Yeah dont you wish we only had 1 in a million false positives lol
Even at top tier labs false positives are way higher than that
Even based on Public Health Ontario own numbers (at a very highly rated / respected lab)
The 1 in a million false positives was to make the math easy to explain and show how the statement about prevalence being important in terms of overall numbers of false positives.
According to that paper you linked, there are roughly 20 false positives per 228,000 tested. Closer to 1 false positive for every 10,000 tests.
If that held and you tested the entire population of Ontario (~14.5 million) you would get 1,272 false positives.
They also go on to discuss what they call subclinical cases (other sources refer to these as false positives; they are not BUT they can not spread)
But it may be a subclinical case, meaning that your viral load is so low that you are not infectious and cannot spread the virus to other people, including those in your immediate household — which is a good thing!
Yes, and this is one of the reasons I argue that PCR is good for diagnosing, but not useful for population screening in terms of getting people back to work. Faster, cheaper, lower-sensitivity tests would be better, even if they had a
much higher false positive rate. For a screening test to open the economy you would want tests that were excellent at avoiding false negatives. Of course, the people who think COVID-19 is fake would complain about the false positives in that scenario, which I am sure is part of the political pressure preventing shifting to those tests.
Obviously, the ideal would be a fast, cheap test that had excellent sensitivity AND specificity but it is really rare for a test to excel at both.