As of March 20th, COVID-19 has spread to 183 countries and territories.
Scientists note the need to improve test systems and identify the disease at an early stage. Expectedly, different countries have different testing practices and different patterns associated with it.
Until a vaccine is found, testing remains the most important measure against the virus along with quarantines.
A virologist from the University of Kent, Jeremy Rossman, in a conversation with Russian outlet RBC, noted that governments should not only take quarantine measures and limit crowds, but also increase the availability of tests for COVID-19.
“For example, in Britain, tests for the new virus are now available only for the most seriously ill, although such tests should be available to everyone,” he said.
Indeed, despite the pandemic, there is no single, standardized, testing protocol.
For example, Russia tests those returning from abroad with a cold
In total, on March 19th, Russia conducted 133,000 tests for coronavirus – eight tests for every 10 thousand people living in the country.
Below is a graph, presenting how many are being tested per 10,000 people of population, and how many out of those tested are positive.
The data for all countries, apart from France and South Korea, is for the period of March 16-18th, while for the other it is between March 10-14th. The separate data for Lombardy and Washington is because those two locations appear to be the epicenter of the epidemic in the USA and Italy.
The Rospotrebnadzor resolution of March 13th indicates the need for testing for everyone who has returned from Europe in the past two weeks, as well as those who have been abroad in the last month and have found symptoms of colds.
The decree also requires determining the order of laboratory tests “of people who have no signs of a cold and are not in contact with patients with COVID-2019, including the possibility of selecting material from such people at airports”. It operates throughout Russia, with the exception of Moscow.
The Moscow authorities explained that the need for analysis is always determined only by the doctor, focusing on priority for several risk groups.
The maximum risk group includes people with symptoms of acute respiratory viral infections, manifested within two weeks after returning from countries with major outbreaks of infection, as well as patients with pneumonia. As of March 19th, in Moscow, coronavirus was diagnosed in 86 of 199 such cases.
On March 16th, Deputy Prime Minister Tatyana Golikova announced that a fourth system for testing for the virus was being developed in Russia.
The government assured that there was no shortage of tests in the country, and Invitro announced plans to provide a commercial testing service. On March 19th, the stock of test systems in the country amounted to 700 thousand units. According to the Minister of Health, Mikhail Murashko, there is no point in testing for coronavirus.
On March 19th, the RDIF (Russian Direct Investment Fund) announced that it was creating the Coronavirus Alliance with the participation of the sovereign fund of the Russian Federation, Russian Union of Industrialists and Entrepreneurs, Yandex and Mail.ru Group. It should provide operational testing of Russians for coronavirus.
“The approved innovative Russian-Japanese testing system today is a unique solution, one of the most effective in the field of diagnostics of COVID-19,” the RDIF said in a statement.
The new system reduces testing time by more than four times, from two or more hours to 30 minutes, the fund said.
Medpromresurs is engaged in the promotion of the new system. Roszdravnadzor has already approved the use of the Russian-Japanese diagnostic system, the RDIF said.
In the US, the low coverage of coronavirus testing on average in the United States – less than one test per 10 thousand people – is due to bureaucratic problems.
Opportunities for development by US laboratories or the use of existing tests from other countries have faced regulatory challenges.
In addition, most of the test systems from the centers for the control and prevention of diseases sent to the field turned out to be defective.
Medical companies received emergency permission to manufacture only by mid-March, and now the number of available test systems in the US should increase – manufacturers promise millions of sets.
Authorities, however, urge that testing should take place only if there are grounds, and after consultation with a doctor.
In those states where more tests are performed, a higher incidence is recorded, for example, in the state of Washington, where the prevalence of laboratory tests is much higher than the national average.
In Japan, as in the United States, they conducted less than one test per 10 thousand people as of March 18th.
The authorities initially decided not to conduct mass testing, considering a laboratory examination as a tool for obtaining the most complete data on infection, and not as a way to identify patients for prescribing therapy.
In early March, Japan included this test in the list of tests covered by health insurance, and the number of patients examined may increase.
Italy has become the epicenter of the pandemic in the EU. A February 25 document from the Italian Ministry of Health states that testing is done only for people with symptoms of a flu-like illness or severe respiratory infection, as well as suspected coronavirus.
In a memo dated February 22, the grounds for suspicion for coronavirus are described: the presence of symptoms combined with a travel history or close contact with the patient or an unexpected clinical course of a previously diagnosed disease of a different origin.
This approach does not allow timely measures to contain the epidemic, said Giovanni di Perry, head of the infectious diseases department at the Amadeus of Savoy Hospital in Turin. He called it passive.
They decided to intensify the diagnosis in Veneto – one of the first regions of Italy where cases were detected. The head of the region, Luka Zaya, said that tests for coronavirus will be carried out even for those who could accidentally contact patients, for example, supermarket staff.
The peak of the epidemic in China has already been passed, and it was possible to take control of the outbreak of the disease, including through testing, Chinese doctors say.
They emphasize that many patients carry a coronavirus infection asymptomatically or with minor symptoms and it is extremely important to identify such infected people and quarantine them in a timely manner.
The importance of testing on the example of China was also noted by the World Health Organization (WHO): the report on the joint mission of WHO and China speaks of the principle of early diagnosis and early isolation applied in the country.
Such an approach included, among other things, temperature measurement, polls at the entrance to various institutions and transport facilities, as well as testing of patients even with a low level of suspected infection.
The same approach is followed in South Korea. There they launched mass testing, including the drive-through system, when you can check for infection without leaving your car and all tests are free.
In this way, a large number of people can be checked for infection by avoiding contact between those who are being tested, doctors say. As early as March 8, South Korea remained the largest focus of infection outside of China.
By March 19, the number of cases in the country increased by about a thousand people, while in Italy the number of infected people increased by several times.
In the UK, as of 19 March, 64,621 people in the UK had been tested for coronavirus. The number of tests has been rising from just over 1,000 a day at the end of February, when testing began, to more than 6,000 per day by mid-March.
The government plans to increase this to 10,000 a day initially, with a goal of reaching 25,000 tests a day within four weeks.
There are two main reasons for testing people – to diagnose them individually, and to try to understand how far the virus has spread in the wider population. This second reason is referred to as “surveillance testing”.
The UK passed its 2,500th case as of 18 March and has tested 828 people per million of its population, or 8.3 people per 10,000 of population.
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