US and Europe encourage constant testing for Covid, while Brazil suffers from shortages

The omicron variant caused an explosion of Covid cases in Brazil. Along with the record of infections, reached on Tuesday (18), and a new record, on Wednesday (19), the country continues to slip in the testing of its population.

Since the beginning of the pandemic, constant testing has been pointed out as a possibility of controlling or, at least, mitigating the spread of Covid.

“The most effective way to prevent infections and save lives is to break the chains of transmission. For that, you need to test and isolate. Blindfolded, you can’t fight a fire. And we won’t be able to stop this pandemic if we don’t know who’s infected.” , said WHO Director-General Tedros Adhanom Ghebreyesus on March 16, 2020, still at the beginning of the health crisis. “We have a simple message for countries: test, test, test. Test every suspected case.”

At first, testing, essentially through RT-PCR exams, was a problem around the world. But over time, capabilities expanded and new options with faster results for detection, such as antigen tests, became available.

Another evolution in the forms of testing were self-tests. The FDA (American drug and food regulatory agency) was already releasing the tests to be done at home in November 2020. In the first months of 2021, some European countries were also starting to use this option and, in March, the ECDC ( European Center for Disease Control and Prevention) was already producing a document pointing out the impacts — possible benefits and problems — of self-tests in the pandemic.

Thus, testing became something almost everyday. In the UK, for example, you can get home tests free of charge from the NHS (English Public Health Service), including by mail order.

“The government will therefore continue to make free access to self-tests available to the public in the coming months. People may want to use regular rapid tests to help manage periods of risk, such as after close contact with others in a higher risk environment. or before spending extended time with a more vulnerable person”, points out the British government document for the winter and autumn period 2021/2022.

In the future, the provision of free self-tests must end, according to the document, which also “recognises that rapid tests may continue to play an important and ongoing role in the future”.

In Germany, rapid tests are also free, and can be purchased at low prices in pharmacies. Also, companies must provide self-test kits, at least twice a week, to employees who do not work from home.

In Portugal, as in some places it was necessary to present a negative test to enter during the end of the year festivities, even in restaurants it was possible to self-test.

In the US, self-tests are sold in pharmacies, where it is not always easy to find them, but they have also been distributed by companies, such as Google, to their employees. Seeking to expand testing in the country, President Joe Biden put in place a policy that allows people to request free self-tests, to be received at home.

Despite these efforts, there were long queues for testing in several, especially with the overlapping of the holiday season and increasing cases of the omicron.

In Brazil, in the first months of the pandemic, while President Jair Bolsonaro (PL) minimized the risk of Covid, it was already pointed out that the lack of extensive testing was a considerable problem to contain the pandemic. At that time, practically only serious hospitalized cases were tested.

In January 2022, the situation is not far from that of 2020, with tests prioritized for inpatients, for example. Brazil, therefore, continues without a testing policy, says infectious disease specialist Julio Croda, a researcher at Fiocruz and professor at UFMS (Federal University of Mato Grosso do Sul).

In 2020, the Ministry of Health promised to make 46 million tests available by September of that year. Then, in May 2021, Marcelo Queiroga, current holder of the portfolio, announced a mass testing plan, with up to 26.6 million exams per month.

A leaf approached the ministry and asked for clarification on the flaws in the testing policies. The folder stated that the “National Plan for Expansion of Testing for Covid-19 has been implemented since September 2021” and that more than 58 million tests of the RT-PCR and antigen types have already been distributed since the beginning of the pandemic.

“We have always been a country that tests little. We have always been a country that does not test its suspected cases. And we have not improved over the years”, says Croda, who emphasizes that it is not a problem only at the federal level.

In a note to the report, the ministry stated that “there is no pending diagnostic tests for Covid-19 to any state and Federal District. Deliveries are scheduled following the agreement with states, municipalities and the DF, considering several factors, such as logistics distribution and storage capacity of each location, for example”.

The lack of a public testing policy, with a high demand for tests being carried out with some frequency, is also a factor that may have contributed to the restriction of the availability of exams at the current moment of the explosion of the Omicron, according to Carlos Eduardo Gouvêia, president- executive of CBDL (Brazilian Chamber of Laboratory Diagnosis).

“The lack of adequate planning and of something consistent ended up discouraging the industry itself”, says Gouvêia. He points out as an example the almost continuous drop in testing in pharmacies, according to data from Abrafarma (Brazilian Association of Pharmacy and Drugstore Networks), until the recent sharp increase.

According to the executive president of CBDL, in addition to the lack of a policy of constant testing, such a drop could be explained by the advance of vaccination and the reductions in hospitalizations and deaths, which increased the feeling of tranquility. “End of the year, with confidence up there, hospitalization down there, ‘that’s it, I’m protected’. With Christmas and New Year’s parties, we had all the spices for a perfect storm cauldron”, says Gouvêia.

Croda says that both the private sector and the public sector failed to plan for the omni, which in December showed explosive potential.

According to the infectologist, the prioritization of tests that is now taking place in Brazil generates less adherence to isolation, in case of symptoms and more difficulty in planning, because the real transmission scenario is not known.

“We know that adherence to isolation is greater when the person knows their diagnosis, knows they have Covid. That’s why we get into the issue of self-test”, says Croda. “Testing increases precautions and this can impact the transmission of the virus. Not having tests favors greater transmissibility.”

Anvisa (National Health Surveillance Agency) did not approve, this Wednesday (19), the use of self-tests in the country, which are prohibited by an agency rule.

According to Gouvêia, 12 to 15 million Covid detection tests should arrive in the country by the end of January. Most are rapid antigen tests, similar to self tests.