State has no intention of curbing millions of euros' worth of PCR testing
According to Minister of Health and Labor Tanel Kiik (Center), the Estonian government has no intention of reducing either PCR testing volumes for the COVID-19 virus or state funding for said testing, as PCR testing is more precise. Last month, for example, the state spent more than €7.1 million on PCR testing.
ERR: What is the government's plan right now in terms of reducing the relative amount of PCR testing that has previously been brought up on the debate level? This relative amount of testing actually decreased only briefly, and according to last month's data, the state spent €7 million on PCR testing.
Tanel Kiik: I have said repeatedly that all kinds of testing, vaccination and other prevention measures are significantly cheaper than dealing with the consequences of this disease and pandemic. Testing will continue, in any case. In terms of PCR testing volumes, it has indeed been considered in what cases these tests should be done, and in which cases antigen rapid test results don't need to be confirmed, for example. But this opinion that we should be the first country in Europe to stop PCR testing, this [is an opinion that] I have most certainly never once expressed, nor has the government believed this.
In the current pandemic situation, it is crucial to maintain a sufficient overview of the spread of the virus as well as the opportunity to sequence these viral samples. And PCR testing is indeed the most reasonable and effective method of doing so.
ERR: So there is no plan to reduce [testing] volumes compared with current levels?
Kiik: PCR testing volumes will start falling once the spread of the virus in society begins to slow. The goal of the various changes that we made, such as not confirming antigen tests, and reducing the PCR testing of cloe contacts, was to keep the test load at levels that the healthcare system could handle. And precisely to avoid a continuing rapid increase in test numbers. And that is what we have done. It was never the case that we thought that we would reduce testing volumes severalfold, with which we would actually rob ourselves of any sort of situational awareness regarding how extensive the spread of the virus is. And, for another thing, that we would create a situation in which many people could not get their necessary proof of infection, which in the EU is only currently valid based on PCR test results.
ERR: What information or added value does PCR testing at current volumes provide us with in a situation where rapid testing is actually widespread and is significantly simpler than arranging for PCR testing? While, meanwhile, some hospital directors have expressed the opinion that PCR testing should remain at the healthcare system level.
Kiik: PCR tests are inevitably more accurate than any antigen tests, especially rapid tests that people do themselves. And it is actually important to the state to maintain an overview regarding whether we are in a rising phase, a stable position or a downward trend. If we were to test only in hospitals and healthcare facilities with PCR tests and everything else were at the at-home testing level, then we would be out any sort of overview of the spread of the virus in our country. If we want to test such a relatively high number of people as is unfortunately necessary in current conditions of high viral transmission, then the testing system is optimal for doing so.
The fact that it will be possible to gradually reduce PCR testing volumes in the future is also clear. Once this bigger and more rapid rising phase passes and the situation in hospitals stabilizes, it would be reasonable to continue PCR testing first and foremost based on monitoring logic, the way the University of Tartu has conducted monitoring based on random samples, or the way sentinel monitoring is conducted for influenza simply to be aware of how big the spread of the virus is, but not so precisely, and maybe not measure infections on a daily basis anymore.
But we are not at that point yet. That point will likely reach us in spring or summer. The question right now is indeed what will become of this fall, and which variants of the virus will be spreading, and how large a scale PCR tests will need to be used again, and these samples need to be sequenced as well, i.e. various variants need to be identified. Only PCR testing allows for this sequencing.
ERR: But do you mean that [testing] volumes can be reduced over the summer, when infections and testing are low already? How will the state reduce these volumes even further, or what did you mean, more precisely?
Kiik: A specific example is that if infection certificates or COVID certificates of any kind are no longer being checked in Estonia by spring-summer, then the need for people to take PCR tests for those purposes will decrease automatically. Changes may also come on the European level, which are currently difficult to predict precisely, as this would require agreements between all countries. But there are currently talks also going, for example, about antigen tests as an additional alternative when issuing infection certificates. This decision has not been made yet.
ERR: So, in conclusion, on the crest of this current wave you are in favor of continuing state funding for PCR testing at current volumes?
Kiik: We've already made those reasonable changes. The PCR testing of close contacts has been eliminated, and positive antigen tests in schools and more broadly aren't being confirmed with PCR tests. But in a situation where transmission of the virus is high and we know that testing provides people with the necessary info to stay home, to remain in isolation, to go on sick leave, and also provides the Health Board and the state with awareness of the spread of the virus, then it is indeed reasonable to continue at similar volumes through the end of this specific, fourth wave.
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Editor: Aili Vahtla