Is Omikron shaking the test infrastructure?

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In a test center, an employee takes a swab for a rapid corona test. © Sina Schuldt/dpa

Corona tests provide some certainty every day in the Corona crisis. Because of the rapidly increasing number of infections, there are more and more. Is Omikron now bringing laboratories to their knees?

Berlin – Omicron is spreading at lightning speed – and a maximum value for new infections and a seven-day incidence is currently chasing the next. Each counted corona case is preceded by a positive PCR test and its recording.

The sheer volume of tests is pushing laboratories and health authorities to their capacity limits. And the question is getting louder and louder: are the PCR tests becoming scarce?

“In northern Germany, the test labs are already at the limit. We now have positive rates of 30 to 40 percent here, I’ve never experienced anything like it,” says the chairman of the Association of German Laboratory Doctors, Andreas Bobrowski, of the German Press Agency. More than 90 percent of the detected corona infections can now be traced back to the omicron variant, said the Lübeck doctor. “We can see that things are now also picking up in central and southern German laboratories.”

Capacity limit exceeded

In many places, the capacity limits of the laboratories have already been exceeded, which means that the target time of 24 hours from the swab to the test result can often no longer be met. Bobrowski is certain: “We will reach our limits everywhere.” When it comes to the waiting time, he “clearly sees 36 to 48 hours ahead of us” – the infection and thus test numbers are likely to continue to rise for the time being.

But what if there are not enough PCR tests available for everyone? With a view to a shortage feared by many, Health Minister Karl Lauterbach (SPD) explained at the end of last week that the test capacities were approaching “full load”. There was therefore no shortage for the time being.

The fact that PCR tests can become scarce in some phases of a pandemic is fundamentally included in the planning. In general, the National Test Strategy prioritizes PCR tests when capacity is limited. Priority will then be given to people with Covid 19 symptoms and contact persons of those who have been proven to be infected. But the protection of people with particularly high corona risks, for example in the health care system, is also a priority.

Hardly any prioritization in PCR tests

The Association of Accredited Laboratories in Medicine (ALM) also reported at the end of last week that the laboratories were increasingly approaching the limits of their capacity. The chairman Michael Müller had told the “Rheinische Post” that so far little prioritization has been given in PCR tests, which is critical for the sick and hospitals.

Laboratory physician Bobrowski also refers to the planned prioritization of the tests and evaluations. He points out that an additional flood of tests is to be expected due to the new regulations gradually coming into force for earlier free testing from corona quarantine or isolation. A corresponding prioritization must also apply to these tests.

Lauterbach had said that for these free tests from the quarantine, he had arranged for health workers to have priority in the laboratory evaluation. In order to “save” on PCR tests, they are only mandatory for employees in clinics, nursing homes and facilities for the disabled when free testing. Otherwise, rapid tests should also be able to be used.

Health authorities groan

But it’s not just the labs that are groaning under the onslaught of tests. For the German health authorities, the record incidences mean a new dimension of effort in recording and contact tracing. From some quarters there are again calls for a short-term increase in staff in order to be able to keep an eye on the ever more branching chains of infection.

“The workload in the reporting system is extremely high,” explains Helmut Dedy, General Manager of the German Association of Cities, in view of the maximum number of positive PCR tests since the beginning of the pandemic. After all, every time a laboratory reports a positive test, the health department must check whether it is a new case or, for example, just an attempted free test before it is passed on to the state and federal government.

Difficult contact tracing

Although the health authorities are more efficient than before the pandemic, at the same time the number of infections also led to maximum loads in contact tracing. Particular attention is paid to nursing homes and facilities for the disabled. Dedy warns that the flood of new infections can now push the authorities to the limit of their capacity. “Then the health authorities have to prioritize.” With a view to a possible restriction of contact tracing, he thinks it makes the most sense to focus primarily on close family members or other close contacts.

For example, Dedy calls for clear guidelines for prioritizing contact tracing and appeals to people to take responsibility for themselves when complying with the quarantine rules. “As soon as you have a positive test, you have to stay at home.” This usually does not require a decision from the health department. dpa

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