Policy on testing for novel coronavirus disease (COVID-19)
Judicious application of testing To control the novel coronavirus, it is important to use our available test capacity and resources wisely. This is important so that enough tests can be administered, both now and in the long term. Laboratory material is not available in sufficient quantities for certain specific steps in the test procedure. This is an international problem and is not limited to the Netherlands. Dutch testing policy To ensure that we will continue to be able to carry out tests in the long term, not everyone in the Netherlands who has symptoms is being tested. Tests can be administered in the following situations: Patients in hospital may be tested because confirmation is important for the protection of other patients in that hospital and for the hospital staff. Patients in hospital (especially in intensive care) may also be tested because confirmation is important for their course of treatment. In care facilities that house vulnerable patients, such as residential facilities for the elderly and the disabled, the first few patients with symptoms are now being tested. This will make it possible to determine whether the virus is present in the care facility. Based on the results, measures for the whole ward will follow. Approximately 40 GP practices in the Netherlands (the ‘testing stations’ designated by Nivel Netherlands Institute for Health Services Research ) are taking part in a study of flu-like symptoms in their patients. The aim is to see how often these symptoms occur and which viruses are causing these symptoms. Since early February, this study has also included testing for the novel coronavirus. The Dutch testing policy is based on advice from the Outbreak Management Team. This is a group of experts associated with various medical institutions and professional associations, under the direction of RIVM, which advises the government on the measures to control the novel coronavirus. Testing capacity will be expanded in the coming weeks. As that happens, the testing policy can also be extended to others. In the new testing policy, priority will be given to care workers (who are showing symptoms) who work with vulnerable patients and/or are essential to continuity of care. Patients with an increased risk of developing a severe case of the disease will also be tested sooner. The new testing policy will be laid down in the LCI National Coordination Centre for Communicable Disease Control guideline for COVID-19 and will be phased in from 6 April. Differences by region There are regional differences in how the coronavirus is spreading within the Netherlands. As a result, there are also differences in testing capacity between certain areas in the Netherlands. When giving general advice, the experts always look at the national overview. Developing alternatives All around the world, there is a shortage of certain laboratory materials needed for the test procedure. For that reason, RIVM is working with national and international laboratories to find alternatives to current test procedures that require other laboratory materials. Besides the current PCR 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.