In Italy, rapid tests failed in the face of second wave

In an outdoor tent, a doctor squats down and scratches the nostrils of his patients with a thin, straw-like instrument. He stamps a strip of paper and in a few seconds obtains a result: “Negativo”.

• Read also: All developments in the COVID-19 pandemic

Italy has carried out millions of such rapid tests for the coronavirus, called “antigenic” tests, and the negative results allow citizens to move freely. Its apparent success thus encouraged Britain, the United States, Slovakia and others to follow this path.

France is also following suit. The government wants to strengthen its strategy to fight the second wave by deploying rapid tests in pharmacies, train stations, airports and in dedicated centers.

“These tests will allow us to strengthen our diagnostic capacities. I hope that we will still test massively in the weeks to come in our country ”, underlined Sunday the Minister of Health Olivier Véran.

And yet, in Italy these tests have not stopped an epidemic which has gone from around 500 cases per day in August, when they were set up, to more than 35,000 now, with infections that will exceed one million cases. Wednesday.

“I think that these tests are not used correctly at the moment, they are offered at random to everyone,” molecular medicine professor Andrea Crisanti from the University of Padua told AFP.

Cheaper and faster

A vaccine against COVID-19 could appear to be ready in the weeks and months to come, but not in time to fight the current wave of infections in Europe and elsewhere.

Politicians must find alternative solutions to avoid the generalized lockdowns of the spring with their very serious economic and social consequences.

Italy has closed bars, restaurants and shops in worst-affected areas and instituted a nationwide nighttime curfew, but has so far avoided a widespread second lockdown, with antigen testing being one element essential to this strategy.

It only takes a few minutes to get a result and they are inexpensive, unlike molecular PCR tests, considered to be the gold standard but the results of which take one to two days, reaching in Italy up to 6-7 sometimes the labs could not effectively process the large number of tests.

“Having such an instrument is essential, you have a way to immediately understand if a patient has the virus. It’s a good starting point, ”argues Dr Francesco Stevanato, who has performed around fifty tests in his clinic in Venice.

Not the panacea

It was thought that their distribution at airports could help protect the travel industry and that with greater availability schools and businesses could also remain open safely.

Professor Sergio Abrignani of the University of Milan, who co-signed a letter in September with some of Italy’s top scientists calling for their generalization, acknowledges that they are not a panacea.

“But there are practical situations where antigen testing has no alternative,” he stresses. “For example, when I’m on a train or a boat and want to reduce the risk. The molecular test takes too long to give me an answer ”.

Anyone who has a positive antigen screening test in Italy is supposed to have a PCR test to confirm the result.

But since rapid tests have an 80/90% accuracy level, infected people can fall through the cracks.

“If your goal is to screen a community to find out if there is transmission, fine,” said Crisanti. But ideally they should be supplemented with PCR tests that are almost 100% reliable.

Italy’s health ministry told AFP that there was no specific strategy for testing other than to strengthen testing capacity.

A comprehensive approach to the fight against COVID-19 is difficult in Italy because the Italian regions are responsible locally for health policy, resulting in a great disparity.

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