Rapid Antigen Test guidance for PHOs and PHUs

Email to PHOs from Dr Justine Lancaster, Chief Clinical Advisor l Primary Health Care System Improvement & Innovation| Office Chief Medical Officers

We understand that GPs and PHUs have received approaches from suppliers of Rapid Antigen Test kits. The Ministry’s current position on the use of Rapid Antigen Testing is set out below for your information. Any approaches that GPs or PHUs receive from suppliers of RATs should be referred to the Ministry for a response.

‘Keeping COVID-19 out’ forms the basis of Aotearoa New Zealand’s elimination strategy This is based on keeping the virus out and finding and containing any identified cases quickly and effectively.

Testing is a core part of New Zealand’s COVID-19 elimination strategy. It is used to ensure other protective measures such as physical distancing, personal protective equipment, and symptomatic people staying at home are effective. The vaccination rollout is another key measure used to reduce the spread of infection.

A range of testing modalities are used within different settings to test sub-groups of people to detect and identify cases of the virus in the community as early as possible. The Ministry continues to consider the potential for the use of antigen testing, and other technologies, as part of the public health response.

The Ministry regularly reviews its Surveillance Strategy and Testing Plan to ensure that our current approach is based on emerging evidence and best practice. Testing modalities are rapidly evolving as we learn more about COVID-19, new variants, and emerging technologies to improve testing processes.

Home testing rapid antigen test kits for COVID-19 are not currently authorised for use in New Zealand.

Rapid antigen testing is currently accepted as pre-departure testing for incoming travellers and is authorised for use within New Zealand in specific pilot evaluation settings. There may be potential in the future to use rapid antigen testing in outbreak scenarios.

The Ministry has purchased rapid antigen kits for use in pilot programmes as part of reviewing its use in the New Zealand context. There are two approved pilots currently underway.

The purpose of the pilots is to consider how RATs can best be used to identify new infections, support outbreak investigations through screening and monitor disease trends.

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Testing of patients arriving at Middlemore Hospital’s Emergency Department.

Samples for rapid antigen testing will be taken from people who are having swabs taken for laboratory-based PCR testing and who consent to an additional sample being taken to help assess the accuracy and usefulness of these tests in this setting.

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Rapid antigen tests (RATs) as a point of arrival test.

These will be included in the Self-Isolation pilots that will take place in Auckland and Christchurch. The participants for this pilot will be selected through an expression of interest

(EOI) process, with defined criteria. This will be a small number of travellers who have travel internationally for business purposes and returned to New Zealand within a short window of time and undertake self-isolation on arrival in Auckland or Christchurch.

The pilot has been approved for up to 150 people and will be spread out over the six-week arrival period of the pilot, from Saturday 30 October to Wednesday 8 December 2021, with final travellers exiting self-isolation on 22 December 2021.

As part of the selection and acceptance process, participants in the pilot will give their consent to the testing regime, which includes the provision of an additional swab at the point of arrival for a rapid antigen test.

The Ministry continues to explore how rapid antigen tests can effectively be used in appropriate settings to support outcomes in Aotearoa New Zealand’s COVID-19 Surveillance Strategy, and to engage with research to inform implementation considerations.