"Test, Test, Test" said the DG of WHO at the beginning of the Pandemic outbreak.

There was and continues to be a very important reason for that - 

  • The virus is highly contagious so one person can infect many others
  • Many patients are asymptomatic or mildly symptomatic

In this situation, the only way to contain the spread of the disease is to diagnose patients early - before they infect others. The only way to do that is by aggressive testing, diagnosing, contact tracing and then isolating the contacts. 

So what are the Tests available for diagnosis?

These are of two types

  1. Checking for Antigen - for the presence of the virus - indicative of fresh infection.
  2. Checking for Antibody- for human response to the infection- indicates recent infection.

1. Testing for Antigen

RT PCR - the gold standard for testing for the virus. This test is done not by taking blood but by swabs that are inserted into your nose (deep inside) and the throat - this is where the virus resides initially. The sample is sent to the lab for analysis and a report is generated in 1-2 days. 

There are some problems with this test- mainly False Positive (due to defective test kit, previous infection with a similar virus, etc), or False Negative (test protocols not followed, cold chain not being maintained, defective kit, etc).

2. Testing for Antibody

These are more important for surveillance purposes and to determine disease load in the population. It is also a useful criterion for picking up volunteers for Convalescent Plasma Therapy. There are two common Antibodies that develop as a result of the infection - these are IgM which rises by about a week of contracting the infection and gradually start reducing in 2-4 weeks. The IgG titers rise later (about two weeks or so) and offer long term immunity - so counts are detectable for a long time. 

Antibody tests are usually skin prick tests and results are available much earlier.

Pic- Courtesy Diazyme Laboratories- with grateful thanks

The Three 'A's of Testing

  • Available - readily available
  • Accurate
  • Affordable

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