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Shortly before the festival, a stick to the throat, and whoever has a negative result, can take a seat at the Christmas table: the tempting idea of doing a rapid wreath test so as not to infect their parents or grandparents at Christmas currently worries many .
But are rapid antigen tests also safe? Or do they simply ease the guilty conscience of those who want to go to their families on Christmas Eve despite the increasing number of infections and deaths? These questions are not so easy to answer.
No sale to individuals
First of all, it is likely that the majority of German citizens will not be able to obtain such a test: rapid antigen tests are not available to individuals in Germany. According to the current testing ordinance, they are only available to physicians and clinics, institutions, and businesses that submit a testing concept to the health department, such as seniors or nursing homes.
But, of course, there are numerous providers who also sell their tests online. And in neighboring European countries like Austria, antigen tests can be bought at pharmacies.
Questionable reliability of online tests
The main problem with online testing is that many products do not meet the minimum criteria established by the Paul Ehrlich Institute (PEI) and the Robert Koch Institute (RKI). Consequently, antigen tests must have at least a sensitivity of more than 80 percent and a specificity of more than 97 percent to be used in Germany. The Federal Institute for Drugs and Medical Devices (BfArM) maintains a verified list of all manufacturers whose tests meet these criteria.
The figures already show that the reliability of antigen tests is much lower than that of PCR tests. Rapid antigen tests do not detect the Covid-19 pathogen itself, but rather the proteins associated with it. A test with a sensitivity of around 80 percent does not recognize 20 out of 100 corona positives. On the BfArM list, however, there are also tests with a sensitivity of around 98 percent, meaning about two out of every 100 infected people have a false negative test. If, of all people, these two were sitting at the table with their grandmother on Christmas Eve, that would be fatal.
On the contrary, couldn’t it be argued that the 98 who show a true positive result are no longer a danger to others? You could.
Self-extraction on the part of the laity is almost impossible
But there is another problem with such rapid home antigen testing: the required sample is taken with a nasopharyngeal swab. Therefore, a swab must be inserted very deep into the throat to obtain a sufficient amount of virus; therefore, testing yourself or a family member is nearly impossible for laymen.
“Self-evaluation of the posterior throat swab by untrained medical personnel can lead to false negative results due to limited smear quality,” says Jan Kramer, internist and laboratory physician, as well as vice president of the professional association of laboratories. accredited in medicine (ALM). The then perceived erroneous safety could lead to non-observance of the AHA + L rules and thus trigger the infection of others. “If people who are not medically trained are tested by others, there is also a risk of infecting themselves or others as part of the aerosol formation that occurs,” says Kramer.
Doctors in private practice have also repeatedly warned against antigen self-tests. Self-tests increase the false negative rate and the risk of super-spreaders, according to a Virchowbund news release in early December. Smears can only be performed by medically trained personnel. “It would be fatal if people received a false negative result after faulty self-defamation and thus lulled into a false sense of security.”
So if experts are against laypeople doing a self-test, why doesn’t the federal government offer rapid antigen testing at the testing centers that have already been established in many cities? So everyone who wants to be more confident for Christmas could get a professional test and at least rule out the uncertainty of incorrect sampling. Countries like Slovakia or Austria have already carried out such antigen mass tests at the national level. Scotland is also using a similar strategy before Christmas.
Mass testing in Germany is currently excluded
In Germany, these massive tests have so far been rejected and their usefulness questioned. The Federal Ministry of Health justifies it with a specific approach to testing. “Testing without a reason leads to a false sense of security,” he said when asked. “Because even a negative corona test is just a snapshot and does not relieve you of hygiene and protection measures.”
Another reason not all of them can simply be tested in a densely populated Germany: there is not enough testing. In early December, Health Minister Jens Spahn was still unsure whether there would be enough testing for all seniors and nursing homes by Christmas. It is probably not yet possible to provide more than 80 million antigen tests at one time. After all: on Wednesday, the federal government announced that it would promote the production of corona rapid tests in Germany with immediate effect. 200 million euros should be available.
The right time is crucial
Assuming you get a certified antigen test and assume that your brother’s wife works for the Red Cross and can properly perform the swab sample, then there is still an uncertainty: the timing of the sample collection. “The best time to use an antigen test is the first five days after symptoms appear,” virologist Christian Drosten said on the NDR podcast in late November. In his opinion, antigen tests are especially helpful when someone is having symptoms and wants to know if they have Covid-19 or another disease.
Antigen testing requires a large amount of virus to identify a person tested positive. We now know that this is the case about two days before or two days after the onset of symptoms; then the person is also more contagious to others. But not all people have symptoms. “The problem with asymptomatic people is that it is not known if they are being tested in the initial phase of the infection,” Drosten said on the podcast. “So if you use the test at the right time.”
A test on Christmas Eve would likely filter out those who are very contagious at the time. But just a day later, this test result would no longer be relevant. “That means if you want to use antigen tests like this for family visits, you basically have to test yourself on them every morning,” Drosten said.
According to Drosten, there is a way to ensure the highest level of security possible: pre-quarantine. Anyone who wants to visit their family at Christmas can voluntarily carry out a ten-day pre-quarantine and at the end of the time can “free themselves” with an antigen test.
