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Covid-19 screening test: who, where and how to get tested?
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The Covid-19 in France can be detected thanks to several tests: the RT-PCR, serological and antigenic test. self-tests are also arriving in pharmacies. The screening strategy is at the heart of the action plan developed to try to control the coronavirus epidemic, with vaccination. Who can take a screening test? Where is it possible to do it? Under what conditions?
Covid-19 screening tests: which methods in France?
The Covid-19 test used on French territory: the PCR
May 12 Update – Week 17, April 26 to May 2, test positivity rate was 7,4%. It is down compared to the previous week (-2,5 points). |
As of December 30, Santé Publique France indicates that epidemiologists are applying a new, more precise method of calculation to estimate the prevalence (the number of old and new cases of a disease in a population) of the virus. In addition, certain PCR and antigen tests are able to identify the N protein (and not S), of the new version of the virus which has been raging in England since December.
As of October 21, RT-PCR screening strategy has evolved, with a capacity of 1,3 million tests per week performed, or more than 170 per day. In France, to date, the test positivity rate is 000%. The list of people authorized to perform the virological screening test has widened: state-certified nurses, students in dentistry, maieutics and pharmacy, nursing aides, firefighters, marine firefighters and first aiders from approved civil security associations with adequate first aid training. Physiotherapists are also authorized to perform the nasopharyngeal sample. In addition, the ordinance is no longer necessary since July 25.
PCR (Polymerase Chain Reaction) is a technique for directly detecting Infection of the SARS-Cov-2 virus. This is the test that has been carried out since the start of the epidemic in France, in January 2020. The PCR is carried out by a doctor or a nurse, or any other trained and equipped health professional. He takes a sample at the nasopharyngeal level, using a swab (a kind of large cotton swab), which he inserts quite deeply into the nose. This test is painless, but can be unpleasant for the person having it. Then the sample is brought to the laboratory for analysis. The presence of viral RNA (genetic material) is sought by scientists. The result is given to the patient a few hours later (24 hours) by the prescribing doctor. It is sent to the ARS (Regional Health Agency), to be included in the statistical data. This type of test for Covid-19 is preventive and offers reliable and fast results. Since March 28, 2020, 12 PCR tests have been carried out every day. However, this requires a medical prescription. Without this precious sesame, screening is impossible.
Antigenic tests
Update May 12, 2021 – The French National Authority for Health has lifted the age limit and says that antigen tests can be used as screening tools in people under 15. November 26 Update – Since November 10, people authorized to perform an antigen test are dental surgeons, midwives, medical electroradiology technicians, childcare auxiliaries, ambulance attendants as well as first aiders from an approved civil security association, holders of the teaching unit ” first aid in a level 1 team ».
In addition, according to the recommendations of the Haute Autorité de Santé, antigenic tests are intended for symptomatic people, and to be carried out within the first 4 days after the onset of symptoms, subject to meeting all of the following conditions:
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New screening tests have been authorized to be placed on the market since the decree of September 15, 2020. The aim is to relieve medical biology laboratories “of certain patients and to improve the transmission times of RT PCR test results«. Antigenic tests make it possible to highlight a protein present in the virus and therefore to know if a person has Covid-19. The result is given in 30 minutes. They can be performed in pharmacies, laboratories, medical practice, etc.) by trained professionals. The antigen test does not replace the PCR test. If the result is positive, it must be confirmed by performing a PCR test.
Lesson car tests
Update of March 22 – Self-tests allow a result to be obtained very quickly, the sampling and interpretation of which is done by the person himself. Since March 16, nasal self-tests have been authorized by the Haute Autorité de Santé. They are less invasive than PCR tests and are recommended for asymptomatic people over 15 years of age, in the following two situations: medical indication and indication for use in the private sphere. |
Some people, who show symptoms of Covid-19, may have recourse to saliva self-tests, especially those for whom nasopharyngeal sampling is difficult (elderly people, children, people with mental disorders, etc.). They are 80% reliable, compared to 90 to 95% for the PCR test. A Toulouse laboratory, Axiotis, has developed self-test saliva tests. “The sampling method is not yet officially approved, the final result should, for now, be used only as a self-check”, warns the start-up. It is possible to get a kit at 48 € (including postage). The instructions are simple and an envelope is provided to return the test to the laboratory. The Montpellier University Hospital and the CNRS have also developed a saliva test: the EasyCov test. It is still under review at the moment.
The serology test
The serological screening test is different. Serology makes it possible to look for the presence of antibodies fighting against the SARS-Cov-2 virus, in a person’s blood. Serology makes it possible to determine whether the individual is immune or not to Covid-19. This test is not preventive, because the subject’s body must have had time to develop antibodies, with possible detection from the 6th day of the disease. The purpose of these serological tests is: “useful in collecting epidemiological data related to COVID-19 (actually infected patients, mortality rate, etc.). ”
The rapid test: TROD or TDR
On March 16, the French National Authority for Health issues its opinion on antigenic RDTs / TRODs on nasal samples (shallower than PCR tests). They are authorized:
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The TROP, Rapid Diagnostic Orientation Test or RDT for Rapid Diagnostic Test, is a test performed by a healthcare professional and staff who have received appropriate training.
The serological TROD is a rapid unit test, looking for the presence of antibodies in the blood. It is made from a drop of blood and gives results in just a few minutes. This type of test is intended for the epidemiological study of Covid-19. The TROD provides diagnostic guidance for patients with non-severe symptoms of infection. They can be made in pharmacies.
The serological test, who can do it?
The Haute Autorité de Santé has given recommendations concerning people who can do this type of test: “they must be carried out from the 7th day following the onset of symptoms for hospitalized serious symptomatic patients and from the 14th day following the onset of symptoms for symptomatic patients without signs of severity ”. The serological test is unable to indicate whether an infection is ongoing or whether the patient is contagious.
Who can get tested with the PCR test?
As of October 21, anyone can get tested, even if there are no symptoms. The test is fully covered by health insurance. Since September 11, Prioritization of screening tests has been put in place to cope with delays in obtaining results, which are too long. Priority people are those who are symptomatic (with a prescription), nursing and similar staff and contact cases (who have had risky contact with a confirmed person). Contact cases must carry out the screening test 7 days after the last contact with the sick person. Time slots are intended for priority people as well as screening tents, especially in large cities. |
Update September 3, 2020 – Anyone can get tested for Covid-19, even without symptoms, by making an appointment at a laboratory near their home. If an individual is suspected of being a case-contact, the Health Insurance calls him and advises him to stay confined for 14 days, in prevention. She will give him an appointment within 24 hours.
According to the government, “The tests are not used to measure, but to contain the epidemic.” At the beginning, screening tests were therefore reserved for priority audiences:
- symptomatic healthcare professionals;
- symptomatic elderly people;
- people with severe breathing difficulties or co-morbidities;
- people hospitalized;
- new homes and new territories.
Unlike other countries, France does not screen massively. However, on Monday April 6, 2020, the Minister of Solidarity and Health, Olivier Véran, announced that “PCR testing capacities are doubling, thus making it possible to launch a vast screening operation for the most vulnerable people, with priority given to the elderly, the most vulnerable people with disabilities and the professionals who support them in establishment”. In addition, from May 11, 2020, Covid-19 screening tests will be available to all people with Covid-19 symptoms. The test strategy in France will therefore evolve in the coming months.
Where to get tested?
Update December 30 – People who show symptoms of Covid-19 and have a prescription can go to a city lab or take the test at home (by a licensed professional). For those who do not have a medical prescription, an antigen test can be performed in a pharmacy since November. For people who do not have clinical signs or a medical prescription, it is possible to do a PCR test in a laboratory, in a screening center or in a dispensary. Those who are identified as a contact case can go to the laboratory and present the prescription or SMS received from Medicare. They will then be considered as priority. |
Hospitalized patients who present with symptoms (with or without severity) are automatically tested for covid-19, to the hospital. For the people mentioned who are part of the priority audiences and who have symptoms of the new coronavirus, they contact their doctor (tele-consultation preferable). The doctor prescribes a prescription for a screening test. The patient contacts the city laboratory. Attention, going directly to the doctor’s office or to the laboratory is excluded, at the risk of infecting other people: one person could contaminate three. Samples are taken at the patient’s home. For the rest of the French population, it will be necessary to wait until May 11, 2020. To be patient and in case of doubts, go to the site maladiecoronavirus.fr. This online test does not replace a consultation with a doctor, nor does it specifically screen, but can provide guidance if there is a suspicion of Covid-19 disease.
The government’s promises
May 12 Update – In week 17, April 26 to May 2, 2021, more than 2 million people were tested for Covid-19 and 150 were confirmed positive. |
The French government acts according to the evolution of the epidemic and promises that “By the end of April, 50 classic tests will be possible” each day. It thus undertakes to follow the recommendations of the WHO (World Health Organization). The latter pushes to massively test the entire population, which commits France to developing its Covid-19 testing strategy. To do this, “Rapid tests are now available and France has ordered 5 million. The capacity for rapid tests will be increased to 30 per day in April, 000 in May to reach 60 rapid tests in June ”. On the other hand, on Saturday April 4, 2020, the NG biotech company launched the project to produce screening kits (immunological kits for rapid blood screening for coronavirus infection) as well as kits for detecting the virus in secretions. nasal and salivary. This operation will be financed by the Ministry of the Armed Forces, to the tune of 1 million euros. The pulp of the finger will be pricked to obtain a drop of blood, which will be analyzed in 15 minutes.
Examples to follow?
How do Taiwan and South Korea manage to have so little people infected with the SARS-Cov-2 virus? The government of Taiwan had put in place a management plan in the event of an epidemic, with speed of action and effective measures: the authorities filtered travelers from Wuhan and took containment measures at the end of January 2020. At 12 May 2021, Taiwan has 1 people infected and 210 dead (for a population of about 12 million). For South Korea, screening for the SARS-Cov-2 virus is done on a massive scale, thanks to test stations located all over the country. Koreans get tested while staying in their cars. South Korea has 1 deaths and more than 884 cases of Covid-128 (population of around 000 million). What Taiwan and South Korea have in common is that they watch their people and follow Covid-19 patients, thanks to their smartphone. Today, the French government is adopting a massive screening strategy to limit the spread of the new coronavirus. The population is particularly invited to use the application “ All Anti-Covid ».