Antigen tests report concludes ‘widespread misconceptions’ as to how they work

The roll out of antigen testing should be accompanied by a “simple, clear message” outlining that it is not a foolproof method of detecting Covid-19, a new report suggests.

The report by Economic and Social Research Institute (ESRI) behavioural scientist Pete Lunn and psychologist Dr Martina Barjaková concludes there is a misconception as to the efficiency of such tests.

It shows that less than half of all Irish people (48 per cent) know that a rapid antigen detection test (RADT) is less effective at detecting the virus than a PCR test.

The Amarach poll for the Department of Health found 57 per cent of people recognised that a benefit of an antigen test was that it could be used to screen people before attendance at activities or events, 36 per cent thought the test was a quick way for people with symptoms to get tested and 27 per cent thought a test was a convenient way for someone to make sure they do not have Covid-19.

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The report recommends that where results of antigen tests are uploaded to an online system such as that of the HSE, a message pointing out the limitations of the test.

The Irish survey combined with ones carried out in Germany and the UK suggest "widespread misconceptions" about antigen testing.

Supporters of antigen tests say they are very effective at detecting when somebody is infectious and therefore likely to pass on the virus to somebody else, but not as effective as PCR tests at detecting if somebody has the virus or not.

“Substantial proportions of the public in all three countries where we have evidence specific to RADT do not understand the difference between RADT and PCR tests, including in relation to public health guidance for individuals experiencing symptoms of Covid-19,” the report stated.

“Where we have evidence of actual use of RADT, the misconceptions persist ... many people presently do not use (or intend to use) RADT in line with public health guidance.”

The report was commissioned by the Government's Rapid Testing Expert Advisory Group as antigen testing is likely to be more widely rolled out in the coming months.

The researchers concluded that antigen testing can only be effectively rolled out if there is clear communication to the public which “repeatedly and simply explains how the two tests differ and when (antigen testing) is appropriate”.

While the majority of people understand that Covid-19 tests have a margin of error a “non-negligible minority of people incorrectly interpret test results as implying certainty about their disease status.

“The main danger in the Covid-19 context are the false negatives, which, if not understood properly, may give false reassurance about not being infectious and possibly lead to riskier social behaviours.

“Despite this relatively poor understanding of test results, there is not strong evidence that people are likely to change protective behaviours following negative RADT, although this should not be taken to imply that behaviour will not be affected.”

The report concluded: “Overall, this review of literature suggests that human judgements and behaviours are likely to be important to the successful implementation of RADT programmes and supports some specific interventions to address the identified problems.”