Public health-focused use of COVID-19 rapid antigen and PCR tests

Yonatan Woodbridge, Yair Goldberg, Sharon Amit, Naama M. Kopelman, Micha Mandel, Amit Huppert

Research output: Contribution to journalArticlepeer-review


During the Covid-19 pandemic, accurate PCR tests were augmented by the cheap, rapid, and logistically convenient, yet less sensitive antigen tests. In Israel, a testing policy shift was implemented due to limited availability of PCR tests during the Omicron surge. Thus, both PCR and antigen tests were used, as this was the only alternative for mass testing and surveillance at the time. Yet, evidence-based surveillance requires a robust understanding of the expected consequences of changing the testing policy. Using 41,065 paired tests performed by trained staff between January and April 2022 in Israel, we estimate how the sensitivity of antigen tests changes as a function of Ct value and other key covariates. The results reveal a logarithmic relationship between antigen detection probability and viral load, as quantified by Ct-values of the PCR tests. Further analysis shows a statistically significant association with an odds ratio of approximately 0.76 with each unit of Ct-value. The analysis suggests that in spite of their compromised sensitivity, antigen tests are a natural solution for routine use, while PCR tests should be considered in situations where a false negative result could have serious consequences. These findings are the foundations of policies that will utilize the strengths of the different tests, and achieve enhanced hybrid surveillance.

Original languageEnglish
Article number1430
JournalScientific Reports
Issue number1
StatePublished - Dec 2024

All Science Journal Classification (ASJC) codes

  • General


Dive into the research topics of 'Public health-focused use of COVID-19 rapid antigen and PCR tests'. Together they form a unique fingerprint.

Cite this