RAT or PCR? Your guide to testing as we live with COVID-19

Key points

• Knowing when to get tested for COVID-19 can be confusing enough without the question of what kind of test to take
• State and Territory Governments may have different advice around when to use each type of test
• For people with disability accessibility may be a factor in whether to take a RAT or a PCR test

Whether you should have a RAT or PCR test depends on a range of things, so we’ve put together a guide to testing as Australians learn to live with COVID-19, including what factors to consider in relation to disability.

Expert advice

The Australian Health Protection Principal Committee (AHPPC), which is made up of each State and Territory’s Chief Health Officers, gives advice to the Australian Department of Health, and says RATs can be used for three purposes:

1. As an alternative diagnostic test to PCR testing for those at high risk of having COVID-19. In most circumstances in the current high-prevalence environment, a positive rapid antigen test should be accepted as a diagnosis of COVID-19.
2. To manage outbreaks.
3. To help early identification of cases in high-risk settings.

This means people who live in the same household as a positive case or have had a high risk exposure to a case can use RATs on the first day they are notified of their contact with a case and on the sixth day after.

If either of these are positive RAT results the advice is that you are considered a positive case, whether you have symptoms or not.

People with COVID-19 symptoms who don’t know of contact with someone who tested positive for COVID-19 can also use a RAT, although if it is negative you should still isolate at home and take another test in 24 hours, or get a PCR test.

If both the RATs are negative or your PCR test is negative you are not a COVID-19 case but you should still isolate until your symptoms go away, so that you don’t make anyone else sick, even if you just have a cold.

In high risk settings like group homes, healthcare facilities and aged care facilities, RATs can be used for all staff and residents, or patients, once a positive case has been detected.

This is to gauge how far the outbreak has spread and should be followed up by a day six and day 12 test – which can be RATs.

For the first few cases identified by RATs, a PCR test is also recommended to confirm the result.

The advice for all residential disability care settings is for staff to take RATs daily where possible, and at least twice weekly if there are not enough tests in supply, while visitors should do a test each time they visit.

Beyond this advice State and Territory Governments may have different rules about when to use each test.

For testing advice specific to your location visit the websites below:

• Australian Capital Territory advice says people who are significantly immunosuppressed should confirm a positive RAT with a PCR test to allow them access to certain treatments
• Queensland relies mainly on RATs
• New South Wales advises PCR tests are more of a back up option if you have symptoms but return a negative RAT
• Northern Territory no longer uses PCR tests unless clinically required or requested by an authorised officer
• South Australia’s advice says anyone with symptoms who is not a close contact should do a PCR test
• Tasmania gives free RATs to people with symptoms
• Victoria says all people should use a RAT in the first instance if one is available
• Western Australia says RATs and PCRs can be used interchangeably, except a RAT should be used by close contacts on the last day of their quarantine period and a PCR should be used if you are not a close contact but have symptoms

General comparisons

There are pros and cons to each of the testing options which make them more appropriate for some situations than others.

RATs and PCR tests can be compared by:

• Accuracy – PCRs are more accurate than RAT results. A list of the approved brands of RATs and each product’s accuracy can be found here
• Speed – RATs offer a quick result within half an hour, PCR results can take hours or even days
• Availability – RATs are supposed to be available from a variety of stores, depending on demand, PCRs are also subject to demand and people may get turned away from testing sites if too many are waiting for a test
• Testing location – RATs can be taken anywhere, including at your own home, but PCRs must be done at a testing clinic
• Administration – PCRs are done by a health professional with training in how to administer the test, whereas RATs you can do yourself or with help from adult family members of children who need a test
• Cost – PCRs should always be free if provided at a testing clinic, but RATs are only free in some circumstances; if you are a designated close contact of a confirmed case your State or Territory Government will give you enough free tests for your isolation period, if you have a Commonwealth concession card you can access 10 free tests over three months and if you have National Disability Insurance Scheme (NDIS) funding you can use it to pay for tests. The price of RATs can vary widely depending on where you buy them from and the demand for them at the time.
• Medical recommendations – some people may be recommended by their doctor to only have a PCR test and not use RATs, including people with immunodeficiency, people with end stage renal failure and people receiving immunosuppressive therapy or dialysis

Accessibility

RATs are not accessible to people who are blind and may be inaccessible to people with visual impairments because they rely on visual notifications of the test result.

If you need to take a RAT as a person with visual impairment you may be able to have someone else in your household help you take the test and have them read the result. However, you still need to be careful not to spread COVID-19 to others around you if there’s a chance you have contracted the virus.

On the other hand, PCR tests are done at centres where staff use Personal Protective Equipment (PPE) when they administer the test for you. The test results are sent by text message, which should be readable with your assistive technology.

PCR testing clinics may not be accessible for people with physical disability, depending on where the clinic is set up. Not all testing clinic buildings have wheelchair access and if you have a modified car which allows you to travel in your wheelchair you may not be able to get tested at a drive through either, if staff can’t test you through a car window.

If you are Deaf or hard of hearing and need instructions about testing interpreted then PCR tests may not be accessible for you, although some centres may have written explanations of the testing process.

Planning ahead

It’s a good idea to have a few RATs in the cupboard, if you can find them in a store, in case you need them. This way you don’t have to go on a treasure hunt to find one when you do need to test at home.

To plan ahead in the case that you need to get a PCR test you can find the nearest testing centre to your home which is specifically accessible to you. Also think about how you will get to the testing centre in the event you need the test and if you will need someone to drive you, how you will keep them and yourself safe if you have been exposed to COVID-19.

Have you got any tips on accessible COVID-19 testing? Tell us in the comments below.

Related content:
Preparing to isolate at home due to COVID-19
Coping with extended self-isolation due to COVID-19
Supports available to protect you from COVID-19