How can self-tests be used today? (30/04//21)

A self-test is a coronavirus test that can be carried out by someone without medical training. You take the swab yourself, you process it right where you are and you can see the result straightaway. This is the case when you use a nasal swab and then carry out the analysis yourself, for example.

An alternative method is taking the swab yourself (self-swabbing) before sending it to a laboratory for analysis. This is the way saliva tests work, for example.

Self tests can be an important addition to the current testing strategy. The capacity of trained medical staff presents an obstacle for the current rapid tests; the tests involve a lot of paperwork and the costs are mounting up. Self-tests can offer a partial solution: taking a swab does not require medical training and the paperwork is less cumbersome.

There are two possible applications: in a business context or in the private sphere.

Self-tests in the workplace can only be used in consultation with the occupational physician. The occupational physician may decide that certain categories of employees are eligible for self-testing. There must be no direct or indirect coercion of any kind. In other words: an employee cannot be forced to carry out self-testing or self-swabbing.

If you do decide to use self-testing, information and training on correct use and the possible consequences of a positive or negative test result are important. This is because self-tests are less sensitive, which means that someone with a negative self-test result cannot automatically assume he or she is not infected.

The employee must be aware that a positive result means he or she has to self-isolate and contact the occupational physician immediately. This physician will use the clinical and epidemiological context to decide whether confirmation by way of a PCR test is needed (due to the lower sensitivity of self-tests) and take responsibility for contact tracing within the company.

It is important that:

• The occupational physician decides who is eligible (using the same criteria used for rapid tests) and which types of tests are used.
• The employee’s health data is confidential.

Self-tests offered for sale at pharmacies (from 6 April) must be approved by the FAMHP. Pharmacists should explain how to use the self-test and point out that a physician must be contacted in case of a positive result. In principle, this is the general practitioner for a test carried out in the private sector. A person who tests positive will be placed in isolation. A positive self-test carried out at home should always be followed up with a PCR test through the GP. Of course, an employee put into isolation must also inform their employer, so that the latter, together with the occupational physician, can trace low-risk and high-risk contacts at work.

Employers are not permitted to put pressure on employees to test in this manner.

People with COVID-19 symptoms must still have a test done at their GP’s or a test centre.

This might be the most important message of the entire self-testing narrative: a negative result is not a green light to start disregarding coronavirus measures. After all, a negative result indicates that you are unlikely or less likely to be able to infect others at that particular moment. You may still carry the virus, meaning that you are contagious. Because the viral load is low, you are not (yet) able or unlikely to infect others. This may be different only one or two days later.

Read more: Rapid tests in the workplace: an update