Widespread coronavirus testing in Germany has been lauded for the country’s low fatality rate, with experts stressing the importance of testing widely early.
Germany has more than 10,000 cases, with experts saying the number of undetected cases is low. Its fatality rate of 0.5% is currently the lowest in the world.
Australia is testing 10,000 people a day with newly-loosened guidelines for who can be tested amid a rise in community transmissions.
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Crikey takes a look at what other measures Australia is taking in testing — and asks if we’re doing enough.
Who can get tested?
Government guidelines have expanded to allow people who have not travelled overseas or been in contact with a confirmed case to be tested.
Testing has been approved for people who have been hospitalised with a fever and acute respiratory symptoms; and people with either fever or acute respiratory symptoms who work in high-risk settings.
These settings include aged care, healthcare or residential care, rural and remote communities, detention or military centres, or regions with an elevated risk of community transmissions.
It also includes people who have been in close contact with confirmed cases within 14 days, or who have travelled internationally or have been on a cruise ship.
Associate professor Adam Kamradt-Scott, a leading infectious disease expert at the Centre for International Security Studies at the University of Sydney, told Crikey the new criteria was timely.
“The focus can now be on community testing as we now have community transmissions,” he said.
Australia currently has a similar fatality rate to Germany, says Kamradt-Scott — though with a smaller sample size.
“We’re able to identify people who are positive. In the event they develop serious illness, we can rapidly get them healthcare to reduce the severity,” he said.
Kamradt-Scott believes, given the scarce resources, Australia’s testing has been conducted as well and widely as possible.
Fifteen-minute test to arrive early next week
Half a million coronavirus tests, which require just a single drop of blood and provide results in 15 minutes, are set to be rolled out in Australia from early next week.
The test has been developed by Australian-based company Endo X and manufactured in Hong Kong, where 100,000 tests can be produced in a day. The tests were approved by the Therapeutic Goods Administration on March 20.
Endo X director Dr David Badov told Crikey the tests were fast and simple. “You don’t need to take blood or swabs and send it to a pathology lab or hospital, which causes delays,” he said.
They cost around $22 each, and check for two different kinds of antibodies present when someone is infected with coronavirus, or if they’ve been protected and developed immunity. Badov was unable to confirm whether the Australian government had purchased all 500,000 kits.
Millions of the kits have already been made available to the general public in the UK, marketed as home-testing kits and delivered by Amazon — though this is unlikely to happen in Australia, Badov told Crikey.
“It can sometimes be difficult to interpret tests, so it’s best to be done by a healthcare professional,” he said. The company doesn’t sell to individuals in Australia, but have had enquiries from large mining companies with nursing staff available to test employees.
“In other countries, people in critical professions like nurses, doctors and people who work in aged care have been doing the finger prick tests daily,” he said.
The test has a detection accuracy rate of 99.3% when used between 11 to 24 days of developing symptoms — though this drops to 94.6% when used from four to 10 days, meaning it can miss positive cases early in the course of the disease, when a patient’s immune system has not yet created antibodies.
Kamradt-Scott stressed the importance of testing all new products, adding immunity rates would provide useful data. For now, “the focus has to be testing, isolating and contact tracing”.
The current state of testing
Australia was the second country behind China to successfully develop a lab-grown version of the disease and develop a test.
Professor Sharon Lewin, a leading infectious diseases expert at the Doherty Institute, which created the test, told Crikey Australia they had tests up and running by January 24.
“The test we use looks for genetic material for the virus. It’s the same method we use to track HIV,” Lewin said. It requires a nose or throat swab to be taken and sent to a laboratory, where a test takes around six hours. Patients usually receive results between 48 and 72 hours from being swabbed.
A spokesperson for the Doherty Institute was not able to confirm the test’s accuracy rate or cost, but both are believed to be higher than the antibody test. It cannot detect if someone has developed an immunity to the disease.
The federal government has also provided $2.6 million funding for the Doherty Institute to develop a blood test which would deliver results in 30 minutes, while a 45-minute gene test has also been approved for use in Australia by the TGA.
Crikey understands doctors are provided tests and do not get to choose the type used.