Critical in control of this pandemic is the ability to rapidly identify infectious individuals prior to their ability to infect others. The original testing approaches for COVID-19 diagnosis through detection of SARS-CoV-2 RNA focused on high sensitivity and are not being used to discriminate between the infected and the infectious. Many diagnostic tests are expensive and suffer from significant resulting delays. The introduction of tests that may be less sensitive at lower RNA copy number and use alternative technology such as antigen detection are potentially of use and may be better at rapidly identifying infectious individuals prior to transmission. We have a growing body of evidence that patients with low levels of RNA and negative antigen tests are very low risk for spread of disease. This information along with timing in disease course can allow for a cut off for infectious levels of RNA and can help guide development and use of different testing modalities as well as pooling decisions.
1. Understand the viral kinetics and impact on testing for patients with COVID-19.
2. Understand available testing options.
3. Be able to determine positive and negative predictive values based on pre-test probabilities.