Testing, testing, and more testing!

Why is COVID-19 testing a key to fight the pandemic?

One thing we know for sure: every single person can help to control the COVID-19 pandemic. From wearing a mask, to washing your hands, to maintaining physical distance and avoiding gatherings, each of us can follow proven public health practices that not only reduce our own chance of getting infected by SARS-CoV-2 (the virus that causes coronavirus disease, or COVID-19), but also prevent the spread of COVID-19 to our coworkers, friends and family.

Another thing that will help is testing as many people as possible.

Testing for COVID-19 is very important and access and acceptance of rapid and reliable testing can help people determine if they are infected with SARS-CoV-2 , regardless of whether they have symptoms and whether they are at risk of spreading the infection to others. Taking measures to prevent the spread of infection will be the most effective strategy for getting us safely back to work and school.

Two kinds of tests are available for COVID-19: viral tests and antibody tests.
▪ A viral test tells you if you have a current infection.
▪ An antibody test might tell you if you had a past infection.

Testing saves lives
Testing of all people for SARS-CoV-2 will help prevent the spread of COVID-19 by identifying people who are in need of care, including those who have no symptoms and those who show symptoms of infection. A positive test early in the course of the illness enables individuals to isolate themselves, reducing the chances that they will infect others and allowing them to seek treatment earlier, likely reducing disease severity and the risk of long-term disability, or death.

Testing of people who have been in contact with others who have a documented infection is also important.

A negative test does not mean you are in the clear; you could become infectious later. Therefore, even if you test negative, you need to continue to protect yourself and others by washing your hands frequently, physically distancing, and wearing a face mask.

Since it is recognised that nearly half of all SARS-CoV-2 infections are transmitted by people who are not showing any symptoms, identifying infected individuals while they are presymptomatic, as well as those who are asymptomatic, will play a major role in stopping the pandemic.

Testing can be easy and quick
A positive test for SARS-CoV-2 alerts an individual that they have the infection. Not only can they get treated faster, but they can take steps to minimise the spread of the virus.

This is why it is so important to get the test results quickly.

Early in the pandemic, there was not enough capacity to process the tests, which resulted in delays. However, lab equipment has improved, capacity and supply have expanded, and results are being returned, on average, within 1-3 days, but, in fact, point-of-care tests provide a result in less than 15 minutes.

When is testing more relevant
When COVID-19 is spreading quickly, testing, particularly of asymptomatic and pre-symptomatic individuals, is the key to interrupting this spread.

It is becoming clear that for a person to test positive, they have to have a significant amount of the virus in their system.

This means that if you have no symptoms but think or were told that you were in contact with a person with COVID-19, call your health care provider and get a test.

Staying informed is essential.

We hope that in the not too distant future, all the efforts that are being done by science around the world will put an end to the pandemic.
In the meantime, let’s all continue to protect ourselves and others from getting infected.

Why does more testing help?
When there is not enough testing in an area, people who are infected with coronavirus do not get counted, and they do not know if they need to isolate themselves. As a result, these people can spread the coronavirus and cause disease in their communities.

People who test positive for the coronavirus (and those exposed to them) should isolate themselves and contact tracing should be done to prevent the infection from spreading.

Without enough testing, the coronavirus spreads “silently”
By the time severe cases begin to surge in hospitals, outbreaks are larger and much harder to control. These outbreaks can be detected earlier and their severity lessened by testing more people.

But, for testing to go to work, people need to get test results quickly. When people have to wait many days to get their results back, they may be less likely to keep themselves isolated. By the time a positive test result comes back, someone who has been waiting many days may have infected more people.

While tracking the number of positive tests is useful, what matters more is the total number of people who are infected, and we can only know this number by testing more people.

Antigen tests could help to keep the pandemic at bay, because they can be done in vast numbers and can spot those who are at greatest risk of spreading the disease.

If a community is doing more testing and responding appropriately to positive tests, by making sure that people who might be contagious are isolated, the amount of transmission should go down over time.

Although the PCR method can test whether someone is infectious, it also detects people who have the virus but are not likely to spread it.

Antigen-based testing, by contrast, could help to rapidly identify people who have high levels of virus, those who are most likely to be infectious to others and isolate them from the community.

Testing cannot replace the basic measures that need to be in place to keep this virus controlled, such as stricter regulations regarding wearing masks, physical distancing, and avoiding gatherings, but all effective ways to reduce transmission must be used.

Widespread testing is necessary, important, and achievable.

Best health wishes,
Maria Alice

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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos