Danish below/Dansk nedenunder

Can we trust a Rapid test? What is the difference between a Rapid test and a PCR test?

If these are some of the questions you have asked yourself, we will not blame you. We experience many Danes are victims of ambiguous, deficient, and inaccurate communication facilitated both by the media and the health authorities.

For the moment, we experience that there is not a sufficient and comparable amount of research, which can document for the safety of the Rapid test. A new Danish study has indicated that the Rapid test only captures 70% of the people who were tested positive with PCR (Read here). According to this study, three out of ten people will be tested false-negative with the Rapid test, without taking the population into account, and whether the tested were symptomatic/asymptomatic. In connection with a comparative case with one of our clients, the Rapid test only found 40% of the positive samples. These numbers are also very strong indicators of the analyses and statistics that the American Center for Disease Control (CDC) has found. The CDC found 59 % of false-negative with the use of the Rapid test on asymptomatic people like in Denmark (See here).

Give yourself a few minutes to reflect on the absurdity that we in Denmark have chosen a test strategy that allows the use of such an undocumented and inaccurate test method. Could you, by comparison, consider using contraception that is only 70% safe? 

The most frequently used argument is that one test is better than no test. It is simply a misconception. The argument originates from an understanding that the Rapid test is the only option. Who imagined that there is no alternative to Rapid tests? There are now a lot of providers who can offer reliable test results within a few hours. And no, it is not the same as a result after 15 minutes. But if the consequence of taking a Rapid test is that more people in the workplace become infected with COVID-19 and a department must shut down, would it not be worth waiting a few additional hours to have a reliable test result?
In January, we had a specific case with one of our clients, in which they chose to get 99 of their employees tested. First, with the Rapid test, and then with our PCR test 30 minutes later. The results were frighteningly different. There were 10 positive cases found but the Rapid test only found 4 of them. If the company had trusted the Rapid test blindly, it could have resulted in a lot of new infection chains, financial losses, and the need for a much larger test effort. In these cases, quality always beats quantity.

“Based on our own testing experience with both methods, we prefer to use the PCR test as a standard method when testing our employees”
– Christian Høy-Petersen, Customer Experience Director, DHL (Denmark) A/S.

The Rapid test is most often the guarantor of dangerous false security. The fact that Denmark is currently shut down while companies go bankrupt and money flows out of the state coffers is perhaps an expression that the government and health authorities do not dare to trust the Rapid test themselves. Nor have they been clear and unambiguous in their recommendations of the Rapid test. On the contrary, an expert group at SSI came with the announcement on 2 November 2020 that the Rapid test was far too uncertain for the national test effort to be built around this type of test (Read in Danish here). A few months later, the Rapid test was good to be used because the response times in the public system were so long that the test results were useless before reaching the recipient.

It seems as if the authorities have focused more on not losing face than offering the Danes a way out of the crisis. Has anyone tried to compare the cost to shut down versus the cost to get help from the private providers and upgrade the national PCR test effort keep up? The Rapid test is called an antigen test, which detects viral proteins using a chemical test. In contrast, the PCR test looks for the virus’ RNA and detects down to a single virus particle in a mucus sample. Therefore, it is much more sensitive and thus far more accurate.

It is our experience that many people think the swab collection from the nose is performed only with a Rapid test. We can dispel this myth immediately. Nasal and pharyngeal swabbing are just two different sampling methods but have nothing to do with the test type. You can also choose to be swabbed in the nose when you need to have a PCR test done. Some have the idea that the private PCR tests are not as valid as the ones performed by the state. This is not correct. Our COVID-19 tests are perhaps even faster, more thorough, and more sensitive. These are the kind of misunderstandings which proves our point; that the danish people are underinformed and are fed with COVID-19 tokenism.

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English above / Scroll up for engelsk

Myten om den pålidelige lyntest

Kan jeg stole på en lyntest? Hvad er forskellen på en lyntest og en PCR-test egentlig? 

Hvis det er nogle af de spørgsmål, du har stillet dig selv, bebrejder vi dig ikke. Generelt er danskerne ofre for en masse tvetydig, mangelfuld og upræcis kommunikation faciliteret af både medier og sundhedsmyndigheder.

Faktum er, at der på nuværende tidspunkt ikke findes en tilstrækkelig og sammenlignelig mængde forskning, der kan dokumentere testens sikkerhed. Et nyt dansk studie har indikeret, at lyntesten kun fanger 70% af de personer, som testes positive med PCR  (Læs her).Ifølge dette studie vil tre ud af ti personer altså blive testet falsk negative med lyntesten. Dette uden at tage forbehold for population og hvorvidt personerne var symptomatiske/asymptomatiske på testtidspunktet. I forbindelse med vores egen virksomhedscase fandt lyntesten kun 40% af de positive prøver. Dette tal stemmer ganske godt overens med, hvad amerikanske Center for Disease Control har fundet (Læs her). De kom frem til 59% falsk negative prøver ved brug af lyntests. Dette på asymptomatiske personer, som testen bruges på i Danmark. 

Den omtalte virksomhedscase skal vi nok komme nærmere ind på. Giv dog lige dig selv et par minutter til at reflektere over, hvor absurd det er, at vi i Danmark har valgt en teststrategi, hvor det tillades, at en så udokumenteret og upræcis testmetode tages i brug. 

Kunne du, til sammenligning, finde på at bruge prævention, som kun er 70% sikker?

Det hyppigst anvendte argument er, at nogen test er bedre end ingen test. Det er simpelthen en fejlopfattelse. Argumentet beror tydeligvis på en forståelse af, at lyntest er den eneste mulighed. Dette er på ingen måde tilfældet. Der findes efterhånden en masse udbydere, der kan tilbyde svar inden for få timer og med et resultat, som er til at stole på. Og nej, det er ikke det samme som 15 minutter, men hvis konsekvensen af at tage en lyntest er, at flere på arbejdspladsen bliver smittet med COVID-19 og at en afdeling må lukke ned, er det så ikke værd at vente et par timer ekstra? 

Vi havde i januar en konkret virksomhedscase, hvor en af vores kunder valgte at få testet 99 medarbejdere. Først med lyntest og 30 minutter senere med vores PCR-test. Resultaterne var skræmmende forskellige. Der var i alt 10 positive at finde, men lyntesten fandt kun 4 af dem. Havde virksomheden stolet blindt på lyntesten, kunne det have resulteret i en masse nye smittekæder, økonomiske tab og behov for en langt større testindsats. I disse tilfælde slår kvalitet altid kvantitet.

”Blandt andet på baggrund af vores egne testerfaringer med begge metoder, foretrækker vi klart at anvende PCR-testen som standardmetode, når vi tester vores medarbejdere.”
– Christian Høy-Petersen, Customer Experience Director, DHL Express (Denmark) A/S.

I bund og grund er lyntesten oftest garant for en farlig, falsk tryghed. At Danmark lige nu er lukket ned, mens virksomheder går konkurs, og pengene fosser ud af statskassen, er måske et udtryk for, at regering og sundhedsmyndigheder ikke en gang selv tør stole på lyntesten. De har da heller ikke været klare og entydige i deres anbefalinger af lyntesten. Tværtimod. En ekspertgruppe hos SSI udmeldte den 2. november 2020, at lyntesten var alt for usikker til, at den nationale testindsats kunne bygges op omkring denne testtype (Læs her). Et par måneder senere, da svartiderne i det offentlige var så lange, at testresultaterne var ubrugelige førend, de nåede frem til modtageren, kunne lyntesten lige pludselig godt bruges. Det virker til tider som om, de offentlige myndigheder er gået mere op i ikke at tabe ansigt end at tilbyde danskerne en vej ud af krisen. Har nogen eksempelvis forsøgt at regne lidt på, hvad det havde kostet at opruste den nationale PCR-testindsats med hjælp fra private udbydere holdt op imod, hvad det har kostet samfundet at være lukket ned? 

Tilbage til spørgsmålet vedrørende den konkrete metode- og testmæssige forskel på en lyntest og en PCR-test. Først og fremmest er lyntesten det man kalder en antigentest. Den registrerer virusproteiner ved hjælp af en kemisk test. Derimod leder PCR-testen efter virussens RNA og kan påvise helt ned til én enkelt viruspartikel i en slimprøve. Den er derfor langt mere sensitiv og præcis. Det er vores erfaring, at mange tror, at der er tale om en lyntest, når podningen bliver foretaget i næsen. Denne myte kan vi aflive med det samme. Næse- og svælgpodning er blot to forskellige prøvetagningsmetoder men har ikke noget med testtypen at gøre. Du kan også vælge at blive podet i næsen, når du skal have lavet en PCR-test. 

Der er også nogen, der har fået det indtryk, at de private PCR-tests ikke er så sikre som det offentliges. Dette er bestemt ikke korrekt. Vores tests er, hvis ikke bedre, mindst lige så gode, som dem, de benytter i det offentlige. Vi er bare mere grundige og hurtigere. 

Det nogle af disse misforståelser, der vidner om, at danskerne generelt er underinformerede brikker i et større symbolpolitisk coronaspil.