15 things not to do when using a rapid antigen test, from storing in the freezer to sampling snot
- Written by Thea van de Mortel, Professor, Nursing and Deputy Head (Learning & Teaching), School of Nursing and Midwifery, Griffith University
Many of us have taken a rapid antigen test (RAT) or have administered them to our school-aged children.
But how many of us are using them correctly?
Here are 15 pitfalls to avoid if you want to get the most out of your RAT.
Read more: Taking your first rapid antigen test? 7 tips for an accurate result[1]
1. Storing at the wrong temperature
RATs should be kept at 2-30℃[2] for them to work as intended.
Storing at higher temperatures means proteins in the tests can be denatured[3] – permanent changes to protein structure, just like when you cook an egg.
Don’t let the kit freeze[4]. This can also damage the kit components.
2. Using straight from the fridge
The reagents[5] (essential test kit ingredients) will not work properly at cold temperatures. Let the kit sit out of the fridge for about 30 minutes before using it.
3. Using an out-of-date test
Always check the use-by date before using, which you’ll find on the carton. Expired tests can contain biological or chemical reagents that have gone off or are denatured.
4. Opening too early
Do NOT open the test items until you are ready to start. Storing the test open[6] can lead to false positives (you can test positive without really having COVID).
5. Taking the test too soon or too late after exposure
A study[7], which has yet to be reviewed by experts, suggests RATs cannot detect SARS-CoV-2 (the virus that causes COVID-19) until at least day two after exposure. It takes a median of three days to test positive.
RATs also cannot detect the virus later than about seven or eight days[8] after exposure. So don’t wait too long to get tested.
RAT sensitivity (ability to detect a positive case) improves if you take a daily test, over several days[9].
6. Assuming all tests work the same
Some RATs need nasal swabs, others use saliva. The way virus is extracted from the sample, the number of drops to add to the testing device, and the timeframe to read the results differ between brands.
Familiarise yourself with the instructions, especially if it’s a new brand, or it’s been some time since your last RAT.
7. Contaminating the test
Do NOT touch the tip of the swab[11] (the soft bit that goes in your nose) with your fingers or allow it to come into contact with other surfaces.
8. Sampling snot
Blow your nose before doing a nasal swab as you don’t want to sample snot. You want to swab the tissue that lines the nasal passages, using the technique below.
9. Swabbing at the wrong angle and depth
When inserting the nasal swab, you are not trying to swab the inside of your nostril but the tissue further back in the nasal passages.
Are you taking the sample correctly?
health.gov.au/PHLN/CDC[12]
So rather than going directly upwards with the swab, try to go horizontally[13] and about 2-3 centimetres back. Then rotate the swab gently against the walls of the nasal passage the exact number of times your test recommends. Repeat on the other side.
Because it’s easy to get the angle/depth wrong, it’s best for parents or caregivers[14] to take children’s samples. Most RATs shouldn’t be used on children under two years old[15], so check the instructions if you’re not sure.
Read more: Go low, go slow: how to rapid antigen test your kid for COVID as school returns[16]
10. Continuing with a bloody swab
Blood on the nasal swab[17] will give you an inaccurate result. Discard the test and do another when bleeding has stopped, or swab only on the side that is not bleeding.
Don’t use a test that requires nasal swabbing if you are prone to nose bleeds. Use a saliva test instead (see below).
11. Eating, drinking, chewing gum, brushing your teeth or smoking before a saliva test
These can give an inaccurate result[18]. So wait 30 minutes before taking a saliva sample.
12. Adding too many or too few drops to the indicator device
Adding the right number of drops will ensure the liquid moves across the test surface in a specific time. If you add extra drops, or too few, you will mess up the timeline and the test will not work properly.
How a RAT – known as a lateral flow test in some countries – works and how molecules move through the kit.13. Reading the result too early or too late
Read the result at the time listed[19] in the instructions.
Read the test too early and it is likely to give you a false negative result (the test reads negative but you are really positive). Too late and it might indicate you are positive when you are not.
Read more: How accurate is your RAT? 3 scenarios show it's about more than looking for lines[20]
14. Misreading the result
When you read your results (at the correct time):
two lines means you have tested positive for SARS-CoV-2
a line at C (for control) ONLY means the test has worked and you have tested negative
a line at T (for test) (or A for antigen, depending on the kit) but NOT C means your test is faulty. Do another one
no lines also means your test is faulty and you need to repeat it.
Your test result will look like one of these.
antibodies.com/screenshot[21]
15. Disposing of the kit incorrectly
Seal any components of the kit that have come into contact with your nasal or saliva sample (swab, containers, reagents, test device etc) in the plastic bag provided and dispose in the garbage.
Only place the cardboard carton and paper instructions in recycling.
References
- ^ Taking your first rapid antigen test? 7 tips for an accurate result (theconversation.com)
- ^ 2-30℃ (www.tga.gov.au)
- ^ denatured (education.seattlepi.com)
- ^ freeze (www.tga.gov.au)
- ^ reagents (www.news-medical.net)
- ^ Storing the test open (www.fda.gov)
- ^ study (www.medrxiv.org)
- ^ seven or eight days (www.thelancet.com)
- ^ take a daily test, over several days (academic.oup.com)
- ^ Shutterstock (www.shutterstock.com)
- ^ NOT touch the tip of the swab (www.tga.gov.au)
- ^ health.gov.au/PHLN/CDC (www.health.gov.au)
- ^ horizontally (www.health.gov.au)
- ^ parents or caregivers (www.nsw.gov.au)
- ^ under two years old (www.nsw.gov.au)
- ^ Go low, go slow: how to rapid antigen test your kid for COVID as school returns (theconversation.com)
- ^ Blood on the nasal swab (www.tga.gov.au)
- ^ inaccurate result (www.tga.gov.au)
- ^ time listed (www.fda.gov)
- ^ How accurate is your RAT? 3 scenarios show it's about more than looking for lines (theconversation.com)
- ^ antibodies.com/screenshot (www.antibodies.com)
