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Rapid antigen tests 'alternative' but PCR tests remain key to handling pandemic: Eijkman Institute

Jakarta Post - October 12, 2020

Jakarta – Seven months have passed since Indonesia announced its first COVID-19 case with the crisis continuing unabated as testing remains insufficient.

Though people in the country are now familiar with polymerase chain reaction (PCR) and rapid antibody tests, and only recently started to learn about rapid antigen tests, many are still confused about the purposes of each test and when they should be used.

Eijkman Institute deputy director for fundamental research Herawati Sudoyo said that PCR tests remained "the gold standard" for handling COVID-19 and the government must continue its efforts to make the test accessible for all.

"PCR tests are the key to handling COVID-19 because they are aimed not only at providing a diagnosis but also used for contact tracing," she said.

Hera said anyone who showed clinical symptoms of COVID-19 and who had made contact with a COVID-19 patient must be swab tested.

"If we stay at home but there is one family member, say, the father, who works at the office, and there is a person in the office who tested positive for COVID-19, it's highly recommended that everyone who lives in that house undergo a PCR test," she said during The Jakarta Post's Instagram Live session Jakpost Special "All About COVID-19 Testing" on Friday.

The other popular method, the rapid antibody test, Herawati said, was best used for surveillance purposes, or to understand the transmission dynamics of the virus, although it is not suitable for making a diagnosis.

Therefore, Herawati said that the use of rapid antibody tests as a requirement for travel or any other situation, such as for pregnant women who were in labor, was ill-advised and should be stopped.

"The rapid antibody test does not examine the virus but the anti-virus substance generated by the human body. So when people take this test and get a positive result, that means they have been infected with the virus but we don't know when. To know whether the virus is still active in the body or not, they must take the PCR test," she said.

However, Indonesia's PCR testing rate remains low despite the country operating 263 laboratories, with 0.10 tests per 1,000 people over a seven-day average, due to scarcity of well-trained personnel, given the complexity of the PCR testing process.

Herawati said the rapid antigen test might fill the gap but only for emergency purposes in places where PCR labs did not exist. The rapid antigen test uses only a paper strip containing coronavirus antibodies that react when touching the virus' spike protein.

"But it's not that simple," said Herawati. "Even though it is more accurate than the antibody test, with 100 percent specificity [will not cause cross reaction] and 97 percent sensitivity, as well as faster, cheaper and not requiring sophisticated equipment as with PCR test, it still requires well-trained personnel to conduct the test safely as samples are taken through nasal swab". (aly)

Source: https://www.thejakartapost.com/news/2020/10/11/rapid-antigen-tests-alternative-but-pcr-tests-remain-key-to-handling-pandemic-eijkman-institute.html