The impact of repeated rapid test strategies on the effectiveness of at-home antiviral treatments for SARS-CoV-2

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Tigist F. Menkir
Christl A. Donnelly
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[1] Harvard University,Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health
[2] Oxford University,Department of Statistics
[3] Imperial College London,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology
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Regular rapid testing can provide twofold benefilts: identifying infectious individuals and providing positive tests sufficiently early during infection that treatment with antivirals can effectively inhibit development of severe disease. Here, we provide a quantitative illustration of the extent of nirmatrelvir-associated treatment benefits that are accrued among high-risk populations when rapid tests are administered at various intervals. Strategies for which tests are administered more frequently are associated with greater reductions in the risk of hospitalization, with weighted risk ratios for testing every other day to once every 2 weeks ranging from 0.17 (95% CI: 0.11–0.28) to 0.77 (95% CI: 0.69–0.83) and correspondingly, higher proportions of the infected population benefiting from treatment, ranging from 0.26 (95% CI: 0.18–0.34) to 0.92 (95% CI: 0.80–0.98), respectively. Importantly, reduced treatment delays, coupled with increased test and treatment coverage, have a critical influence on average treatment benefits, confirming the significance of access.
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