Evaluation of the Peterborough Public Health COVID-19 Rapid Antigen Test Self-Report Tool: Implications for COVID-19 Surveillance

Abstract Background The ongoing COVID-19 pandemic has necessitated novel testing strategies, including the use of Rapid Antigen Tests (RATs). The widespread distribution of RATs to the public prompted Peterborough Public Health to launch a pilot RAT self-report tool to assess its utility in COVID-19 surveillance. Objective To investigate the utility of a RAT self-report tool through an analysis of the temporal association between RAT results, PCR test results, and wastewater levels of COVID-19. Methods We investigated the association between RAT results, PCR test results, and wastewater levels of COVID-19 using Pearson’s correlation coefficient. Percent positivity and count of positive tests for RATs and PCR tests were analyzed. Results PCR percent positivity and wastewater were weakly correlated ( r =0.33 p =0.022), as were RAT percent positivity and wastewater ( r =0.33 p =0.002). RAT percent positivity and PCR percent positivity were not significantly correlated ( r= -0.035, p =0.75). Count of positive RAT tests and count of positive PCR tests were moderately correlated ( r =0.59, p <0.001). Wastewater was not significantly correlated to count of positive RAT tests ( r =0.019, p= 0.864) or count of positive PCR tests ( r =0.004, p =0.971). Conclusion Our results provide evidence in support of the use of RAT self-reporting as a low-cost simple adjunctive COVID-19 surveillance tool, and may suggest that its utility is greatest when considering an absolute count of positive RAT tests rather than percent positivity due to reporting bias towards positive tests. These results can help inform COVID-19 surveillance strategies of local Public Health Units and encourage the use of a RAT self-report tool.