Elon Musk's Analysis of the COVID Rapid Antigen Test

Recently Elon Musk tweeted the following statement. I'm going to explain why he almost had it right and where he went completely wrong.

Musk recently stated in a tweet that he got tested four times in one day for COVID19 using a rapid antigen test. Half of the tests resulted positive and the other have resulted negative. He concluded that "something extremely bogus is going on" implying that they are out to get you!

Here's what he got right. Most of the COVID tests that we have out there are not that great at producing accurate results. There are several reasons for this; the tests are user sensitive, meaning how well of a sample you can get depends on the person swabbing. When it comes to the PCR tests, most assume because it is a genetic test it must be 100% accurate. Here's the thing. I have ran PCR machines when I worked in a lab and I can tell you even that is user dependent. Because you are working with such small amounts of a sample, making your dilutions correctly are crucial and even the smallest microscopic error can cause inaccurate results. This is very dependent on the skill level of the lab technician running the machine. Musk is correct that most of the screening tests that we currently have for SARS-CoV2 aren't that great!

Ok here's what he made him earn the title "Space Karen." Musk eluded that the tests have a high rate of false positives and that the numbers reported are inflated. How did he conclude it was a high rate of false positives and not false negatives? If he read the package inserts of these tests he would note that most actually have quite a low sensitivity rate. A study even showed one rapid antigen test having a sensitivity rate as low as 32%. Of course this study which was done back in May is already considered outdated as we do have better tests out there now. But they are far from being the ideal screening test. Screening tests must have a very high sensitivity rate in order to capture a larger population of individuals who are infected. A PCR or other confirmatory test usually will have a higher specificity rate. If you'd like to learn more about the basics of how screening tests must be designed click here!

Unfortunately his post became trending top on r/Conspiracy on Reddit. Now we have thousands if not millions of Americans who believe these tests are inaccurate as a result of some government conspiracy trying to control the masses. When in reality if he took the time to understand basic screening test methodology he would would see these tests are inaccurate because the scientific community is, in short, working on it. As more data and information comes to light, laboratories can update their tests to have higher sensitivity. Just last week my hospital received an updated rapid PCR test that produces results in 15-20 minutes with much higher sensitivity rates than the most recent and popular screening test out there. So I ask for your patience, to trust the science and to trust the process.

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