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Are antigen tests OK to use in cold weather?

Beginning at 10 a.m. on Jan. 12, Vermonters were invited to help “test” a new system for ordering and delivering rapid COVID-19 tests by visiting SayYesCovidHomeTest.org.

“It is our hope that rapid tests will be readily available at every local pharmacy for lower prices in the near future,” Gov. Phil Scott said. “We need to bridge the gap between where we are today and where things will be in the months ahead. That’s why we are partnering with the team at the National Institutes of Health to ‘test drive’ the effectiveness of this online ordering and home delivery model, while also surging thousands of tests into our communities.”

State officials noted that this program is not the same as the rapid testing tools being implemented for schools and childcare programs, which along with long-term care facilities and nursing homes have been prioritized by the state. And though it is similar to the system President Biden has said the federal government would use to make rapid tests more easily available later in the month, this YesCovidHomeTest program was in addition to that federal effort.

The program was developed by the National Institutes of Health (NIH) and is expected to deliver recently purchased rapid COVID-19 tests to households across the state in two phases, beginning with 350,000 tests. Details of when 150,000 additional tests may be made available are still to be determined. The date will be set following a review of lessons learned in the first round, the production timeline of the test manufacturer and other considerations.

How did the rollout of the free rapid COVID-19 tests go? The website was flooded and Vermonters claimed all of the first 350,000 free tests by Thursday.

So, with about 350,000 at-home antigen tests on their way to Vermonters’ mailboxes, readers wrote to VTDigger to ask how the antigen tests would hold up if left for an afternoon or overnight in cold weather. Some antigen test kits, such as the QuickVue one sent through the pilot program, specify that the tests should be stored above freezing temperatures.

“We encourage people who have questions about storage and transport conditions to consult the test manufacturer’s instructions for use or the product insert,” Jason Malucci, a spokesperson for the governor’s office, said via email.

At a press conference last week, Health Commissioner Mark Levine said there are worries about tests being exposed to cold temperatures, although he emphasized the concern was for “prolonged” periods of time.

“We’re trying to get a better handle on what that means exactly, ‘prolonged,’ and how much work (manufacturers) have done to understand it,” Levine said. “They’ve tried to give us an indication that this is not something we should be overly concerned about.”

Information from the QuickVue test manufacturer appears to back that up. Although the FAQs page for the tests says the kits should be stored at 59°F to 86°F or 15°C to 30°C, “Quidel has performed studies that demonstrate the product performs as expected under different temperature conditions (i.e., heated and frozen conditions) encountered during shipping.”

The Food and Drug Administration’s instructions for the tests say that they were studied at room temperature, which suggests that you should probably allow the test components to fully thaw and come up to room temperature before using them.

MinnPost, a nonprofit news outlet in Minnesota, has compiled a range of manufacturer responses for other brands of antigen tests you might pick up at the pharmacy or order online. None of the manufacturers said that the tests should be tossed if they have been exposed to cold weather.

Tim Lahey, an infectious disease expert at the University of Vermont Medical Center, said via email that until data shows otherwise, “we should expect they work and focus on that most important message.”

“It’s kinda like someone said, ‘What if you were hanging upside-down from a coconut tree when you had your rapid antigen test done, would it still work?’” he wrote.

A “compulsively careful” scientist might say that it has not been tested yet under those conditions, but “if a skeptic came along and said, ‘Those tests don’t work where it’s cold,’ when push came to shove the answer is, ‘Prove it,’” Lahey said.

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