Italy’s pioneering rapid tests fail to stop the virus


A doctor in an open-air tent in Rome crouches and scratches up in his patient’s nostrils with a thin straw-like instrument. Dab a strip of paper and produce a result: “Negative”.

Italy was the first country in Europe to bet heavily on these rapid coronavirus “antigen” tests – a negative result allows masked citizens to roam almost at their leisure – and its apparent success has encouraged Britain, the United States, Slovakia and others to follow him. suit.

Yet the tests, which are roughly 80 to 90 percent accurate, haven’t stopped an outbreak that has gone from around 500 cases a day in August, when they were first launched, to over 35,000 now – with infections set to first million Wednesday.

“I think these tests are not used correctly at the moment, they are randomly distributed to everyone,” Professor Andrea Crisanti of the University of Padua told AFP, saying the government does not have a master plan.

He said their use as a measure to protect vulnerable people in nursing homes, for example, is “absolutely criminal” because positive cases could escape the net.

– ‘Without alternatives’ –

A vaccine may be on the way, but not in time to fight the current wave of infections in Europe and elsewhere.

Instead, policymakers are left scrambling for solutions that avoid the economically devastating blockades of the beginning of the year.

Italy has closed bars, restaurants and shops in the hardest hit areas and introduced a nationwide night curfew, but has so far deflected a second closure, with antigen testing becoming a crucial part of its efforts.

They only take a few minutes to produce a result and are inexpensive, unlike “gold standard” molecular PCR tests which are nearly 100% accurate.

“Having such a tool is essential, you have a method to immediately understand if a patient has the virus. It is a good starting point,” says family doctor Francesco Stevanato, who performed about 50 tests from his clinic in Venice.

It was thought that distributing them at airports could help protect the travel industry. With increased availability, schools and businesses could remain open safely.

Professor Sergio Abrignani of the University of Milan, who co-authored a letter with some of Italy’s leading scientists asking for widespread use in September, admitted they were not a global solution.

“But there are practical situations where antigen testing has no alternative,” he told AFP.

“For example, when I get on a train or a ship and I want to reduce the risk. The molecular test takes too long to give me an answer.”

– We need a better plan –

Anyone who tests positive for the antigen in Italy should undergo a PCR test to confirm the result.

But the real danger is false negatives – if rapid tests have an accuracy level of 80 or 90 percent, infected people will return negative results.

“If your goal is to check out a community to see if the broadcast is present, that’s fine,” Crisanti said.

However, he said that in order to stop transmission, rapid tests must be complemented by the accuracy of PCR tests, along with surveillance tools and home stay orders.

The Italian Ministry of Health told AFP that there is no specific strategy for testing other than capacity building.

And the Istituto Superiore di Sanità, in charge of monitoring the epidemic on behalf of the ministry, was unable to provide any data relating to the dissemination of rapid tests.

An integrated approach is frustrated by the fact that health policy in Italy is largely controlled by regional officials, creating wide variations.

But Crisanti said the government should have built a larger plan to capitalize on the fewest cases after the blockade.

“If they had built a molecular testing (PCR) network, if they had integrated this capability with an information tool … and if they had built an infrastructure to make beds available where they are needed, I am sure we would be in a completely different situation. “

str-jxb / ar / mbx

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