By now, many laboratories in the Netherlands can test whether people are infected with the coronavirus. As of 6 April, it is therefore possible to start testing more widely for COVID-19, but it remains important to use the test capacity wisely.

Judicious application of testing

The testing policy will continue to focus on specific patients in higher-risk groups and healthcare staff who are caring for vulnerable groups. This means that not all people who have symptoms will be tested. Regardless, people who are ill should stay home, isolate themselves, and focus on rest and recovery. The test result makes little difference to what you have to do next. The spread of the virus in the Netherlands is being investigated in other ways.

Testing in vulnerable groups

Vulnerable groups are people who have a higher risk of severe illness from COVID-19. These people can be tested if they develop symptoms, and confirmation of whether or not they have COVID-19 is important to determine the correct treatment or care. People with symptoms may also be tested because it is important to protect other people in the immediate vicinity of these patients.

This applies to the following groups of people:
•    people aged 70 years and up;
•    people aged 18 years or older with underlying health conditions, such as chronic heart disease, abnormalities and disorders of the respiratory tract and lungs, diabetes, severe kidney disease or severe immune disorders;
•    people with serious behavioural problems in a residential institution;
•    people with physical disabilities who need significant care.

Testing for healthcare workers

When testing healthcare workers, the factors that are taken into account include the health of the employees, the risk of patient infection, and the limited availability of personal protection equipment (PPE). These general principles have been applied to various sectors, resulting in sector-specific policy advice on deployment and testing for healthcare workers. This information is on our website for professionals (in Dutch). When deciding whether or not to test a healthcare worker, the decision is based on the employee’s symptoms, as well as the option of staying home or adjusting the work activities. Healthcare workers who have intensive contact with elderly or physically vulnerable patients have priority.

Testing capacity

When operating at full capacity, the Netherlands can handle about 17,500 tests per day. If necessary, the labs can increase testing capacity to about 29,000 tests per day. Testing capacity depends on people and resources. Materials are needed to perform the test, such as cotton swabs, packaging materials and personal protective equipment for the workers taking the samples. Materials are also needed for the analysis in the lab: fluids, filters and components in the analysis equipment, as well as the devices themselves. And people are needed: people to take the tests, transport them to the lab, and analyse them in the lab and communicate the results.
In short: when we refer to testing capacity, we are talking about many different aspects. Some of the resources needed for the test are in short supply. By testing according to careful guidelines, we are ensuring that sufficient facilities are available to use these resources efficiently. The Dutch testing policy is based on advice from the Outbreak Management Team.  
 

Testing
PCR test: testing for a current infection (detects genetic material of the virus)
Serological test: testing for a previous infection (detects the body’s natural immune response) 

Developing alternatives

RIVMNational Institute for Public Health and the Environment is also working with national and international laboratories to find possible options to supplement current test procedures. Besides the current PCR polymerase chain reaction  (polymerase chain reaction) tests, which detect the genetic material of the virus, we are also looking at other types of tests. One type is antigen tests, which show the presence of virus proteins. Another type is serological tests, which show the presence of antibodies in the blood. By using these tests, for example in combination with the current test, more people can be tested whether they have (or had) the coronavirus.