Association of Mass Distribution of Rapid Antigen Tests and SARS-CoV-2 Prevalence: Results from NIH-CDC funded Say Yes! Covid Test program in Michigan

  1. Apurv Soni
  2. Carly Herbert
  3. Jonggyu Baek
  4. Qiming Shi
  5. Juan Marquez
  6. Emma Harman
  7. Vik Kheterpal
  8. Chris Nowak
  9. Thejas Suvarna
  10. Honghuang Lin
  11. William Heetderks
  12. Adrian Zai
  13. Michael Cohen-Wolkowiez
  14. Giselle Corbie-Smith
  15. Warren Kibbe
  16. Ben S. Gerber
  17. Nathaniel Hafer
  18. Bruce Barton
  19. John Broach
  20. David McManus

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Abstract

Importance

Wide-spread distribution of diagnostics is an integral part of the United States’ COVID-19 strategy; however, few studies have assessed the effectiveness of this intervention at reducing transmission of community COVID-19.

Objective

To assess the impact of the Say Yes! Covid Test (SYCT!) Michigan program, a population-based program that distributed 20,000 free rapid antigen tests within Ann Arbor and Ypsilanti, Michigan in June-August 2021, on community prevalence of SARS-CoV-2.

Design

This ecological study analyzed cases of SARS-CoV-2 from March to October 2021 reported to the Washtenaw County Health Department.

Setting

Washtenaw County, Michigan

Participants

All residents of Washtenaw County

Interventions

Community-wide distribution of 500,000 rapid antigen tests for SARS-CoV-2 to residents of Ann Arbor and Ypsilanti, Michigan. Each household was limited to one test kit containing 25 rapid antigen tests.

Main Outcome and Measures

Community prevalence of SARS-CoV-2, as measured through 7-day average cases, in Ann Arbor and Ypsilanti was compared to the rest of Washtenaw County. A generalized additive model was fitted with non-parametric trends for control and relative differences of trends in the pre-intervention, intervention, and post-intervention periods to compare intervention municipalities of Ann Arbor and Ypsilanti to the rest of Washtenaw County. Model results were used to calculate average cases prevented in the post-intervention period.

Results

In the post-intervention period, there were significantly lower standardized average cases in the intervention communities of Ann Arbor/Ypsilanti compared to the rest of Washtenaw County (p<0.001). The estimated standardized relative difference between Ann Arbor/Ypsilanti and the rest of Washtenaw County was -0.016 cases per day (95% CI: -0.020 to -0.013), implying that the intervention prevented 40 average cases per day two months into the post-intervention period if trends were consistent.

Conclusions and Relevance

Mass distribution of rapid antigen tests may be a useful mitigation strategy to combat community transmission of SARS-CoV-2, especially given the recent relaxation of social distancing and masking requirements.

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  1. ScreenIT

    SciScore for 10.1101/2022.03.26.22272727: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    These benefits need to be weighed against the limitations of rapid antigen tests, including lower sensitivity among asymptomatic individuals and those with low viral load.8,9 Our finding indicating that distribution of tests several months prior to a surge in SARS-CoV-2 cases was still associated with a reduction in community transmission suggests that recipients of this intervention were responsible owners of a personal supply of rapid antigen tests. These findings, taken together with recent reports that rapid antigen tests’ performance remain consistent across variants, underscore the continued utility of rapid antigen tests.9 With emerging reports of the BA.2 variant causing a surge in cases across the globe and in the United States, these findings hold particular importance for the public health of the country.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2022.03.26.22272727 on medRxiv