Test choices for COVID-19, flu confusing for many: new survey

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Approaching the end of a third year with COVID-19, two out of three Americans are confused by the differences between PCR and rapid antigen tests, according to a new survey conducted by Wakefield Research for Roche Diagnostics.

People are likewise confused about when to use the tests -- the primary tools to diagnose respiratory infections.

At the same time, at least a quarter of those surveyed know that a PCR test is the most accurate for detecting the virus that causes COVID-19, and about one third of parents recognized PCR tests as being more accurate than antigen tests.

The survey findings are compelling in the context of a potential tripledemic, as influenza, COVID-19, and respiratory syncytial virus cases rise.

"Before the pandemic, most outside of a clinical setting didn't know that PCR testing was the most accurate in detecting viruses, such as SARS-CoV-2, and there's still room to grow that understanding," Jamie Phillips Deeter, infectious diseases scientific partner at Roche Diagnostics, said in a statement. "It's important to know that PCR testing is the best option for early detection, when treatment is most effective."

Flu antivirals are most effective within two days of symptom onset, and COVID-19 antivirals can be effective within five days of symptom onset if symptoms are present.

Confidence in the PCR test also varied among different demographic groups and based on family composition, according to the survey.

Overall, the omnibus survey gauged perceptions of 1,000 nationally representative adults, ages 18 and older, and was conducted online between November 4 and 13, 2022. 

Of Gen Z respondents, 85% think PCR is not the most accurate test, compared to 71% of millennials, 69% of Gen X, and 72% of boomers. Generations are defined as 18 to 25 years old for Gen Z; 26 to 41 years old for millennials; 42 to 57 years old for Gen X; and 58 to 76 years old for boomers.

Many respondents (79%) believe their doctor can order one diagnostic test to determine whether they have the flu, COVID-19, or RSV. It is accurate that multiplex PCR tests can identify more than one illness with one swab, and most physician practices, hospitals, and laboratories provide a wide range of testing based on the medical need, the survey noted.

"Although respiratory viruses have historically had a defined seasonality, they can cause illness throughout the year," Deeter said. "The ability for viruses to transcend seasons has been particularly evident this year, making it difficult to define the beginning of a traditional respiratory season."

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