Getting tested for coronavirus in South Africa - What you need to know about test accuracy

Jamie McKane

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Moto Guzzi

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I have two questions:

1-Are these test aimed at only this virus, meaning if another onw appears will it be picked upthrough these tests-?

2-Sloppy GP appointments. Having apointment with a GP, unlike a Specialist, you have to sit and wait up to an hour amongst other sick people for chronic medication in one room, now with this the person may be put at risk.
Will this practise now be stopped and prescription renewal(6-mnthly) faxed to pharmacy by doctor on request where no adjustments is requesteed or any complaits to raise, just a renewal-?
 

Jan

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Sloppy GP appointments. Having apointment with a GP, unlike a Specialist, you have to sit and wait up to an hour amongst other sick people for chronic medication in one room, now with this the person may be put at risk.
It is for this reason that the Department of Health advises against going to the doctor if you think you have COVID-19.

It advises that you rather call the NICD hotline for advice on what to do: 0800 029 999
 

Gordon_R

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IMO the real issue is not the exact accuracy of the test (I am familiar with Bayes Theorem), but the fact that it is expensive, and not suitable for testing large numbers of people. It mainly serves to confirm cases, enforce isolation or quarantine, and begin the contact tracing process.

Once the person-to-person transmission stage begins, the testing process will always be 'behind the curve', and become less useful in containing the outbreak (SA is not yet at that stage).
 

4cer

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So I have all the COVID symptoms, went to the doctor, and I am not "High Risk" so they won't test me for COVID, it's a good way to keep cases low.

Basically only if you have the symptoms and have travelled internationally/have had contact with someone who has been tested as positive or are elderly/have underlying illnesses, will they test you. If you are a 30 year old with no health issues and just have they symptoms, you will just get some meds and be told to self quarantine.

*Me personally, I was at the doctor today
 

saor

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So I have all the COVID symptoms, went to the doctor, and I am not "High Risk" so they won't test me for COVID, it's a good way to keep cases low.
Feels different to flu or anything you've had before?
 

Gordon_R

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So I have all the COVID symptoms, went to the doctor, and I am not "High Risk" so they won't test me for COVID, it's a good way to keep cases low.

Basically only if you have the symptoms and have travelled internationally/have had contact with someone who has been tested as positive or are elderly/have underlying illnesses, will they test you. If you are a 30 year old with no health issues and just have they symptoms, you will just get some meds and be told to self quarantine.

*Me personally, I was at the doctor today
That is the correct medical response, at least at this stage of the epidemic. Doing a R1000 test on a 1 in a million chance that you have the virus, is not good use of scarce resources. There are hundreds of people who have had contact, who do need testing. If every person who feels sick requested tests, the laboratories would not be able to keep up.

Public health decisions may not be popular, but they look at the big-picture, not necessarily your individual concerns.
 

4cer

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Feels different to flu or anything you've had before?
Yup, feels like flu, but emphasis on the effect on my breathing. Like I struggle to get a full breathe of air.

But i understand as per Gordon, they are using our testing resources smartly on high risk cases, else if everyone could get a test we would have to wait weeks to get a result.
 

Azg

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That is the correct medical response, at least at this stage of the epidemic. Doing a R1000 test on a 1 in a million chance that you have the virus, is not good use of scarce resources. There are hundreds of people who have had contact, who do need testing. If every person who feels sick requested tests, the laboratories would not be able to keep up.

Public health decisions may not be popular, but they look at the big-picture, not necessarily your individual concerns.
Understandable. But without me knowing the identity or at least the movements of an infected person before they were finally tested and quarantined, I can never know whether there was contact or not.

It appears only relatives or colleagues of infected persons will ever qualify to have had contact.

Is there any benefit to the COVID-19 infection being identified early to the clinical outcome (i.e. whether you recover or kick the bucket)?
 

NarrowBandFtw

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There are hundreds of people who have had contact, who do need testing. If every person who feels sick requested tests, the laboratories would not be able to keep up
The root cause of that problem is not the number of people requesting tests, that's merely a symptom, the root cause needs to be addressed ... just ask South Korea:
There is no shortage of testing kits in South Korea. Four companies have been given approval to make them. It means the country has the capacity to test 140,000 samples a week.

Prof Kwon believes the accuracy of South Korea's Covid-19 test is around 98%. The ability to test so many people has made the country a role model as others look to battle their own coronavirus outbreaks.
 

Hemi300c

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The root cause of that problem is not the number of people requesting tests, that's merely a symptom, the root cause needs to be addressed ... just ask South Korea:
In SA some idiot cadre will get the tender to produce tests a nd need to set up the manufacturer etc but will first go buy himself and his family cars with the money.
 

Gordon_R

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Understandable. But without me knowing the identity or at least the movements of an infected person before they were finally tested and quarantined, I can never know whether there was contact or not.

It appears only relatives or colleagues of infected persons will ever qualify to have had contact.

Is there any benefit to the COVID-19 infection being identified early to the clinical outcome (i.e. whether you recover or kick the bucket)?
Testing positive has no little effect on the clinical outcome, since there is no specific treatment at this stage. If you can't breathe, you go on ventilator assistance. You either recover naturally, or you don't, there are no other outcomes (at this stage). AFAIK there are no limited after effects, for those who do recover.
 
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Gordon_R

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The root cause of that problem is not the number of people requesting tests, that's merely a symptom, the root cause needs to be addressed ... just ask South Korea:
The situation in South Korea was at a very different stage of the epidemic from where we are in SA. They had a lot of person-to-person transmission, and had to ramp up testing to stamp out the epidemic. In SA we have had mostly travel-related cases, and very few local cases (so far). That may change with time, and the testing protocol would also change in sync, with the number of cases and transmission chain.
 

Gordon_R

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Which is most likely a side effect of not testing more people, rather than confirmation of having the outbreak under control.
More that the contact tracing process has been effective for those who traveled, and those contacted who were asked to self-isolate during the incubation period, did not pass on the virus to others.

The number of recent cases has not (so far) been growing as fast as it has in other countries. See:

And:

While panic grips the country following President Cyril Ramaphosa's declaration that the coronavirus outbreak is a national disaster, the Gauteng health department says that it will not be conducting mass screenings at this stage.

This comes after members of the public flocked to Charlotte Maxeke Johannesburg Academic Hospital to have themselves screened for the deadly virus which first emerged in Wuhan, China. There were 62 confirmed cases in South Africa at the time of publication.
 

NarrowBandFtw

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The number of recent cases has not (so far) been growing as fast as it has in other countries
Due to under reporting or just not testing I bet. Of the countless countries with over 50 cases in the world, we are one of only four to not report a single new case in the last 24 hours.

All four of those countries happen to be decidedly third world countries ... coincidence?
(fwiw: ZA, Algeria, Panama, UAE)
 
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