Do-it-yourself test kits are a useful tool in the fight against Covid-19, but experts report concerns, Singapore News & Top Stories
Do-it-yourself (DIY) Covid-19 test kits will be a useful tool in Singapore’s arsenal to fight the coronavirus because they are quick and convenient to use, experts said yesterday.
But experts have also flagged potential areas of concern, such as the underreporting of results, one suggesting that authorities regulate these kits and integrate them into government health systems.
The DIY tests, which are already in use in places like South Korea, the United States and Europe, will soon be available at pharmacies in Singapore, Prime Minister Lee Hsien Loong said on Monday. He added that they will be simple to use and not as uncomfortable as the polymerase chain reaction (PCR) test.
Do-it-yourself tests work like rapid antigen tests (ART) which are widely used in pre-event testing. ART – and most DIY tests currently available overseas – return results in about 30 minutes, but are less accurate than PCR tests, which typically take a day or two to process.
The health ministry told the Straits Times that it is currently in discussions with relevant agencies and partners to bring in over-the-counter ART kits, and will provide more information when it is ready.
Infectious disease expert Paul Tambyah, president of the Asia-Pacific Society for Clinical Microbiology and Infection, said the DIY kits are useful because they can be used at home or if some travel is required. leaves in an emergency and a regular PCR test or ART cannot be done.
“These are basically simplified ART … Many US airlines accept home test results. Companies can also ask their employees to do them regularly until vaccinations are complete,” he said. he declares.
Rophi Clinic infectious disease specialist Dr Leong Hoe Nam said a DIY test would be simple to administer – almost like a pregnancy test kit.
“It’s much cheaper, costing $ 15 to $ 20 per day. It takes the complexity out of testing, empowering consumers,” he said.
In comparison, a PCR test costs around $ 150 to $ 200, while an ART costs as little as $ 10.
The convenience that DIY kits offer makes them ideal for businesses wishing to reassure their customers and workers at high risk of virus exposure wishing to reassure their families, said Dr. Ling Li Min, infectious disease physician. by Rophi. Clinical.
Home kits used in some other countries
Cheaper, faster and less invasive home kits for Covid-19 testing have already been approved for sale in a number of countries. They are not as accurate as the polymerase chain reaction (PCR) test. Doing a DIY test, however, is only the first step and any positive results should be confirmed with the reference PCR test administered by healthcare professionals in a medical setting. Here is an overview of the two main types of over-the-counter tests and where they are currently available.
RAPID ANTIGEN TEST (ART)
What he tests: Proteins made by the virus, not the virus itself. This detects how active the virus is, and therefore infectious. People infected with Covid-19, even the most asymptomatic, will be most at risk of passing the virus on to others during the first week after infection, which is also when the test works best.
How to use: A cotton swab (similar to a cotton swab) is used to take a sample from the nostrils or throat. Some tests allow saliva to be used instead. For greater accuracy, Britain’s National Health Service recommends a nasal swab and a throat swab for each test.
The swab is then applied to a specially treated strip or tube. Results appear in 15 to 20 minutes.
How reliable: The journal Science reported that most antigen tests have a sensitivity of between 50 and 90%.
If available (cost): United States (from US $ 25 / S $ 33), Great Britain (free from National Health Service), Germany (€ 25 / S $ 40.30), China (80 yuan / S $ 16.60) , India (250 rupees / S $ 4.50).
What he tests: Traces of genetic material of the coronavirus on samples. Requiring specific equipment and chemical reagents, it is useful in confirming infection, but its high sensitivity means that it can also detect remnants of dead or deactivated viruses still present in a person recovered from Covid-19.
How to use: Users place a nasal or throat swab in a tube with chemical reagents before sealing it. Some tests allow saliva samples to be taken.
Typically, these tests are mail-in kits, which means the tube will be sent by priority mail to a lab and the results are available within the day.
The US Lucira test allows users to plug their vial into a portable device that produces a result within 30 minutes.
How reliable: More than 90% accuracy to detect the virus and avoid false negatives.
If available (cost): United States (from US $ 55 / S $ 73), Great Britain (free from National Health Service), Japan (4,500 yen / S $ 54.30).
But the kits carry several risks, including the possibility that they could produce false results if administered incorrectly.
Dr Ling stressed the risk of false negatives. “This means that infected people may think they are virus-free, especially if they don’t yet have symptoms,” she said, adding that they could then spread the disease unknowingly.
Experts agreed that the results of these tests should be interpreted with caution.
Professor Tambyah said they could also show a false positive, so a confirmatory PCR test – the gold standard for Covid-19 tests – is needed to confirm a diagnosis.
Experts noted that not declaring a positive DIY test result could be dangerous, as it would mean infectious people could spread the disease.
Prof Tambyah suggested regulating the sale of these kits in pharmacies and integrating them into Singapore’s national gateway to citizens’ medical records, prescriptions and clinical appointments.
“The loop could be closed between buying a kit and communicating the results before the kit expires,” he said.
In India, users of the CoviSelf DIY test kit need to download an app to use the kit. The app is synchronized with the test results, which are fed directly into a report on the Indian Council of Medical Research portal.
On the fact that some might not report a positive test result for fear of discrimination or because of a reluctance to be admitted to hospital, Dr Leong said the stigma surrounding Covid-19 should be fought to encourage people to see a doctor if necessary.
He and Professor Tambyah drew parallels with how some patients with the human immunodeficiency virus might hide their condition.
“There is a need to remove the stigma. Being positive for Covid-19 doesn’t mean anything, but some people might face the stigma,” Dr Leong said.
The test does not replace seeing a doctor if one is sick, said the experts, who stressed that anyone who is sick or showing symptoms of Covid-19 should see a doctor.