Abstract
Rapid antigen testing (RAT) is a cost-effective and time-efficient method of identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and therefore a critical part of infection control strategies. There is no published evidence evaluating the use of RAT during the Omicron wave of the COVID-19 pandemic for asymptomatic patients or its performance between waves. All patients presenting to an Emergency Department over a two-week period without COVID-19 symptoms were screened for SARS-CoV-2 using both the Abbott Panbio RAT as well as the gold standard reverse transcriptase real-time polymerase chain reaction (PCR). The Abbott Panbio RAT sensitivity was 13% (95% CI 0.028, 0.336) for asymptomatic patients. The use of this test in asymptomatic patients during the Omicron wave had a statistically significant reduction in sensitivity compared with two reports of the same test in previous waves (13% vs. 86%, p < 0.0001; 13% vs. 83%, p < 0.0001). As SARS-CoV-2 continues to mutate, the sensitivity of RATs are altered and needs to be continually re-evaluated for each variant of concern if they are to be used as part of an infection control strategy.
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