BACKGROUND: We evaluated whether occupancy modeling, an approach developed for detecting rare wildlife species, could overcome inherent accuracy limitations associated with rapid disease tests to generate fast, accurate, and affordable SARS-CoV-2 prevalence estimates . Occupancy modeling uses repeated sampling to estimate probability of false negative results, like those linked to rapid tests, for generating unbiased prevalence estimates .

METHODS: We developed a simulation study to estimate SARS-CoV-2 prevalence using rapid, low-sensitivity, low-cost tests and slower, high-sensitivity, higher cost tests across a range of disease prevalence and sampling strategies .

RESULTS: Occupancy modeling overcame the low sensitivity of rapid tests to generate prevalence estimates comparable to more accurate, slower tests . Moreover, minimal repeated sampling was required to offset low test sensitivity at low disease prevalence (0.1 %), when rapid testing is most critical for informing disease management .

CONCLUSIONS: Occupancy modeling enables the use of rapid tests to provide accurate, affordable, real-time estimates of the prevalence of emerging infectious diseases like SARS-CoV-2.