The impact of population-wide rapid antigen testing on SARS-CoV-2 prevalence in Slovakia

Pavelka, Martin; Van-Zandvoort, Kevin; Abbott, Sam; Sherratt, Katharine; Majdan, Marek; Jaruka, Pavol; Kraj, Marek; Flasche, Stefan; Funk, Sebastian

Slovakia conducted multiple rounds of population-wide rapid antigen testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2020, combined with a period of additional contact restrictions. Observed prevalence decreased by 58% (95% confidence interval: 57 to 58%) within 1 week in the 45 counties that were subject to two rounds of mass testing, an estimate that remained robust when adjusting for multiple potential confounders. Adjusting for epidemic growth of 4.4% (1.1 to 6.9%) per day preceding the mass testing campaign, the estimated decrease in prevalence compared with a scenario of unmitigated growth was 70% (67 to 73%). Modeling indicated that this decrease could not be explained solely by infection control measures but required the addition of the isolation and quarantine of household members of those testing positive.