Unions and employers are embracing the use of rapid-antigen (RA) testing as it ramps up in some industries, but questions remain around cost, access, administration and how it should fit with other measures to reduce the risk of COVID-19 transmission at work.
Authorised workers in NSW's local government areas of concern must have had their first vaccination in order to travel out of their area for work unless their employer provides RA testing at their workplace.
For construction workers in these areas, they must have had one dose of a vaccination at least 21 days ago or have had a recent dose plus a standard polymerase chain reaction (PCR) COVID-19 test or a rapid antigen test within the previous 72 hours.
While other states continue to chiefly rely on PCR tests, the use of RA testing in overseas workplaces suggests it is just a matter of time before it becomes a regular part of the pandemic-fighting arsenal in Australian workplaces.
The RA test process in NSW requires workers to check in with a QR code and wait in a socially-distanced designated area before moving to a testing station, where a health practitioner supervises taking a nasal swab that is placed into a chemical solution.
With results displaying within 15 to 20 minutes, a worker with a negative result proceeds to work, while those with a positive result must isolate and undergo a PCR test.
RA tests can detect the virus in the acute phase of infection, especially in the week before symptoms surface and the first week of symptoms being apparent, according to the Therapeutic Goods Administration, which continues to update advice relevant to all states and territories.
While the RA tests are quicker and more convenient than PCR tests and take pressure off the PCR testing system, the TGA says in settings such as Australia where COVID-19 rates remain low, RA tests are "less accurate as there is a higher risk of both false positive and false negative results".
Employers reporting "significant hurdles": Ai Group
Ai Group chief executive Innes Willox stated that while while there is a "lot of interest" in rapid antigen testing amongst employers, they are also "widely reporting a number of significant hurdles", including cost and requirements to conduct workplace RA tests onsite.
As the cost is "prohibitive for many businesses", he says governments should be prepared to cover it, "given the important community benefits that flow from it".
Willox says the tests are free and widely available in various other countries, such as in the UK where they can be "picked up free of charge from pharmacies or other collection points or ordered online".
He says the requirement for rapid antigen testing to be carried out on-site under the supervision of a health professional is a further barrier.
"In the UK, employees are encouraged to take the tests at home so that they don't come to work if COVID-positive," Willox says, while if they test positive, "they can immediately report this through an online facility on a government website".
Given NSW public health orders require many workers to have had a vaccination dose or take a rapid antigen test, if one is available, he says "current barriers to testing are leading a lot more employers to mandate COVID vaccinations than would otherwise be the case".
He continues though, that on the "positive side, the TGA is rolling out a lot of information to assist employers interested in introducing rapid antigen testing".
"Expensive exercise": MBA
Master Builders Association NSW executive director Brian Seidler says the speed of RA testing is particularly important to the building industry in Greater Sydney, where only 50% of workers are allowed on site and productivity levels are understood to be far lower.
He says the "big issue is to get more of the industry open" through a proper, staged process and RA testing, while "not the be all and end all", forms "part of that plan".
Given workers had been queuing for hours for PCR testing in some Sydney LGAs of concern three times a week and waiting up to two to three days for a result, Seidler says the 15-to-20-minute wait for an RA test result is "important" in reducing workers' downtime.
But he says it is also "annoying" for building contractors to be bearing the costs of RA tests rather than have them paid for, such as via Medicare.
Seidler says there are a "whole host of different providers out there" costing between about $20 and $100 a head, and "then of course you've got to have someone to administer the test", with some employers engaging more than one nurse to speed up the process.
"If you're doing that every three days and you've got hundreds of building workers on jobs, then. . . it does become a reasonably expensive exercise," he says.
Because a public health order recognises RA testing and it is helping to keep the largest employer in the Australian economy going, Seidler says there is a "position in the industry that says we're doing the testing on our workers and the government should be looking at a system there".
Supply an "absolute priority": CFMMEU
CFMMEU construction and general division national secretary Dave Noonan says Victorian industries had "already rolled out the longer form [PCR] testing" thanks to unions and employers "working collectively through the redundancy fund", with the next stage to involve onsite vaccination and rapid antigen testing.
But while unions and "progressive employers" are taking a lead and "we're happy to take responsibility for our industry", Noonan says they "need as much assistance from government as possible".
He says supply "would be an absolute priority" and there is a "question of funding".
However, Noonan says RA testing is much cheaper than PCR and it will still be a "lot better option for employers to be putting some money into rapid antigen testing and not having to shutdown because of positive cases or industry lockdowns such as we've still got in Canberra".
Rapid tests must be "at workplace, on paid time": UWU
UWU logistics coordinator Alycia Economidis says access and affordability are "two key issues" with RA testing.
"Many employers have reached out to United Workers Union for assistance in securing rapid antigen testing because they're having trouble getting in contact with the New South Wales Government to secure the testing facility," she says.
Given vaccination access "has been a real problem" in NSW, the "only option, if people don't have their first dose by 30 August, is the testing which appears to be in high demand with limited supply, and the cost to have it on site is very expensive".
"One employer said it is costing more than $20,000 per week," Economidis says.
Because "not all companies, especially smaller worksites, can afford" RA testing, she says it is "not a long-term viable plan".
Economidis adds that "as a public health order it should be paid for or subsidised by the Government", with test kits "made available" and companies "able to hire a medical health practitioner".
She says workers and unions must also be consulted about the introduction of any testing policy and testing should be conducted "at the workplace, on paid time, prior to commencing usual duties".
"Any mandatory testing must be applied to all persons entering a workplace and employers must also provide union delegates and HSRs with adequate paid time to educate workers about testing."
"Local HR" should not administer test: AMWU
AMWU national secretary Steve Murphy says that where a workplace COVID-19 safety plan includes rapid antigen testing "it must be conducted by a competently trained person, not just the local HR manager".
He says it must also use the "approved testing method and be conducted during paid time".
"Workers who test positive should be provided paid pandemic leave to isolate and get well," Murphy says.
"We are recommending to workplaces that a collaborative and consultative approach is required to eliminate workplace transmission of this virus."
ACTU 100% supportive but aware of "inequity"
ACTU assistant secretary Liam O'Brien says unions are "100% supportive" of RA testing as a "really effective control if it can be used appropriately" and there is "no doubt that immediate, rapid testing is a real game changer when it comes to COVID".
Where employers can "test people at the workplace and we have real confidence in the ability of those tests to return reliable results, then we have a real ability to keep COVID out of workplaces", he says.
But O'Brien says unions are "also very conscious of its limitations at the moment", including "inequity in terms of how it can be deployed, as small workplaces can't really do rapid antigen testing" in the way larger companies might.
Because the costs will be "prohibitive" for a lot of employers, he says it is the "sort of the thing that needs to be introduced by government".
O'Brien adds that while "rapid testing is important, especially in an outbreak context" there are also other issues that workplaces "need to be focusing on a lot more", including ventilation.
"We're pushing for a COVID code of practice that will include greater obligations on employers to consider issues like ventilation in workplaces."
The MTA will continued to monitor and update on the position around rapid COVID-19 testing, but if members have any queries, please contact the WR team on firstname.lastname@example.org, or on