What are the most reliable rapid antigen tests?

Patients across the globe have come to rely on rapid antigen tests (RATs) to confirm a COVID-19 diagnosis, but a new Australian study has revealed most are not producing accurate results.
 
Researchers from James Cook University (JCU) say they were left ‘shocked’ after an analysis of 26 RATs from Australia and Canada found just six were effective at detecting the lowest concentration of COVID-19.
 
One Canadian test failed to detect the COVID-19 protein entirely at any level of concentration.
 
The findings come as RAT usage remains high, with 93% of Australians who tested positive for COVID-19 last year using a RAT to confirm their infection.
 
Study co-author Associate Professor Patrick Schaeffer said the study’s findings highlight the need for independent evaluation of RATs, both in Australia and overseas.
 
‘What was most shocking in this study was not only that we have some poorly performing RATs but that there seems to be no easy way to get them off the shelves,’ he said.
 
‘There’s no point in having these underperforming RATs sold to people, especially those which can only detect COVID-19 in people who are at the peak of their infection.’
 
The JCU study included 16 RATs approved by the Therapeutic Goods Administration, and 10 approved by Health Canada.
 
It found the six best performing RATs included the Canadian-approved BTNX Cassette, Flowflex, and Medsup, as well as the Australian-approved Fanttest, Innoscreen, and Juschek.
 
Meanwhile, it found BTNX, PCL, Medriva, Medomics, PanBio (Australia), PanBio (Canada), SDBiosensor, StandardQ, and Touchbio to be the least responsive tests.
 
The research comes after Australia spent more than $2 billion on RATs at the height of the COVID-19 pandemic, with Victoria alone ordering 210 million.
 
With many of those tests nearing expiration, governments have been left to decide what to do with the leftovers.
 
But moving forward, Associate Professor Schaeffer said the researchers now hope to broaden their study to analyse RATs capable of detecting different strains of influenza A and B viruses.
 
‘There were actually two RATs in this latest study which are designed to detect influenza A and B as well as COVID-19, but neither of them detected influenza proteins particularly well,’ he said.
 
‘We’d like to look at how well influenza RATs can detect subtypes like H3N2, H5N1 “bird flu” and H1N1, otherwise known as swine flu.
 
‘We have all of those proteins produced and the next stage is to start a review of these particular RATs.’
 
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COVID-19 SARS-CoV-2 infection Therapeutic Goods Administration