respond to Crikey’s question about whether the government plans to make the tests free for households. Victoria and NSW’s Health Departments also didn’t respond by deadline.
Hi Amber. I picked up a pack of five for $64 the other day. I wasn’t impressed with the price and will be keeping the receipts to try and claim them back as a work expense at tax return time.
Just a note on who can get free tests, I’m a disability support worker, supporting clients in their own homes and I’m not eligible for free RAT tests because we don’t have a nurse at the house who can administer the tests and that’s one of the requirements. Few disability support workers work in big facilities with nursing staff any more- we haven’t for decades- and there’s no way the horrible LNP Government don’t know that.
Yet again, people with disabilities and their support staff are a very low priority for this mob. It’s the vaccine strollout all over again.
Oh, I don’t know. I run a small business and was happy to buy six tests on the off chance any of the crew suspected infection after arriving at work. A negative test could mean peace of mind and avert the need to close down for the rest of the day. At $10 a pop, cheap insurance.
I actually had cause to use it last week after my wife found out while she was interstate that two people at her table at the work end-of-year do had tested positive. Saved me going out for a PCR test and canceling a day’s appointments. Then she used one of the RA tests this morning when she woke up sneezing, running nose etc. Confirmed negative meant she was free to get stuck into the Christmas shopping.
But sure, privilege speaking here, for poorly remunerated essential workers, quick and cheap testing is likewise essential to protect the health system, vulnerable citizens and the economy. In that order.
Hate to tell you this, but she could quite easily be a false negative. Test her again daily as long as she is symptomatic. And if she does test positive you’ll need to go through the whole rigmarole.
I’m a pensioner. Wont be buying any test kits.
The problem with RATs is not the low sensitivity, it’s the low specificity. This means the rate of false positives it troubling. And the lower the rate of virus in the community the higher the proportion of false positives to true positives becomes. This is why authorities in SA and WA don’t want them used, if they were almost every positive result there would be a false one as there is so little COVID in the communities there, the false positive rate is not related to the amount of COVID, but simply to the number of tests done.
And every positive on a RAT then needs a confirmatory PCR, adding to the PCR burden. And if you are doing mass testing in a location then everyone who was standing around the person with the false positive is automatically deemed a close contact (because they were next to someone who may be positive, even if you’re not sure yet), so they all have to isolate and also get a PCR.
The rate of false positives is somewhere between 0.5 and 2% depending on the test. So for every thousand RATs you do you generate between 5 and 20 false positives. If the carriage rate in the community is high (much higher than in Australia right now) then and only then are they useful. In specific crcumstances (like health care workers caring for COVID patients) they are also a useful tool. But for the rest of the community right now, more trouble than they are worth.
The RATs aren’t only expensive, they also attract GST