Tribune. The Covid-19 self-tests will finally be available in pharmacies from Monday, April 12. A final twist after several adventures. They first received the green light from the High Authority for Health (HAS) on March 16, but the Ministry of Health announced that these tests will first be tested with “Target audiences”, before generalization in pharmacies no earlier than mid-April. The nature and necessity of an experiment questioned and the words “target audiences”, therefore limited, and “pharmacy” worried. The notion of target populations has finally disappeared, because [le ministre de la santé] Olivier Véran declared, Friday April 2, that these tests will be accessible “For those who wish to buy it”.
In the minds of policymakers, a deep misunderstanding about the scope and goals to be achieved through self-testing has apparently set in. Self-tests are not made for an individual diagnosis, to find out whether an individual is a carrier (or sick) or not of SARS-CoV-2. They must be carried out only with a screening aim.
Breaking of transmission chains
The detractors make them, in fact, two major reproaches. The first is that the sensitivity of these tests (being able to detect positive people) is low and that a negative test does not exclude the fact of being a carrier of the virus. This is correct and this is the reason why these tests should not be used for an individual diagnosis. Self-tests are informative at the individual level only when they are positive.
The second criticism is that the results of these self-tests will not go back to the databases making it possible to trace and monitor epidemiological indicators. For this reason, the HAS recommends carrying out a confirmatory PCR test following a positive result. The argument about the disruption of epidemiological indicators is not admissible. While these tests play an important role in breaking the chains of transmission, we should not limit their use to the pretext that the classic early epidemiological indicators, based mainly on PCR tests and antigenic tests (performed in the laboratory or in pharmacies), will be made less reliable. We can put in place new tools to follow the evolution of the epidemic.
Great Britain, for example, carries out a survey of around 150,000 people every six to eight weeks in order to monitor the epidemic but also to meet other objectives, such as the role of social factors in transmission or effectiveness of vaccines. Rapid and recurring flash surveys can also help to set up and adjust the indicators obtained by traditional tests.
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