Estonia planning on using rapid antigen tests by February 2021

Coronavirus testing at Tallinn Airport.
Coronavirus testing at Tallinn Airport. Source: Siim Lõvi /ERR

The Health Board (Terviseamet) is currently conducting rapid antigen test validation studies in many closed environments, such as hospitals, prisons and carehomes, with the hopes of putting antigen tests to use by the end of January 2021.

"There are rapid antigen test validation studies conducted in different European countries, including Estonia. The Health Board has acquired 1,000 rapid tests that are being tested in closed environments, such as hospitals," said Health Board deputy director Mari-Anne Härma.

She said the results of the validation studies will be compared to regular PCR tests and an assessment will then be made on whether or not rapid tests can be used to replace PCR tests in some cases or used as a supplemental test to the PCR tests.

Estonia is looking into two tests listed by the World Health Organization (WHO): a rapid test from pharmaceutical company Abbott Rapid Diagnostics Jena GmbH and a test from SD Biosensor Inc.

Both are tests with high effectiveness indicators and have gone through independent testing, said Külli Räe, director of the Health Board's infectious diseases laboratory.

Responding to a question about why nations are re-validating tests already tested by independent labs, Rae said that while the tests could be put to use using European Union directives, they are tested because the virus is a new and unknown one.

"When dealing with SARS-Cov-2, we are dealing with a virus that has little scientific data, which is why analytical effectiveness indicators provided by producers must be checked with clinical trials. It is appropriate to follow the principle: trust but verify," the lab director said.

"Clinical trials have shown lower confidence limits for some tests and due to the attractiveness of the market, there could be fakes," Rae said.

The lab director also considered it possible that there will be differences in results by country due to testing methods.

Results by late-November, tests to be here by February

Health Board deputy director Mari-Anne Härma told ERR that the results of the validation studies should be published by the end of November. If the European Union's joint procurement were to go through, rapid antigen tests could make it to Estonia by February.

Härma explained that the Health Board assesses the tests could be used to monitor close contacts because the test is sensitive on the initial days of infection, meaning the time when people considered close contacts are awaiting test results.

"So, according to the Health Board's assessment, the rapid antigen tests could be used in care homes, schools and other institutions, where an infected person has been in the work collective. In this case, the initial test could be conducted as a PCR test and then can be followed with antigen tests," Härma said.

In addition, rapid antigen tests could be used for people who need regular testing for work purposes - doctors, care home workers and prison guards, for example.

Rae added the use of rapid tests could be considered for people with symptoms in regions with high infection rates; in situations where there is high likelihood that a person could be infected when it comes to close contacts and in outbreaks; in health care institutions, when admitting ill people and separating symptomatic patients; testing employees in different institutions such as prisons or hospitals where regular testing is concluded.

Härma noted: "At the same time, the WHO assesses that rapid antigen tests should not be used to screen symptomless people on border crossing points."

Air travel companies are especially intrigued by rapid tests, seeing it as an opportunity to restart flights in a wide scale.

European Council discusses defeating the coronavirus pandemic

European Union heads of state held a European Council conference by video on Thursday, discussing the battle with the coronavirus as one of the key topics.

While the discussion revolved around vaccines, the topic of rapid tests was also discussed. Prime Minister Jüri Ratas (Center) emphasized via the government's press agency that the trustworthiness of testing methods is of utmost importance.

"The effectiveness of rapid antigen tests is different, which is why member states have to agree on common standards and criteria in test selection and usage. Estonia has started on studying the effectiveness of rapid tests and we are prepared to share our results with other countries," the prime minister said.

Both the President of the European Council Charles Michel and the President of the European Commission Ursula von der Leyen emphasized cooperation between member states and avoiding sudden steps when exiting the crisis.

"We need to learn past lessons and be cautious when we lift restrictions. It should be gradual and regressive. We all want to celebrate the end of year holidays but safely. Let's ring in the New Year safely," Michel said during the video conference.

Coronavirus tests divided into two groups

COVID-19 tests could be divided into two groups by their measurement principles.

The first group consists of tests that are used to identify SARS-CoV-2 - antigen tests and PCR tests. The second group consists of tests that are used to discover previous contact - antibody tests.

In the first case, the virus' genetic material (PCR tests) or components such as surface proteins (antigen tests) are identified. In both cases, analysis results could be recieved faster than regular laboratory methods, which is why these tests are called "rapid tests".

Rapid PCR tests were put in use in spring, when the coronavirus first appeared in Estonia.


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Editor: Kristjan Kallaste

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