A coronavirus test that can deliver results in 10 minutes is set to be rolled out in Australia, but staff at just one quarantine facility will get access to it.
The Howard Springs quarantine facility, south-east of Darwin, will soon adopt a rapid antigen testing regime for COVID-19.
The New Daily has confirmed at least two other states are considering following the Northern Territory’s lead.
A spokesperson for the National Critical Care and Trauma Response Centre (NCCTRC) told The New Daily it had purchased antigen tests which will provide additional COVID-19 surveillance for the staff there.
Dr Ian Norton, an emergency response practitioner who has been trialling the rapid antigen nasal-swab tests, is calling for them to be made available to staff at all locations in Australia where returned travellers are in quarantine.
But he says we shouldn’t stop there.
The former head of the World Health Organisation’s Emergency Medical Team Initiative in Geneva, Dr Norton now runs a business contracting with government agencies to deliver emergency responses, including the roll-out of rapid coronavirus tests.
Given supplying the US-made, TGA-approved tests is now his business, it’s perhaps not surprising that Dr Norton wants to see the fast tests rolled out to more workplaces across the nation.
There’s clear evidence the tests work – at least in some ways. Twelve different antigen tests have already been approved by the Therapeutic Goods Administration.
Answers within 10 minutes
Dr Norton said the expectation is workers will be tested on-site every three to four days (twice a week). The antigen tests will reveal within 10 minutes if they’re OK to start work, he said.
While it won’t misdiagnose someone as having the virus when they don’t, the problem is that it won’t detect the coronavirus in about one in ten people who really are infected Dr Norton said.
Professor Catherine Bennett, chair in epidemiology at Deakin University, said false negatives are more worrying than false positives.
“Missing those true cases because the test isn’t sensitive enough means that while it’s better than nothing, it’s actually still a 10 per cent error rate,” Professor Bennett told The New Daily.
She said rapid antigen testing is not “quite to the level, as I understand it, that would make it a safe option”.
The NCCTRC said it will continue to deploy the polymerase chain reaction (PCR) test, which the Therapeutic Goods Administration deems the gold standard for COVID testing.
Compared to the PCR, Dr Norton said, the rapid antigen test is “definitely as good” in the first three days of a person having the virus and not feeling ill.
Dr Norton said worried staff members “were looking at Victoria, saying ‘Oh my goodness, we do not want to be Victoria. We don’t want to have our quarantine staff who are working here, taking it home to their families'”.
“Then just imagine if it had broken out in the Northern Territory with our Indigenous population and vulnerable people up there. It will be catastrophic,” he said.
Dr Norton said the test is about one-quarter of the price of the PCR test, meaning “we can afford to do them much more often”.
Professor Bennett said as the technology improves, rapid antigen tests will come in handy as we navigate to a COVID-normal.
She said most PCR test results are being returned on the same day that the tests were conducted.
“For workers currently, it doesn’t impact on them having to wait for a test result before they return to work if this is part of routine testing.
“In other settings, particularly for border control, for people moving interstate, we might still have low risk, but it is one other tool that could be offered to do what we’d normally call point of care, but point of border testing – to do that quick test, that takes a lot more than a temperature check.”
Other states yet to commit
A Queensland Health spokesperson said it will await the results of the trial in Howard Springs before including the rapid antigen test in its testing program.
Meanwhile, Victoria’s health department is waiting for results from the Doherty Institute’s investigation into the usefulness of antigen testing, which it had requested.
“This will determine if antigen and rapid molecular tests may play a role in screening high-risk asymptomatic cohorts and complement existing PCR testing capacity,” a spokesperson for the department said.
The other high-risk staff that Dr Norton wants the antigen tests used on are aged-care workers.
“I can’t understand why we’re not screening aged-care workers,” he said.
“For this outbreak now in Adelaide, I would be testing every single aged-care worker before they start their shift, and do that every three to four days.”
Dr Norton said the tests could also be used on food-sector workers, particularly those in the meat industry who work in chilled environments where the virus is able to survive for longer.
The New Daily contacted the health departments in every state and territory to gauge if there were any plans to roll out rapid antigen tests.
A spokesperson for NSW Health Pathology said the antigen test is generally less sensitive than the PCR test in detecting the virus and would “not be suitable for widespread use”.
It said: “NSW Health Pathology does not recommend the use of rapid antigen tests currently, but will continue to monitor emerging evidence regarding their performance.”
NSW Health Pathology said it conducts PCR testing for COVID-19 at 15 of its laboratories and most patients receive their results within 24 hours.
It said rapid PCR testing, which is used in high risk, high priority cases where an urgent diagnosis is needed, is also available at 38 of its NSW laboratories.
A spokesperson for ACT Health said that given most coronavirus cases are among returned travellers in hotel quarantine, it is exploring a new testing regime that would ensure workers at their government-mandated quarantine facility had regular access to “the gold standard PCR test”.
“In South Australia, the most accurate way to test for COVID-19 is an oral and nasal PCR test,” SA Health said in a statement.
“Oral and nasal swab testing (PCR testing) is a highly sensitive, gold-standard method for detecting COVID-19,” it continued.
A spokesperson for the Western Australian Department of Health said there are no plans to roll out rapid antigen tests in WA “but work continues to monitor and evaluate all emerging testing technologies”.