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23rd Mar 2023

EU urges rollout of rapid coronavirus tests

  • Rapid tests can be less accurate than laboratory-performed diagnostic tests - but they offer results in 10-30 minutes (Photo: World Bank / Henitsoa Rafalia)

The European Commission on Wednesday (18 November) recommended a slew of anti-corona measures, urging member states scale up testing capacity, by increasing the use of rapid antigen tests, in order to help ease travel restrictions and prevent laboratory collapses.

While rapid tests can be less accurate than laboratory-performed diagnostic tests (PCR), they can offer results in 10-30 minutes, instead of days - useful for the detection of infections in large outbreaks or targeted population-wide investigations.

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The commission said rapid tests should be applied mostly on people already showing symptoms since there is "very limited data available regarding the performance of rapid antigen tests" on asymptomatic cases.

"Rapid antigen tests should be used within five days after the onset of symptoms or within seven days after exposure to a confirmed Covid-19 case," according to the commission's non-binding recommendation.

However, the commission also suggests testing all individuals, including those who are asymptomatic, in situations where more than 10 percent of tested people are expected to be positive.

The EU executive also urged national capitals to mutually recognise rapid test results and share testing strategies "with the aim of aligning them as much as possible".

Brussels is convinced that this approach could limit restrictions of free movement while contributing to the smooth functioning of the internal market in times of limited laboratory capacities.

However, many member states are still sceptical about rapid tests, including in relation to travel, according to an internal document.

"A large number of member states made clear that discussions on common minimum standards and criteria were premature, as more robust scientific evidence was still needed," reads the note prepared by the German government, which currently holds the EU Council presidency.

That is why the commission is advising member states to use only rapid tests that carry a CE-marking certificate (with at least 80-percent sensitivity and 97-percent specificity) in order to maximise the avoidance of false-negative and false-positive test results.

Sensitivity refers to how often a test correctly generates a positive result, while specificity refers to the ability to precisely detect those who are not infected.

"Antigen tests are a promising alternative as they are cheaper, faster and easier to administer. However, their reliability varies," a World Health Organization spokesperson told EUobserver.

Airlines want consistency

Meanwhile, airlines have been calling for a "European testing protocol" for travel, which relies on rapid antigen tests to support safe travelling and restore the confidence of passengers. This is currently under development.

"For aviation, in particular, surviving this unprecedented crisis will only be possible through close cooperation and a harmonisation of measures at European level," the Association Airlines for Europe said in a statement.

They are also demanding the duration of quarantines to be harmonised throughout Europe, and be reduced to the minimum number of days.

So far, EU capitals have not even been able to agree on how long the quarantine period should be, with differences in the length of isolation (from seven to 14 days), and in the criteria to lift such measures.

The European Centre for Disease Prevention and Control currently recommends 14 days of quarantine, although a negative PCR test at day 10 can be used to stop quarantine periods earlier.

However, the WHO warns that available scientific data indicate that the mean incubation period for the coronavirus is between five to six days, with an upper limit of 14 days.

The commission recommendation comes ahead of the virtual meeting of EU leaders on Thursday on the EU response to the Covid-19 pandemic, where they aim to enhance coordination.

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