Tension over shortage of coronavirus tests across Europe

How could actor Idris Elba get tested for coronavirus in the U.K. even if he didnt have symptoms, while some health care workers cant?

As the number of confirmed cases of coronavirus has skyrocketed in Europe, access to testing has sparked tensions among ordinary citizens and disagreement among national and international health officials.

At issue is that most European countries prioritize testing only for the most severe cases and tend to focus on those admitted to hospital, so medical staff know how to treat them and ensure the infection doesnt spread. But the World Health Organization (WHO) still advises that countries test as widely as possible, even if the virus has spread in the community.

Some health experts, however, think the window for widespread testing to make a difference has closed.

“We will not get that disease out of the world anymore,” said Mika Salminen, the director of health at the Finnish National Institute for Health and Welfare (THL), at a government briefing on Thursday, Helsingin Sanomat reported.

But since infected people can spread the virus before symptoms show, more and more Europeans want to get tested. This sentiment has only grown amid stories of people with serious symptoms who have gone without testing.

The case of an academic in the U.K. who was refused a test got widespread attention on social media. Then there is the story of a Hungarian woman whose doctor told her remotely she didnt have the virus even though she had a fever for days. One of her sons recounted his familys struggle via YouTube videos from his hospital quarantine. His mother eventually tested positive, as did his brother.

Meanwhile, health care workers in Britain who think they might be infected are initially told to self-isolate, without testing. That precaution could change, however, when the country ramps up its testing capacity, Patrick Vallance, the U.K. government chief scientific adviser, told a parliament inquiry.

The lack of access across Europe has sparked complaints about government preparedness and inequalities, compounded by celebrities and politicians having access to testing when showing mild or no symptoms.

European countries are running out of laboratory testing materials and capacity.

While Finlands Salminen said he understood peoples wish to be tested, those who can ride out the virus at home dont benefit from it, he said.

“The test is not a cure,” he said.

More cases = fewer tests

In the early days of the outbreak, when Europes first confirmed cases were imported, many countries tested people who had been exposed to those carriers.

The gold standard test is based on health care workers using swabs to take samples from the respiratory tract and sending them to government-designated labs.

But with numbers exploding every day in recent weeks, that model is now under severe strain.

European countries are running out of laboratory testing materials and capacity. By extension, governments have to prioritize resources, said Maria-Rosa Capobianchi, the director of the Virology Laboratory at Italys National Institute for Infectious Diseases and one of the members of the European Commissions coronavirus advisory group.

A health worker dressed in protective gear takes samples from a driver at a drive-through testing center for COVID-19 in San Sebastian, Spain on March 25, 2020 | Ander Gillene/AFP via Getty Images

For now, testing suppliers are ramping up their production. But major companies that provide the reagents that labs need to analyze tests are reaching “the maximum of their capacity,” said Capobianchi, noting theres also a need for more swabs for collecting samples. “I dont know how long they would require to scale up their capacity,” she said of reagent producers.

At the same time, it would be dangerous to flood labs with tests for people who dont need urgent diagnosis, she warned.

Furthermore, most of the so-called rapid tests now on the market may not detect the virus in the early stages, she cautioned, since they measure antibodies that people can develop to fight the virus. These appear later than symptoms and can give false negative results.

A survey by the European Centre for Disease Prevention and Control (ECDC) launched at the beginning of March showed laboratories were already running out of test kits, reagents, personnel and personal protective equipment, one spokesperson said.

To address these shortfalls, the Commission launched a public procurement process for laboratory equipment on March 19, with suppliers expected to submit their offers by March 31, according to a Commission official.

And last Thursday, it recommended that countries prioritize testing based on the severity of the cases, starting with people hospitalized with severe acute respiratory infections and ending with those with milder forms of respiratory infections, if resources allow.

People without symptoms whove been exposed to confirmed cases could also be tested, the Commission said. But with tens of thousands of such cases in some EU countries, many are recommending that those exposed self-isolate.

The British government hopes to be able to increase testing capacity to 25,000 hospital patients per day, in about a month, it said on March 18.

“I understand the frustrations of those who want a test,” British Health Secretary Matt Hancock told the House of Commons on March 16. “[But] weve got to make sure we use those tests on the people who need them most and that means saving lives in hospital.”

As of March 23, the U.K. had tested almost 84,000 people, out of which 6,650 were positive.

The government hopes to be able to increase testing capacity to 25,000 hospital patients per day, in about a month, it said on March 18.

Testing has also been an issue in France due to limited resources, the president of the countrys Scientific Coronavirus Committee, Jean-François Delfraissy, told La Croix on March 20.

The country has the capacity to do some 5,000 tests a day, with 60,000 done from the beginning of the crisis until March 23, the health ministry told POLITICO.

But some of the needed testing products come from China and the U.S. and arent in sufficient supply, Delfraissy said. The authorities are in the process of taking “industrial measures” to procure these products so they can implement a massive testing strategy.

The government is also setting up a scientific committee to look into moving from limited testing to a wider approach.

Belgium, one of the first countries to take a conservative approach to testing, is also now looking to increase its capacity.

Belgian Prime Minister Sophie Wilmès announced on Sunday a task force to increase testing from the current 2,000-plus tests per day. At present, not everyone who experiences symptoms — including health care workers — get tested.

Austria and Spain are also working hard to be able to test more widely.

Wider testing = lower death rates?

Germany seemed to be the outlier on testing so far. German labs are conducting some 160,000 tests per week, according to Lothar Wieler, the president of the countrys Robert Koch Institute, which monitors infectious diseases.

Testing is crucial in an epidemic, Richard Pebody, WHO Europe Team Lead for High Threat Pathogens, told POLITICO.

“At each stage, [whats] really, really important is finding your cases rapidly, investigating them, testing them, isolating them, identify their contacts, quarantine the contacts, test them and try to prevent onward spread,” he said.

Authorities in some German and French regions have also set up drive-through testing sites, similar to South Korea, which is seen as an example of how widespread testing can help contain the virus.

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