New ASTHO Report Spotlights National Approaches for Rapid COVID-19 Testing

November 06, 2020

ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) today released a new report detailing strategies for using rapid point-of-care tests in the COVID-19 response.

Due to early issues with test quality and ongoing supply chain management challenges, COVID-19 testing continues to be a challenging aspect of the pandemic response. There is now opportunity to address the testing demand with new and plentiful antigen-based point-of-care tests that offer results in as little as 15 minutes. Despite these advantages, use of antigen tests in the field has been challenging because of accuracy issues, testing capacity, and result reporting.

“State and territorial health officials have embraced the potential for increased testing capacity with fast, less expensive tests, but they are struggling to determine how they can be allocated responsibly and administered safely,” says Marcus Plescia, chief medical officer at ASTHO.

The report shares considerations for public health leaders in the wide-spread use of antigen testing. Notable considerations include:

  • Antigen tests have been authorized by the FDA for diagnostic use, but providers should confirm negative results with a standard polymerase chain reaction (PCR) test if the probability of infection is high.
  • Antigen tests may be useful as screening tests if screening is performed on a regular and frequent basis every few days.
  • Operator errors may have contributed to recent reports of false positives in some settings. Training of personnel and establishing quality assurance practices in these settings is critical.
  • Public health leaders may want to consider advising facilities against moving nursing home patients to COVID-19 wards until a positive antigen screening test is confirmed with a positive PCR test.
  • In communities where transmission rates are low and mitigation efforts are effective, PCR testing may be a more reliable and manageable approach to screening.


ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.