Rapid tests could clear close contacts in major testing change

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People exposed to COVID-19 in workplaces, social settings or at businesses and events would be able clear themselves from isolation using rapid antigen tests rather than queuing for a PCR test under a major change being considered for Victoria’s testing rules.

The government placed a large pre-Christmas order for rapid tests, and the push to allow asymptomatic contacts to use at-home tests is partly designed to take pressure off the state’s PCR testing sites, where people faced hours-long delays again on Boxing Day.

Victoria’s COVID-19 response commander Jeroen Weimar.Credit:Justin McManus

The policy to expand use of 15-minute tests for some close contacts after exposure at places such as churches, cafes, stadiums and social occasions is still being developed and has not received final approval, according to a senior government source speaking anonymously to detail confidential talks. Under the plan, anyone who tests positive to a rapid test or develops symptoms would still be required to take a PCR test, as would household contacts.

Two public health experts told The Age the change would be low-risk and sensible.

Deakin University epidemiologist Hassan Vally said it would mark “the fact that we’re moving into a new stage of the pandemic, and it’s about understanding the level of risk that each situation poses and trying to ease the pressure on when you use those PCRs”.

Such a switch would be the latest change to pandemic protocols designed to minimise disruption to people’s lives as high caseloads are normalised, and it comes after isolation rules were loosened in Victoria last month and NSW followed suit last week.

The requirement for asymptomatic contacts to get tested at government facilities is contributing to lengthy queues. One test recipient said they waited 6½ hours in a Geelong West queue on Sunday. The average wait time across Victoria was between 60 and 90 minutes, but many metropolitan sites had longer delays, prompting COVID-19 commander Jeroen Weimar to urge people to use the Health Department’s website to find lesser-known testing sites where queues were shorter.

Professor Catherine Bennett, chair of epidemiology at Deakin University.Credit:Jason South

Mr Weimar said testing capacity was running at 80 per cent because some staff were on leave. The diminished capacity coincided with the summer period, and Victorians needing PCR tests to travel interstate were comprising one-fifth of the current demand for tests.

“We recognise our staff need time with their loved ones and families as well. More of those staff will be back tomorrow,” Mr Weimar said on Sunday, adding the government added 50 per cent more testing capacity in recent months. “We look forward to the day when we don’t have those unnecessary bureaucratic hurdles that are getting in the way of interstate travel.”

South Australia on Sunday moved to drop the requirement for incoming travellers to have a PCR test before entering the state. Queensland’s PCR testing requirements remain in place, although Premier Annastacia Palaszczuk has signalled a possible move to rapid antigen testing from January 1, pending health advice.

Victoria recorded 1608 cases from 72,500 tests on Christmas Day, compared with 2108 cases the day before from 83,500 tests. NSW continued its spike in cases, recording 6394 positive results.

NSW Health Minister Brad Hazzard said everyone should expect to contract the more transmissible Omicron variant of COVID-19.

“Everybody in Australia will get Omicron, and what we’re seeing at the moment is far milder symptoms,” Mr Hazzard said.

Mr Weimar said Victoria had stopped checking every positive test for signs of the new variant and acknowledged it was now “established in the community” despite less than 2 per cent of COVID-19 cases carrying the new variant before screening ceased last week.

If the proposed change to Victoria’s testing requirements is enacted, Victoria would become the first state to scrap PCR testing requirements for some close contacts. The move was described as “very sensible” by Deakin University epidemiology chair Catherine Bennett.

Rapid tests are much cheaper but also less sensitive than PCR tests, meaning they occasionally produce false negatives. Those approved in Australia must identify at least 80 per cent of PCR-confirmed cases, and the rate of error diminishes significantly if at-home tests are completed over consecutive days, Professor Bennett said.

“This change will come with very little risk,” she said, noting the government could allow pharmacists to supervise the tests to reduce the proportion of them administered incorrectly.

The rapid antigen tests, which were approved for use in November, have been the focus of national debate in recent weeks as they sold out at retailers, and business groups and unions have called on the federal government to subsidise their use. Australia’s top medical advisory body is investigating how the quick-turnaround tests can be used more widely and whether they are necessary for interstate travel.

Professor Bennett said about 2.5 of every 100 people in COVID-19 testing queues were infected with COVID-19 compared with 2.5 out of 1000 in the broader community. Therefore, she argued, it was counter-intuitive for interstate travellers to queue up among people more likely to be infected.

The greater volume of tests has caused waiting times for PCR test results to blow out over the Christmas period. Previously, 90 per cent of people received their result within a day, but now the figure is 70 per cent. Professor Bennett said these lost days were crucial for people who may have underlying health conditions, and rapid testing would allow them to quickly begin thinking about treatments.

NSW Premier Dominic Perrottet said there was no need for people who were not unwell to get a PCR test. “It is actually less safe for there to be longer queues because the turnaround time is longer, and as a result, we will have more people in the community with COVID,” he said.

“If you’re going into a high-risk setting, if you’re visiting an elderly person, if you’re going into one of those areas where you might be thinking, ‘now I’ll go and get a PCR test’, no, have these rapid antigen tests at home, and as we move through 2022, we believe this will become the new norm.”

With more than 2000 health staff furloughed across NSW, the Perrottet government is considering easing isolation restrictions for healthcare workers who have been identified as close contacts. Victoria had 700 healthcare workers in isolation as of last week.

Also in NSW, more than 400 people who tested positive for COVID-19 were mistakenly sent messages on Christmas Day telling them they recorded negative results.

More than 400 people were incorrectly notified by St Vincent’s pathology service that their PCR test results were negative on Saturday night.

“These people in fact had tested positive,” SydPath medical director Professor Anthony Dodds said on Sunday.

With Tom Rabe.

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