Where and how to get a coronavirus test

Who is being tested for coronavirus now?

It all depends on the country. The RF Ministry of Health recommendsInterim guidelines PREVENTION, DIAGNOSTICS AND TREATMENT OF NEW CORONAVIRUS INFECTION (COVID-19) test only those who have signs of SARS and who returned from abroad 14 days or less before onset of symptoms or has recently had close contact with people who have confirmed the diagnosis COVID-19.

Regions can clarify recommendations. But the decision on the need for testing in each specific case is still made by the doctor.

The Moscow Department of Health is expandingCORONAVIRUS: ANSWERS TO MAIN QUESTIONS the list also determines the order. People from those risk groups who are at the top of the list are given a coronavirus test first. The rest - after all patients from the priority groups have been examined.

1. People with signs of SARS who have crossed the border of one of the countries with an unfavorable epidemiological situation in the last 14 days (China, South Korea, Iran, USA, Great Britain, most European countries, Ukraine, Belarus) or had contact with a person who fell ill
   instagram viewer
   COVID-19 or came from the listed countries.
2. Those who have signs of SARS and are diagnosed with pneumonia.
3. People over 60 who have symptoms of the flu or cold.
4. People with signs of ARVI who have chronic diseases - cardiovascular, oncological, endocrine.
5. Citizens who have come from countries with an unfavorable epidemiological situation in the last 14 days.
6. Those with SARS symptoms.

Why aren't tests done to everyone?

Because the world medicine has not yet decided how to do it right. Despite the fact that WHO is calling for mass testing, each country takes a different approach. And he hopes that he will be the most effective.

Our callMedia briefing on # COVID19 to all states is simple: test, test and test!

Tedros Ghebreyesus, Head of the World Health Organization (WHO), at a briefing in Geneva on March 16, 2020

China and South Korea have chosen the path of a large-scale examination of citizens: tests for coronavirus are done to everyone with the slightest symptoms and even suspicions of symptoms. Germany followed them: up to 500 thousand are spent hereGermany ‘increases its COVID ‑ 19 tests to 500,000 per week’ tests per week.

In Italy, according to the recommendationsDIREZIONE GENERALE DELLA PREVENZIONE SANITARIA. UFFICIO 5 PREVENZIONE DELLE MALATTIE TRASMISSIBILI E PROFILASSI INTERNAZIONALE local Ministry of Health on February 25, examine those who have pronounced symptoms of coronavirus. In the UK, for a long time, tests were carried out only for seriously ill patients.

French authorities, according toIt's about numbers: why different countries are tested for coronavirus differently news radio station RFI still believe that mass testing will not change the situation with the spread of the epidemic. It is much more important to pinpoint specific cases, testing people at risk, and isolate those who get sick.

The Minister of Health of the Russian Federation Mikhail Murashko adheres to the same point of view. “There is no point in running today and everyone being tested for coronavirus,” March 1 quotedThe Ministry of Health told who should be tested for coronavirus his words are TASS. On March 27, the minister reaffirmedMinistry of Health advises only people at risk to take a coronavirus testthat only those people who are at risk need to do the test.

In general, this is reasonable given how complex the testing process is.

Do all countries do the same tests?

No. Both methods and test makers are different. Test systems from six organizations are registered in Russia alone, three of which state - SSC "Vector", Center for Strategic Planning and Risk Management of the Ministry of Health and Central Research Institute epidemiology. But some generalization can still be made.

Now there are two types of tests for coronavirus - PCR and express. Each has its own advantages and disadvantages.

When organizing mass testing, an express option is usually used. If such a test is positive, it must be rechecked by PCR.

What is PCR?

PCR stands for polymerase chain reaction. This testing method is considered the gold standard for the diagnosis of any infection and is used in government laboratories.

In general terms, it is carried out as follows. A smear is taken for research. It detects DNA fragments similar to fragments of a virus or bacteria. These DNA fragments are then propagated in a test tube. After some time (from several hours to several days) the test tube is checked. If traces of the pathogen can be detected, the test is considered positive. If not, negative.

PCR diagnostics of coronavirus is generally carried out in the same way, a swab is taken from the nose and oropharynx. But there is a nuance. The SARS ‑ nCoV ‑ 2 coronavirus is based on RNA, not DNA.

DNA molecules are made up of two strands of polynucleotides (nucleic acids in which genetic information is encoded) spirally twisted around each other. RNA - from one. The difference is palpable, so the analysis process becomes more difficult.

To begin with, researchers have to translate pieces of RNA from the putative virus into DNA. Then replicate the DNA. Then again translate DNA into RNA to identify the coronavirus. In microbiological parlance, this process is called reverse transcription PCR.

PCR analysis can detect coronavirus even before the first symptoms appear.

But the research takes at least a few hours (and then a few more hours to process the result) and requires quite large material and financial costs: special laboratory equipment, highly qualified technical specialists. That is why making a PCR test for everyone is a rather expensive and difficult task.

But there are also express tests. Why not do them all in a row?

The fastest research options are based on blood tests. A rapid test detects IgM immunoglobulins in it - antibodies that the human body begins to produce when it detects that it has encountered a new infection. Such research gives the result within 15-20 minutes.

The only problem is that a sufficient amount of antibodies for the test appears in the blood only on days 4-10Fast, portable tests come online to curb coronavirus pandemic diseases (including the incubation period). If a person has recently become infected, such a test may show an erroneous negative result.

Or, conversely, a quick test can be positive in a person who has had a mild illness, perhaps without even noticing it. This is because the level of antibodies in the blood does not decrease instantly and for some time remains high even in a recovered person. This creates uncertainty: is the patient still sick and may need help, or has he already recovered and is not dangerous to others?

This is why rapid antibody tests are rechecked by PCR.

A PCR analysis is not wrong at all?

The polymerase chain reaction method is generally considered more reliable than rapid diagnostic options. But it is also not always reliable.

PCR with reverse transcription is a lengthy, complex and rather inaccurate procedure: it has a high percentage of errors in one direction or the other.Interview with Alexey Vodovozov.

Alexey Vodovozov, toxicologist, interview to YouTube channel Myatom

To improve accuracy, the PCR test is performed several times. The Moscow Health Department, for example, insistsCORONAVIRUS: ANSWERS TO MAIN QUESTIONS on two tests if the patient has no symptoms of ARVI, and three if there are signs of a cold.

All this makes the process of making a diagnosis even longer.

However, science does not stand still. For example, Rospotrebnadzor statesRospotrebnadzor scientists have created a high-precision test for the diagnosis of COVID-19that the new tests he developed do not give false positives.

I know that paid tests can be taken in Russia. Is it worth it?

Indeed, from March 26, PCR analysis for coronavirus can be done in private laboratories. Helix conductsHelix company will start testing for coronavirus in Moscow and St. Petersburg from March 26 research in Moscow, St. Petersburg and Yekaterinburg. "Gemotest""Gemotest" launches paid testing for coronavirus in Moscow and the Moscow region - in Moscow, Moscow region (Dzerzhinsky, Podolsk, Mytishchi, Krasnogorsk, Balashikha and Odintsovo), and from March 31 in Simferopol"Gemotest" launches paid testing for coronavirus in Simferopol. In the near future he plans to visit themNew coronavirus test to be performed by PCR join "Invitro".

In addition, some private clinics have begun taking samples for testing.

However, the need for the procedure is questionable. For several reasons.

1. It's not free

You will have to pay about 2,000 rubles for a commercial test. The exact cost depends on the specific laboratory.

2. It's long

Tests are done by appointment only. Since there are not many laboratories, it is not a fact that you will be able to make an appointment for analysis, not only in the coming days, even in the coming weeks.

By that time, even if you do have a coronavirus infection, you will have time to get sick and recover.

3. It is not safe

To get tested, you have to go to the laboratory. This means that you run the risk of catching the coronavirus on the way or in line at the institution itself. If you are infected, you can infect other people.

Plus, for residents of Moscow and the Moscow region, this is a violation of the regime self-isolation. After all, taking tests is not like seeking emergency help.

4. It might be completely pointless

If you have ARVI symptoms that suggest COVID-19, you are eligible for a free test by contacting your GP. If you still want to get tested for money, please note: in laboratories you will simply not be accepted with ARVI symptoms. We'll have to look for private clinicsMedsi starts testing for coronavirus.

Consider another situation: you have no symptoms and you just want to be checked for every fireman. Good. Imagine you got a positive test. What happens next? So far, only one private Moscow clinic hospitalizes patients with COVID-19. There is no data yet on how much the treatment will costMedsi will treat patients with coronavirus.

And to get to a public hospital, you need a doctor's referral. He will first of all evaluate your symptoms - those that do not exist. And if he finds good reason for that, he will offer to double-check the results of the analysis done in the state laboratory. That is, it will not work to get to the hospital solely based on the results of a commercial test.

In general, if you suspect you have a coronavirus, the most logical thing you can do is isolate yourself and monitor your symptoms. And only when they appear, to contact with your GP and act in accordance with his instructions.

And if I want to know if I had a coronavirus, will the test show it?

No. Existing tests determine if there is an active virus in your body right now.

However, theoretically anything is possible. To find out if you have encountered a coronavirus before, you need a blood test for IgG immunoglobulins - antibodies that the body produces, acquiring a stable immunity to infection. But modern science still does not know enough about IgG immunoglobulins and immunity to SARS ‑ nCoV ‑ 2. Therefore, such tests are not done.

What else to read?