Background
The COVID-19 pandemic presents health policymakers and clinicians with difficult decisions under conditions of uncertainty, facing an infection that in its early stages mimics many other influenza-like illnesses (ILIs) (1). The range of diagnostic tests available for SARS-CoV2 is growing but they have important limitations. RT-PCR is the reference standard but depends on advanced laboratory facilities that are not available in primary care or community settings, and long turn-around times for results increases the risk of nosocomial transmission (2). Performance profiles for RT-PCR tests for SARS-CoV2 are also sub-optimal, with reported false negative rates of up to 30% (3).
Point-of-care tests (POCTs) could transform epidemic control by better guiding triage decisions to reduce risks of nosocomial and community transmission. However, reliable POCT options in the period before a detectable antibody response has been mounted are few. There could therefore be a role for surrogate tests (those that do not directly diagnose SARS-CoV2) for screening. These include FebriDx, a low-cost POCT used to distinguish bacterial from viral infections and originally designed to support rational antibiotic prescribing (4). A number of evaluations are ongoing to consider the value of FebriDx in acute and primary care settings during the COVID-19 pandemic (5,6).
This short report explores the place of surrogate POCTs in the diagnostic mix in high income settings, by considering the performance of FebriDx and SARS-CoV2-specific POCTs on the market.