JMIR Publications

ABSTRACT

Background:

COVID-19 isolation recommendations have evolved over the course of the pandemic. Rapid antigen tests (RATs) are a tool that can be used to shorten isolation periods.

Objective:

The purpose of this analysis is to report on the experience of implementing RAT policies, examine the number of days that isolation was reduced via RAT testing, determine the factors that predicted uploading a RAT, and determine RAT positivity rates to illustrate the utility of using RATs to end isolation.

Methods:

In this study, 880 individuals in COVID-19 isolation at a university in Washington, DC uploaded 887 RATs between February 21 and April 14, 2022. Daily positivity rates were calculated and multiple logistic regression analysis examined the odds of uploading a RAT by campus residential living status (on/off-campus), student/employee designation, age, and days in isolation.

Results:

Seventy-six percent (669/880) of individuals in isolation uploaded a RAT during the study period. Overall, 38.6% (342/887) of uploaded RATs were positive. Positivity rates for RATs were 45.6% (118/259) at day 5, 45.4% (55/121) at day 6, 47.1% (99/210) at day 7, and 11.1% (7/63) at day 10 or above. Adjusted logistic regression modeling indicated cases living on-campus had increased odds of uploading a RAT (OR 2.54, 95% CI 1.64-3.92), whereas primary student affiliation (OR 0.29, 95% CI 0.12-0.69), and days in isolation (OR 0.45, 95% CI 0.39-0.52) had decreased odds of uploading a RAT. Of the 545 cases with a negative RAT, 477 were cleared prior to day 10 of their isolation due to a lack of symptoms and timely submission, resulting in a total of 1,547 days of lost productivity saved compared to all being in isolation for 10 days.

Conclusions:

Future isolation policies should be guided by similar protocols and research to reduce the spread of COVID-19 and minimize lost productivity and disruption to individuals’ lives.