COVID-19 cases are surging, so why aren’t rapid antigen tests being offered for free?

Rapid antigen tests are on sale at pharmacies, supermarkets and online from anywhere between $10 and $17 a test. RATs are best used several times a week to make sure the virus can be adequately screened, meaning that to use them properly households could be forking out hundreds of dollars a week.

New South Wales Health Minister Brad Hazzard wants the tests flying off the shelves: “Forget the ham,” he said. “A RAT test is the best Christmas present you can give your family.”

Many places have sold out as families snatch them up before Christmas gatherings.

For many, $15 for a test doesn’t break the bank. But for others — single parents, those in low socioeconomic areas, or those using the tests as a preventive measure, such as people with disabilities or those working in retail or hospitality — the cost is too much.

As Australia records the highest number of active COVID-19 cases since the pandemic began, and with health experts urging people to continue wearing masks, why are at-home testing kits not being given out free?

How good are the tests?

On December 19, NSW recorded 2501 new daily cases after 144,368 people came forward for testing. Victoria recorded 1240 new cases, Queensland recorded 42 — double the number from Saturday — and South Australia recorded 80.

PCR tests are still free but in NSW many have waited in queues over an hour long. Crikey has heard of one woman waiting 72 hours for her test result, only to learn it had been lost. She later tested positive. NSW Health has said it can extend testing hours and add testing clinics “should the need arise”.

RAT tests aren’t as good as PCR tests. RAT tests involve a nasal or saliva swab and take about 15 minutes for a result. They don’t require lab analysis like PRC tests. But they also can’t pick up the virus when in its early or late stages as the viral load decreases.

One study found RAT picked up 77% of the cases PCR tests picked up, although this rate increased to 100% when the person was tested within a week of the onset of symptoms. False positives and false negatives are more common with RAT.

But they are good for fast, frequent testing — a few times a week in high-risk settings like healthcare — to screen for the virus, and have been approved by the Therapeutic Goods Administration.

In South Australia and Western Australia, using rapid antigen tests to screen healthcare workers, for example, is illegal, slowing the screening rate for COVID-19.

Where are the tests free?

Free RATs are federally available to healthcare workers, disability and aged care workers, and businesses that hire health practitioners to oversee the tests in Australia. In Victoria, schoolchildren — many of whom won’t be vaccinated until next month — can access free RATs if they’re deemed close contacts.

But that leaves a huge gap in the general public who either have to pay for the test themselves, or queue and isolate for days for a PCR test.

Ontario, in Canada, is giving free tests to citizens in high-risk areas, and the Biden administration in the US also has plans to distribute free tests to uninsured Americans. The UK allows households to order free tests, and Germany has 15,000 free RAT sites.

Wouldn’t this ease the burden?

As Australians pack their bags for Christmas travel, many are getting precautionary tests before visiting their families — despite not showing any symptoms. In these cases, RATs could ease the burden on state testing clinics and allow them to focus on those who have returned a positive RAT reading or those who have cold-like symptoms.

Federal Health Minister Greg Hunt didn’t respond to Crikey’s question about whether the government plans to make the tests free for households. Victoria and NSW’s Health Departments also didn’t respond by deadline.

This article was first published by Crikey.