Using large scale rapid antigen testing (RAT) to inform participatory ad-hoc community surveillance for emerging communicable diseases epidemics

Abstract

<p>Besides the diagnostic use for infectious diseases in a point-of-care clinical settings, the simplicity and ease of self-performed RAT can also be an alternative approach for informing disease surveillance at the community level, carrying the potential advantage of enhanced timeliness, acceptability, and flexibility. Commissioned by the Hong Kong Government during the catastrophic fifth wave of the COVID-19 pandemic, our team established and maintained an ad-hoc large-scale participatory daily antigen rapid testing surveillance (DARTS) system for real-time situational awareness of SARS-CoV-2 activity to inform policy consideration in a timely manner. This Chapter will describe the concept and design of the surveillance approach, examine the practical feasibility and challenges, related logistical consideration on implementation and maintenance, technical aspects of data analysis to cater for the unique surveillance need, and other potential additional contribution of the data on understanding the novel disease (estimating vaccine effectiveness, and symptomatology and viral shedding pattern).<br></p>