Drs Nick Beeching, Tom Fletcher, and Mike Beadsworth from Liverpool School of Tropical Medicine and the Royal Liverpool University Hospital’s Tropical and Infectious Diseases Unit have written an editorial in the British Medical Journal urgently calling for rapid near-patient testing for COVID-19.
They look at the current gold standard viral RNA molecular testing, which, due to the delays in transporting samples to central reference laboratories and sending back results, often takes longer than 48 hours. It is for this reason that they say fully validated, rapid, near-patient testing is needed to provide more timely information for both diagnosis and public health interventions.
They use the examples of Singapore and South Korea, who have tested, and contact traced substantially initially, which, alongside isolation, resulted in early control of the virus. The strategy moving forward is to focus is on symptomatic patients and key workers and their families, as testing to exclude infection in the household would enable staff to return to work earlier.
The authors describe as game-changing the wide availability of testing for antibodies. Many healthcare staff are likely to have already been infected in the community or at work and identification of resolved past infection could allow them to return to work, on the assumption that past infection confers some level of immunity. Wider antibody testing would also provide a clearer picture of the proportion of infections that are asymptomatic and the true spread and overall morbidity of COVID-19.