Nevada revokes halt on rapid antigen testing in nursing homes

Under pressure from the federal government, Nevada health officials Friday rescinded a statewide order directing nursing homes to halt the use of two government-issued rapid coronavirus tests that the state had deemed to be inaccurate.

The reversal came shortly after the United States Department of Health and Human Services issued a threatening letter, dated Oct. 8, to Nevada officials. The federal document noted that swift punitive actions could be taken if the state did not promptly revoke its ban, which Adm. Brett Giroir, assistant secretary of Health and Human Services, called “unwise, uninformed and unlawful” and a violation of the Public Readiness and Emergency Preparedness Act.

Outside health experts who reviewed the letter, which condemned the state’s actions as “based on a lack of knowledge or bias,” described its tone as “acid.”

In a statement released on Friday, Dr. Ihsan Azzam, Nevada’s chief medical officer, said that he and his colleagues were “very disappointed by the letter received today.” Nevada’s priorities, Azzam said, remained aligned with the federal government’s: to protect “those most vulnerable in our communities from COVID-19.”

The two brands of rapid tests, manufactured by Quidel and Becton, Dickinson and Company, had been shipped en masse to nursing homes around the country in August to address the delays and equipment shortages that for months had stymied laboratory testing. Both tests detect bits of coronavirus protein, or antigens.

In submitting applications to the Food and Drug Administration for emergency clearance, BD and Quidel reported no false positives from their products, and advertised these accuracy rates on their packaging.

But among a sample of 39 positive antigen test results collected from nursing homes across Nevada, 23 were found to be false positives when confirmed by a more accurate laboratory test. The discovery prompted state officials to issue their directive on Oct. 2, urging nursing homes to promptly pivot from antigen tests to other types of tests that look for viral RNA while the discrepancies were being investigated.

Dr. Valerie Fitzhugh, a pathologist at Rutgers University, said the number of false positives the state had reported was “significant” and worthy of scrutiny. “In the meantime, switching to an alternative, accurate method of testing would be the responsible thing to do,” Fitzhugh said. “Nevada was on the right track for trying to fix this issue.”