Wed, 27 May 2020

Covid-19: How South Africa will test for the virus

07 Apr 2020, 04:10 GMT+10

Testing for Covid-19 in South Africa will, hopefully, be massively increased in the next few weeks. A machine called the GeneXpert, currently used to diagnose tuberculosis (TB), will be used by the state to test for the coronavirus.

Minister of Health Zweli Mkhize has expressed concern that not enough testing is being done, GroundUp reports.

"Our testing criteria are reactive and restrictive. This means we don't have a true picture," he said previously in his daily briefing on the Covid-19 epidemic.

South Africa had conducted over 50 000 tests by 4 April. This compares well to, say, Brazil, which has conducted about the same number of tests but has a much bigger population. But our capacity is far behind Australia (nearly 300 000 tests), South Korea (over 460 000 tests) and most European countries.

Also, in the early stages of the epidemic here, it was clear who to target: people with symptoms of Covid-19, who were returning from overseas. Now it is much less obvious and we risk missing outbreaks, unless we can do much more testing in many more communities.

Will it be enough? Inside South Africa's plan to ramp up coronavirus testing

Another concern is that using the machines for Covid-19 will impede TB testing. Asked about this, Kana said: "The GeneXperts are very effective and they can run for 24 hours, if needed. It is also very early in the pandemic, and it is hard to say now how the system will respond."

Beyond the GeneXpert, laboratory capacity is also being increased.

Dr Kamy Chetty, CEO of the National Health Laboratory Service (NHLS), said they currently have six laboratories where Covid-19 tests are done. By late April this will be increased to nine. The mobile laboratories will bring patient samples to these facilities. Most tests are still being done in the private sector.

Antibody tests

Currently, the country can do about 5 000 tests in 24 hours. Later this month, it will increase to 15 000 and, by the end of April, to 36 000. At least that is the plan. The proof will be in the execution.

Mkhize is also hoping that antibody tests will be useable in South Africa soon. These can be done by nurses at a clinic or hospital, are usually much cheaper than lab tests, and give results in less than 20 minutes.

But they have a shortcoming. Because they test for antibodies, not the virus directly, a person who has been infected and recovered will test positive. A further lab test that checks directly for the virus would then need to be conducted to see if they are still infected (and infectious). Also, it can take 10 to 14 days from infection for antibodies to develop.

Nevertheless, antibody tests, when they eventually are used, will help surveillance of the epidemic and contribute to our understanding of it in South Africa.

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