Evidence supporting Ministry of Health information that individuals recovered from Covid will continue to test positive on Rapid Antigen Tests
Ben Dickson made this Official Information request to Ministry of Health
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From: Ben Dickson
Dear Ministry of Health,
The Ministry of Health twitter account (@minhealthnz) recently dispensed the following advice:
"Kia ora, if you have taken a Rapid Antigen Test (RAT) after recently recovering from COVID-19, it will likely show as positive — but this does not mean you are infectious." (https://twitter.com/minhealthnz/status/1...)
Similar advice is found on the Ministry of Health website:
"In contrast, some people continue to test positive even after they feel well and are no longer infectious. If you’re isolating after a positive RAT, there’s no need to test again at end of the seven-day isolation period - but remember to stay home if you still have symptoms."
(https://www.health.govt.nz/covid-19-nove...)
Finally, in the interim clinical guidance there is reference to "Persistently positive RAT from previous infection", although this advice acknowledges that this is less likely to occur with NAAT./PCR (https://www.health.govt.nz/system/files/...)
Could the Ministry please provide the scientific evidence that informs the position that individuals who have recovered from Covid (here recovered is interpreted to mean no longer symptomatic and infectious) are likely to return positive Rapid Antigen Tests. Additionally could the Ministry also include scientific evidence that speaks to a concern of persistent positive RAT tests post infection (beyond the normal disease course).
Ngā mihi,
Dr Ben Dickson and Dr Julie Blommaert
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From: OIA Requests
Kia ora Dr Dickson and Dr Blommaert,
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[2]Ministry of Health information releases
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From: OIA Requests
Kia ora
Thank you for your request under the Official Information Act 1982 (the
Act) to the Ministry of Health (the Ministry) on 31 May 2022. You
requested:
“Could the Ministry please provide the scientific evidence that informs
the position that individuals who have recovered from Covid (here
recovered is interpreted to mean no longer symptomatic and infectious) are
likely to return positive Rapid Antigen Tests. Additionally could the
Ministry also include scientific evidence that speaks to a concern of
persistent positive RAT tests post infection (beyond the normal disease
course).”
The Ministry acknowledges that there is the potential for individuals to
test positive using a rapid antigen test (RAT) beyond the period where
they are considered infectious. A positive RAT result only indicates the
presence of SARS-CoV-2 antigens within the sample, and it is not able to
determine whether the individual is currently infectious. Current research
indicates that it is possible for individuals to test positive from a RAT
beyond the average infectious period. Therefore, the current health
guidelines do not require a negative test as a requirement for an
individual to leave isolation. More information is available at:
[1]www.health.govt.nz/covid-19-novel-coronavirus/covid-19-health-advice-public/about-covid-19/covid-19-what-we-know-about-infection-and-immunity.
The length of time a person is symptomatic can vary depending on a range
of factors. Research indicates that the vaccination status of the
individual and the COVID-19 variant type play a significant role, as shown
at: [2]www.bmj.com/content/377/bmj.o922.
The Omicron variants are the most prevalent circulating in New Zealand
currently, with research showing symptoms lasting on average between 3-5
days, as shown at:
[3]www.health.govt.nz/covid-19-novel-coronavirus/covid-19-health-advice-public/about-covid-19#symptoms.
It is possible for individuals to return a positive RAT result after they
are no longer experiencing symptoms. Therefore, the Ministry continues to
recommend individuals to remain in isolation until 24 hours after becoming
symptom free.
The latest SARS-CoV-2 Variants of Concern update shows that once an
individual contracts SARS-CoV-2, there is an average latency period (the
time from infection until the person becomes infectious) of three to four
days. However, this has been reported in some cases to be as long as six
to eight days. This has also been supported by further research, which can
be found at: [4]academic.oup.com/cid/article/74/9/1678/6359063. During
this time, RATs are unable to detect COVID-19 as the person is not
infectious or symptomatic. Once a person develops symptoms, the viral load
increases with detection using RATs occurring after 58 hours and usually
peaking around day 4-5. This is when RATs are most likely to detect the
presence of SAR-CoV-2 and display a positive result. References within the
SARS-CoV-2 variants of concern update provide evidence in support of these
statements. The update can be found at:
[5]www.health.govt.nz/system/files/documents/pages/10-june-2022-variants-update.pdf.
The above evidence shows that the time periods for when a RAT can detect
SARS-CoV-2 and when a person is infectious are similar, however, these do
not align perfectly. It is for this reason the Ministry recommends using a
RAT primarily if you feel unwell, rather than for use at end of isolation
periods. This is outlined on the Ministry’s website at:
[6]www.health.govt.nz/covid-19-novel-coronavirus/covid-19-health-advice-public/covid-19-testing/covid-19-test-results-and-their-accuracy.
The Ministry strongly advises that individuals who test positive remain in
isolation for seven days or until 24 hours after becoming symptom free.
This aligns with the key message of staying home if you are feeling
unwell, as outlined at:
[7]www.health.govt.nz/covid-19-novel-coronavirus/covid-19-health-advice-public/covid-19-staying-home.
Under section 28(3) of the Act, you have the right to ask the Ombudsman to
review any decisions made under this request. The Ombudsman may be
contacted by email at: [8][email address] or by calling 0800
802 602.
Ngâ mihi
OIA Services Team
[9]www.health.govt.nz
[10]Ministry of Health information releases
[11]Unite against COVID-19
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References
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1. http://www.health.govt.nz/covid-19-novel...
2. http://www.bmj.com/content/377/bmj.o922
3. http://www.health.govt.nz/covid-19-novel...
4. https://academic.oup.com/cid/article/74/...
5. http://www.health.govt.nz/system/files/d...
6. http://www.health.govt.nz/covid-19-novel...
7. http://www.health.govt.nz/covid-19-novel...
8. mailto:[email address]
9. http://www.health.govt.nz/
10. https://www.health.govt.nz/about-ministr...
11. https://covid19.govt.nz/
From: Ben Dickson
Dear OIA Requests,
Thank you for your response, I do not feel that it sufficiently addresses the request. The original request refers specifically to evidence that informs the Ministry of Health's position that recovered individuals (as previously defined) are likely to return positive Rapid Antigen Tests.
The response to this aspect of the question acknowledges the possibility that individuals could test positive beyond the period they are considered infectious and further states "Current research indicates that it is possible for individuals to test positive from a RAT beyond the average infectious period.", but does not provide the scientific evidence that informs this position (which was the requested information).
The response then goes on to talk about length of symptom times, latent period and the current circulating variant which were not a part of the request. Although it is noted that as part of this the Ministry does acknowledge: "During this time[the latent period], RATs are unable to detect COVID-19 as the person is not infectious or symptomatic." This begs the question why that would not be true during the recovery phase as well.
The response refers to a Variant of Concern update containing 212 references, and states that it contains information which then speaks to the statement: "The above evidence shows that the time periods for when a RAT can detect SARS-CoV-2 and when a person is infectious are similar, however, these do not align perfectly." I do not feel that it is appropriate to point to 212 references and claim that some of them speak as evidence. Specific references that are informing policy and public communications should be identifiable.
I do not feel that the second part of our request was responded to at all. We asked "Additionally could the Ministry also include scientific evidence that speaks to a concern of persistent positive RAT tests post infection (beyond the normal disease
course)." This is a feature of communications and has become a widely held view in the community. If there is clear data showing this to be true it is in the best interest of the public that this is released. If this is not correct, then it is critical that the error in communication is corrected.
I note that the original response to this request arrived a day late. I hope that this does not require an entire 20 working day period to properly respond to my original query.
Yours sincerely,
Dr Ben Dickson
Chris McCashin left an annotation ()
Done many of these OIAs before Ben? Suggest you get ready to cut and paste this part of your first response to them “I do not feel that it sufficiently addresses the request”
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Chuck Schooner (Account suspended) left an annotation ()
Oh this is interesting. This MOH statement implies that there is no asymptomatic spread (which is what a lot of doctors said that got silenced)
So if there is no asymptomatic spread then the basis for lockdowns and all the other trampling of civil liberties were based on flawed science and therefore all restrictions should be lifted immediately. Oh that’s right it’s never been about health but centralized power with NZ looking to cede the limited rights we still have fully to the WHO under the guise of these treaties. Oh well nothing to see here, put your masks on sheep, shut up and don’t ask questions.
Link to this