Rethink the needs of RATs and PCR testings

Australians’ fondness for queuing has been tested over the past few weeks, as hundreds of thousands seeking Covid-19 results waited for hours in the summer heat, in lines that snaked around city blocks.

Healthcare staff administering the standard clinical Covid-19 tests, known as polymerase chain reaction tests (PCR tests) – were forced to turn people away before closing time, sending them home with the next-best thing: a rapid antigen test (RAT).

But the RATs have been in short supply, with supermarket and pharmacy shelves emptied, or only briefly stocked with pricey tests, some sold individually in ziplock bags.

Late last year, a collective of businesses were given the green light to import more than 300,000 RAT kits into New Zealand, the New Zealand government announced RATs would be made available to some groups from mid-December, and pharmacies quickly reported they were swamped by demand.

This week, Australia’s national cabinet agreed to a plan to get more rapid tests to those who need them and ease the pressure on PCR testing clinics. But for now, Aussie warehouses are bare and waiting times are still sky high.

RATs supply chain issues

While there appear to be plenty of the testing strips and plastic casings that make up most rapid tests, some manufacturers are struggling to get their hands on another piece of the raw materials puzzle.

There have been reports that some retailers were intentionally hoarding stock to inflate demand and justify price gouging, but Whiting said there were genuine supply chain issues at play.

Supplies of cardboard and packaging materials have been dwindling since October. But for Australia, chief among these supply chain issues is the scarcity of air freight.

The vast majority of rapid tests being sold for use in Australia are being imported from overseas, which means an overnight emergency delivery to replenish stocks is near-impossible.

Airlines around the world scrounging for healthy crews have been cancelling thousands of flights since Christmas, and cargo data providers reported prices on key routes almost doubled in the last three months of 2021.

Can we even trust the case numbers?

Every state and territory — apart from Western Australia which is yet to fully relax border restrictions — saw COVID infections break records this week as Omicron supercharges the virus’s ability to spread, alongside relaxed restrictions. But what do the official figures even tell us now?

Anecdotal evidence suggests some with symptoms are not even getting tested, assuming COVID symptoms probably are just that, a case of COVID.

Others are being turned away from long testing queues, or waiting days for results (if you are living with a positive case, do days-old results even make a difference when they are received?).

Rapid antigen tests are nigh impossible to find and large numbers of those with a positive test haven’t been following up with an official PCR. And from this week, that step was no longer even required in most states.

Infectious disease modeller Michael Lydeamore, from Monash University, believes New South Wales and Victoria are fast reaching a point where official case numbers are almost meaningless.

“They are beginning to lose more and more meaning because the proportion [that are] positive across New South Wales and Victoria is so high,” he said.

By the end of the week, many states introduced requirements to log positive RAT results. Combined with the new testing rules, this will help reduce the stress on the system, but it’s unclear whether official figures will ever reflect reality again.

However, that may be a moot point, as authorities and experts move towards a focus on other statistics.

Epidemiologist Catherine Bennett says the time has come to divert focus away from case numbers and towards surveillance and hospital admissions as part of the “logical next phase”.

But for a country fixated on case figures for so long, it’ll be slow going for many to reach that phase.

Getting tested or self-isolate?

In an open letter published in the British Medical Journal this week, public health experts called for a “vaccines-plus” approach that incorporates not just vaccination, but face masks, ventilation, and set criteria around effective testing, tracing and isolation to suppress transmission.

Meanwhile In Victoria, the health authority said 40 percent of cases being recorded are people aged in their 20s, and a significant proportion from hospitality and entertainment environments. Most of the new Omicron cases are currently under self-isolating. With over 92% of the Victorians double jabbed, the vaccines do efficiently reduced large numbers of hospitalizations, people only having mild systoms, going through self-isolating and get recovered within few days.

For people who are either close contacts or symptomatic, getting tested on sites is recommened by the health authroity. However, self-isolating at home until fully recover is also perferred if only having mild symtoms under the current shortage of Rapid Antigen Tests and overloaded testing sites.