Lots of unanswered questions when prioritizing PCR tests

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If ordered by the health department, a PCR test is mandatory. © Peter Kneffel/dpa

The laboratories reach their limits with the PCR tests. Now a new order is planned: The high-quality tests should primarily be for certain areas.

Berlin – The Omicron variant drives up the number of infections. Laboratories evaluating PCR tests could reach their limits. In the future, certain groups for which the clarification of the infection status is particularly important should be given preferential treatment with the precise tests.

This is a key issue at the federal-state consultations this Monday. However, it is still largely unclear how the so-called prioritization will be structured in concrete terms.

What is currently still valid?

Anyone who has a positive self-test or gets a positive rapid test result at a test center is entitled to a PCR test according to the currently valid nationwide Corona Test Ordinance. According to the federal government, this also applies if the Corona warning app is on red. In such a case, those affected can contact their family doctor, who will then either carry out a test themselves or refer them to a test center. The health department can also order a free PCR test if it has been informed of a positive rapid test.

Is a PCR test mandatory?

In any case, if ordered by the health department. According to the Federal Ministry of Health, positive rapid tests, for example from test centers, must be reported. So if the office receives the relevant information, it can request a subsequent PCR test. In principle, the Ministry of Health writes on its website that if the rapid test – including self-test – is positive, a PCR test “should” be carried out for confirmation. Whether the “should” generally means an obligation also depends on the regulations of the respective federal state. In some countries, a follow-up test using a PCR test is prescribed, and in some cases a follow-up test using a rapid antigen test at a test center is sufficient if the self-test is positive.

What is planned now?

PCR tests should primarily be available for so-called vulnerable groups and for employees who care for and treat them. Mentioned are older people or other risk groups, employees in clinics, medical practices, nursing homes and integration assistance facilities for people with disabilities.

However, the questions about practical implementation are still open here, such as when this should apply, who exactly will be entitled to the PCR test, how this should be specifically proven and what about those who, for example, have a positive rapid test and/or or have symptoms. After the political agreement at the Prime Ministers’ Conference, the federal and state governments must first change the Corona Test Ordinance and the specific provisions on tests in the states. In the course of this there will be more clarity.

In which direction could it go?

The health ministers of the federal states had spoken out in favor of the fact that a PCR test can be dispensed with in the future if the rapid test is positive and there are no symptoms at the same time. For this, however, paragraph 4b of the Corona Test Ordinance would have to be changed, which currently still grants a right to PCR retesting in the case of positive rapid tests – including self-tests. Even if the Corona warning app shows a red tile, the state health ministers believe that a “high-quality” antigen test should be sufficient.

In addition, however, there are other questions, such as whether a PCR test restriction would also affect privately paid tests that are necessary for trips abroad, for example, or what effects a restriction would have on the subject of recovery status, because only those who have one are considered officially recovered positive PCR test can prove that he already had a corona infection.

How many PCR tests are currently being done?

Most recently, according to the Robert Koch Institute and the laboratory association ALM, there were around two million tests in one week – a peak in the Corona crisis. Of the two million tests, about one in four was positive. The laboratories were therefore 86 percent utilized. A capacity of around 2.5 million tests was reported for the past week.

What is going better elsewhere?

Vienna already set up the infrastructure for this in 2020. With the offer “Everything gargles”, a PCR test for home use was developed, in which the ID card is recorded and the gargling is filmed, according to a spokesman for the city’s health department. The tests can be picked up at many drugstores and dropped off at hundreds of convenience stores and gas stations. The post office collects the mountains of samples twice a day.

According to the city, everyone gets their PCR result around 16 hours after gargling on average. This is ensured by a large laboratory that now employs around 1000 people. “The costs are now just under six euros per test, only slightly above those of antigen tests,” the spokesman continued. They are taken over by the federal government. The capacities are enormous. Around 2.1 million tests are evaluated every week. In view of the Omicron variant and the now record high number of infections, the capacity has been increased: from 500,000 tests a day to 800,000. dpa


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