A world-first study by Australian researchers shows only two of 10 brands of COVID-19 rapid antigen tests (RATs) analysed picked up low concentrations of the virus.
James Cook University researcher Patrick Schaeffer said there needed to be an "overhaul" of the various brand of tests in Australia.
"We need to have a clean-up of the RAT tests that are currently available," Professor Schaeffer said.
"The RAT tests that are available are not cross compared independently because they were released in an emergency act.
He said companies producing RATs had to use an analytical system to disclose the sensitivity of their tests.
"It's probably the worst method available these days to actually do this, because it's highly variable," he said.
James Cook University researchers engineered fluorescent nucleocapsid protein to test the effectiveness of the RATs.
Professor Schaeffer said the method allowed a high level of quality control.
He said the method could be used to create a benchmark for the more than 50 other brands of RATs available in Australia.
"We need to totally benchmark all RATs ... to know what the detection limit is of those RATs," he said.
"So we can actually say, 'this is our most sensitive RAT test, this is the one that is going to protect most people'."
Testing in the future
Infectious disease physician and University of Queensland clinical microbiologist, Paul Griffin, said there would still be a need for rapid antigen tests for years to come.
From the 1st of January this year Australians needed to obtain a referral from a GP or a nurse practitioner to receive a medicare-funded PCR test.
"It's clear COVID is not going away and so testing for it readily is going to be really helpful," he said.
"I think we've made a few missteps with rapid antigen testing in our country.
"Earlier on the pandemic, we were very against them ... and then almost overnight, we pivoted, to recommending them almost solely without still appreciating the context and some of the limitations."
But Dr Griffin said polymerase chain reaction (PCR) tests should still be accessible and encouraged if someone had symptoms of COVID-19.
"It obviously does perform a little bit better than rapid antigen testing, but also gives us the ability to check what sequence and what sub variants might be circulating in our population," he said.
"The fewer PCR based tests we have, the less data we get on those sorts of things."
