Rapid antigen tests still not counted toward local COVID numbers—but that could change

When the University of Texas at Austin hosted its first home football game of the season, administrators required student attendees to be tested for COVID-19 before entering the Darrell K Royal-Texas Memorial Stadium.

Of the 1,198 students who were tested that day, 95 returned positive results, according to a university spokesperson. But none of these cases were logged on the Austin-Travis County COVID-19 dashboard or counted toward official totals.

Why?

Because the tests used at the game were rapid antigen tests. Like the genetic, or polymerase chain reaction, tests offered by Austin Public Health and other providers, these tests detect active COVID infections. They also provide results in 15 minutes, bypassing the need for processing at clinical labs, which can lead to wait times of up to two weeks.

The Centers for Disease Control and Prevention recommend that positive rapid antigen test results be considered "probable" rather than "confirmed" because they are marginally less sensitive than genetic tests.

As a result, the Texas Department of State Health Services and Austin Public Health do not count positive rapid antigen test results toward their official "confirmed" caseload or consider them when calculating the local positivity rate.

Austin Public Health did not respond to multiple inquiries about how many rapid antigen tests have been conducted locally. Austonia has filed a public records request for more information.

State data indicates that rapid antigen tests make up a small portion of the tests administered in Texas.

DSHS began reporting the number of antigen tests administered on Aug. 6; since then, just over 71,000 tests have been conducted. In that same time period, DSHS reports around 1.7 million genetic tests and more than 128,000 antibody, or serology, tests have been administered.

Some private testing sites, however, only offer rapid antigen tests or report more demand for them compared to other kinds of tests because of the convenience they offer.

Tarrytown Pharmacy has offered rapid antigen tests since mid-July, Pharmacist-In-Charge Rannon Ching said, and demand has remained steady, despite the deflated surge.

UT students whose parents were concerned about case clusters on campus have sought out testing, as have Austinites who want assurance they can see parents and grandparents for the first time since the pandemic and aren't putting them at risk, Ching said. The local business, which has two locations, has also coordinated with companies and restaurants that seek testing for their employees.

"I would say demand is up," Ching said.

Other private testing sites have seen similar trends.

At Total Men's Primary Care, which has 16 locations in and around Austin, demand for genetic tests is down because of the long turnaround times, CEO Robert Sek told Austonia last month.

Similarly, Texas MedClinic COO David Gude has said rapid antigen tests are the clear favorite among patients at its 19 Central Texas locations. Genetic test results, which may be required for patients traveling abroad or awaiting surgery, tend only to be requested when an agency or entity is requiring them, he added.

This summer, Austin-Travis County Interim Health Authority Dr. Mark Escott floated the idea of offering rapid antigen tests at public testing sites.

At the time, slow turnaround times for genetic tests were interfering with containment efforts. Residents were waiting up to two weeks to get results at the height of the local surge; by the time they learned they were positive, some had already recovered—and missed the chance to avoid infecting others.

"It's not quite as accurate as the regular (genetic) testing that we send off to labs, but it's probably good enough," he told Travis County Commissioners on July 28. "So we can get a whole lot better control over this for future outbreaks than sending off tests that are going to take three or four or 10 days."

APH has not added rapid antigen tests to its repertoire in the time since.

But Escott has hinted at the possibility of more rapid antigen testing data in the short term.

"I expect that we may see some changes in how the state and federal government want to treat those cases (indicated by rapid antigen test results)," he said during a press conference on Sept. 18. "But for now, we're looking at options to display both the probable and the confirmed (cases)."

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