Antigen rapid-diagnostic tests detect proteins of the pathogen, for example, the famous spikes of SARS-CoV-2. These tests can be used, by the general public themselves, without assistance from healthcare workers. As such, "self-tests" promise to make people more autonomous in disease management. They can complement testing performed by healthcare professionals by offering several advantages. Antigen rapid-diagnostic tests improve accessibility to testing. Patients can quickly obtain results, supporting early detection of cases and reducing infection spread. Thus, self-testing can optimize the transition from pandemic response to pandemic control. The COVID-19 pandemic allowed studying the dynamics of self-testing and the characteristics of the population prone to embrace it.
In France, the ComCor study showed that the population quickly and widely adopted self-testing. During the Omicron waves, 0.5 to 2 million people self-tested daily, primarily motivated by symptoms or contact with an infected person. In addition, females, people of higher education level (bachelor's degree and above), and those living in regions other than Ile-de-France or Hauts-de-France, were more likely users. Teaching-related activities or having children also favored self-testing, which may be explained by the free distribution to children and teachers who have had contact with an infected child at school. Age above 60, French nationality acquired by naturalization, and living in densely populated cities contributed to lower self-test use.
Similar testing inequalities were reported in the USA and the UK. In future epidemic waves, the socio-demographic groups less open to self-testing could be reached through better communication, for example, educational videos, articles, and local events combining education and entertainment tailored to the target audience. The French healthcare system wasn't reimbursing the rapid diagnostic tests, which may have caused their lower use in some socio-demographic groups. Free distribution, as shown in schools, or inclusion in the portfolio covered by healthcare insurance, could render such tests more available to populations of lower income. Further analysis, may lead to the right balance for self-testing in the context of future pandemics.
The COVID-19 pandemic is luckily behind us. But not to be forgotten, research and data analysis is continuing, bringing lessons to be learned.
Supplisson O, Charmet T, Galmiche S, Schaeffer L, Chény O, Lévy A, Jeandet N, Omar F, David C, Mailles A, Fontanet A. SARS-CoV-2 self-test uptake and factors associated with self-testing during Omicron BA.1 and BA.2 waves in France, January to May 2022. Euro Surveill. 2023 May;28(18):2200781. doi: 10.2807/1560-7917.ES.2023.28.18.2200781. PMID: 37140451