It is still important to use a self-test if you have symptoms that could indicate COVID-19. If you do have the coronavirus SARS-CoV-2, you go into isolation and stay home, so the virus cannot continue to spread. Also immediately inform the people that you had contact with. They may also have been infected. 

COVID-19 testing

Testing is an important tool in controlling COVID-19. If you have symptoms, get tested. You can usually use a self-test. In some situations, the advice is to go to the Municipal Public Health Services (GGDs) to get tested. Go to Government.nl to check whether this applies to you. 

Do you want to know which test is used and when? Then look at the table showing the different types of COVID-19 tests.

  Target group Indication/reason for test Type of tests
A

Everyone (vulnerable* and non-vulnerable)

Note: see B and C for specific risk groups
 
 

Preventive or in case of symptoms (not seriously ill)

1] Self-test ¥ 

Seriously ill and requesting medical assistance (e.g. GP, emergency care)

1] PCR/TMA test 

2] (TNO) LAMP test or rapid antigen test or self-test – confirm negative result with PCR/TMA test

After exposure (for people who are advised to self-quarantine)   As soon as possible, and a self-test on day 5. 
Note: see B and C for exceptions
After entering the Netherlands from another country

Testing when arriving in the Netherlands

To obtain a coronavirus entry pass/DCC/recovery certificate see Government.nl
B

Living in an institution where vulnerable people* live / going to adult day services attended by vulnerable people*

In the event of symptoms

In the context of outbreak investigation


 

1] PCR/TMA test  

2] (TNO) LAMP test or rapid antigen test or self-test – confirm negative result with PCR/TMA test  
 

 

After exposure (for people who are advised to self-quarantine)     Self-test as soon as possible, and PCR/TMA test on day 5
   
C ZHealthcare workers  

In the event of symptoms 



 

1] PCR/TMA test 

2] (TNO) LAMP test or professional antigen test – confirm negative result with PCR/TMA test    

3] In exceptional cases, care workers (who are essential to continuity of care) can use a self-test to determine whether an employee can be scheduled for work, while awaiting the results of a PCR test. If the self-test is negative, the employee can work using personal protective equipment (PPE). Confirmation of a positive self-test with a PCR test is not necessarily required.

After exposure (for people who are advised to self-quarantine)   

Self-test as soon as possible, and PCR/TMA test on day 5

For exceptions: https://lci.rivm.nl/afwegingskader (in Dutch)

* See LCI guidelines

¥ In the event of symptoms, use a self-test as soon as possible after symptoms start. If symptoms persist, use second self-test on day 2. The Municipal Public Health Services (GGDs) or treating physicians may recommend a PCR/TMA, (TNO) LAMP or professional antigen test on an individual basis. 

Types of tests

There are various types of tests. Which types are there, and what do they tell us?

The polymerase chain reaction test or “PCR test” 

The PCR test detects specific fragments of genetic material from the coronavirus SARS-CoV-2. To perform this test, a smear is taken from the nose and throat with a cotton swab. This sample goes to a laboratory, where research is done to check for the presence of the SARS-CoV-2 virus. In the PCR test, a small fragment of genetic material inside the virus is replicated repeatedly, in order to detect its presence. The PCR test has a high test sensitivity. That means that the PCR test also detects the virus in someone who is not carrying much of the virus yet, or no longer has much virus left in their body. The PCR test is also referred to as a nucleic acid amplification test (NAAT). Another type of NAAT is a transcription mediated amplification (TMA) test. 

What is the Ct value of the PCR test?

To ensure that the test will be as sensitive as possible, a specific fragment of the genetic material is amplified (copied) using the polymerase chain reaction method, known as PCR. This fragment of genetic material is specific to the SARS-CoV-2 virus. That means that the test cannot give a positive result for other viruses, such as those that cause the flu or the common cold. 
The genetic material is copied in different rounds or ‘cycles’. During each cycle, the genetic material doubles in volume; this continues until it is detected by the PCR device. The ‘Cycle threshold’ or Ct value is the number of amplification cycles required to detect the first signal that the virus is present. If the virus is present in higher levels, it will take fewer amplification cycles to reach that cycle threshold. A lower Ct value means that there is more virus present in the specimen. Amplification takes time for each cycle. That is why a PCR test result always takes a little longer (at least a few hours). 

LAMP test

The LAMP (loop-mediated isothermal amplification) test is a form of testing in which small fragments of genetic material are copied or replicated, similar to the PCR test. However, the method used for that purpose in the LAMP test is completely different from the PCR test. The major advantage of the LAMP test is that the fragments of genetic material are replicated at only one temperature.  Therefore, this test is faster than the PCR test, which requires fluctuations in temperature. The LAMP test requires different equipment and chemical substances than are needed for PCR tests. As a result, they can complement each other in this respect, rather than competing if supplies become scarce.   

The antigen test

The antigen test detects the presence of antigens for SARS-CoV-2 in nasal and/or throat mucus. Antigens are proteins on the exterior surface of the virus that can produce an immune response in the body (in contrast to the genetic material in the virus). If you are carrying the virus, an antigen test can detect its presence early on. In contrast to a PCR test, the antigen test will quickly show whether the virus is present – usually about fifteen minutes after applying the sample to the test set. The test is also easy to use outside a laboratory setting, and is currently used extensively. Because there is no amplification of the signal as in the PCR test, an antigen test is less sensitive, which means that the test will give a false negative result more often. This is especially likely if virus levels are low, such as very early after the onset of symptoms or right after a known contact. Virus levels decrease again later in the infection, which also means the infected person will be less contagious. When virus levels are low later in the infection, a person may wrongly get a negative test result on the antigen test, even if they may still have COVID-19. Self-tests that you can buy in shops are antigen tests. Always follow the manufacturer’s instructions when using a self-test.

Serological test or antibody test

The serological test determines if there are specific antibodies against the coronavirus SARS-CoV-2 in your blood. Antibodies are part of your natural defences (the immune system) and indicate that you have built up protection against the infection. The antibody response is how your body responds to the antigens that are on the virus, and are therefore found after antigens are present. It can take 2 to 3 weeks for your body to produce the right antibodies and release them in sufficient quantities in your blood, so they can be detected. The test shows if you have had the virus in the past, and cannot be used to show if you are infected right now. When you are vaccinated, your body also makes antibodies, so the serological test will also show a positive result after vaccination. This test is primarily used for research and screening at the population level, by selected laboratories.