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what are rapid serological tests for?

An indication but no in-depth diagnosis. The rapid diagnostic orientation tests (Trod), which pharmacists have been able to perform since the publication of a decree on Saturday July 11, are creating controversy within the medical profession. In doubt, their reliability and their interpretation.

These tests are supposed to determine in a matter of minutes if a patient has made antibodies against the SARS-CoV-2. In other words, if it has been contaminated in the past. But they do not confirm whether it is contagious or not.

→ EXPLICATION. Coronavirus: which serological tests to favor?

Until now, Trods have only been performed in medical analysis laboratories, in the city or at the hospital. They consist of taking a drop of blood, usually at the fingertip, in order to put it in contact with a reagent. The result appears in a few minutes.

The Ministry of Health has put online a list of 51 authorized tests of this type. On average, they cost 20 €, although each pharmacy sets its own prices. “These tests carried out in pharmacies are not covered by health insurance”, specifies the Union of pharmacist unions on Twitter.

No medical report

“The attending physician and the laboratories have been put aside: no medical report is made when the test is done in a pharmacy, once the test is done, the patient is notified if the test is positive or negative, and he must get by with that “, deplores Doctor Lionel Barrand, president of the National Union of Young Medical Biologists (SJDM). The medical biologist will file an appeal against the government decree with the Council of State.

In the event of a positive result, the test must be supplemented by a larger blood sample, analyzed in the laboratory, or even by a virological test, by nasal or salivary sample in order to know if the person is carrying the virus at the time of the test.

“Serological tests do not provide information on the contagiousness of a patient and do not allow, in the current state of knowledge, to rule on a possible protective immunity against the virus”, declared the High Authority for Health (HAS) via a press release on June 26. HAS said in mid-May that serological tests were used “In epidemiological surveillance and diagnostic strategy”, but that they were only a complement to virological tests.

“A lot of people want to know if they have had the disease, points out Carine Wolf-Thal, president of the Order of pharmacists. The role of pharmacists will be very important in making it clear that, whatever the outcome, the person must not change anything in their behavior and must continue to apply barrier gestures. “

No national directory

The possibility for pharmacies to carry out Trod is seen as a means of expanding the epidemiological map in France. However, “Private and public biology laboratories have an excellent territorial network with nearly 5,000 sites. They are able to respond to all requests for serological tests ”, reported on July 3 the inter-union of medical biologists. In addition, pharmacies are not linked to the national information system (Sidep) for Covid-19 screening.

Carine Wolf-Thal regrets that the rapid serological test does not imply the establishment of a national directory: “We could have imagined a feedback to establish epidemiological statistics, as the laboratories do, in order to provide information on the state of the population in terms of serological status. Especially since today it is estimated that between 5 and 7% of French people have been in contact with the virus. “

For the moment, not all pharmacies intend to market the vaccine, which will go on sale in the coming days.

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