Covid-19 policy Now includes priority test access for some, Drops Schiphol testing

The Dutch government has introduced a new policy stance on coronavirus testing that gives priority access to some healthcare workers and teachers at a time when demand for testing has shot up substantially. In a letter to Parliament, Health Minister Hugo de Jonge laid out his plan to tackle the shortfall in test capacity, and said the Outbreak Management Team will assist the government in deciding what other groups of people should get priority access if the testing system falls under further strain.

For now, the Minister said it means the end of testing airline passengers who arrive at Schiphol Airport having recently been in a coronavirus hotspot identified by the Ministry of Foreign Affairs. He called the testing of a over a thousand passengers daily regardless of symptoms an "experiment", and said that the effectiveness of that will be evaluated. He said the test capacity needs to be reallocated to help decrease wait times for people who are symptomatic. The airport said it hoped testing would return to the airport, and that passengers would instead get tested before flying to the Netherlands.

Priority access is only temporary until the government can provide tests for everyone who makes the request, De Jonge said in the letter submitted Friday night. The policy covers healthcare workers who have a symptom consistent with Covid-19, and are essential to patient care and continuity of care including laboratory staff. Priority is given to those who cannot be replaced by a colleague, and who are employed by government-recognized healthcare providers. Some freelancers and temporary workers are also eligible, but voluntary care providers and informal caregivers are not included.

“In addition to care workers, teachers with Covid-related complaints can also be tested as a priority in the coming period,” De Jonge said. Teachers include those working in primary education, secondary schools, and special education, and who cannot be replaced by another worker. The decision to include teachers was to guarantee children could continue with compulsory education, he said. "In addition, sending classes home not only affects the development of the students of compulsory school age, but also for parents who cannot go to work as a result."

Pedagogical staff and administrators will generally not get priority access to testing. "As soon as the test capacity meets demand again, priority testing of certain groups is no longer necessary," he said.

Testing up to 70,000 per day

The reason for the policy shift is because testing demand has exceeded expectations, and is growing faster than the Ministry's plans to expand testing availability. He said demand is also expected to continue to increase. Last week, 36,800 tests were requested daily, while test capacity is around 30,000 mucus swab tests per day, putting a strain on the stock of lab materials needed for tests, and the staff handling the testing process.

“Unfortunately, the past week has shown that the demand for corona tests is growing faster than the test capacity. This indicates that the willingness to test among the Dutch population is high, which is of course positive. But the downside is that the waiting times are very long at the moment, which creates disadvantageous situations both for the fight against the virus and for society,” he said.

Earlier in the month, De Jonge said that the Netherlands was optimistic about increasing capacity to 50 thousand tests daily by the end of September, and up to 70 thousand tests per day by the end of October. Deals have been made with three labs abroad, and talks are progressing with three others, to expand processing capabilities. An agreement to acquire more test materials and equipment is expected to be completed next week, with delivery likely at the end of September or beginning of October, he said.

“I therefore expect that we will be able to meet the test demand again in early October. An uncertain factor here remains how the test demand develops.” De Jonge wrote. Until test capacity improves, he again asked that people only get tested for the viral infection when they have symptoms of the disease. He was also critical of private laboratories which offer testing directly to patients for a fee, instead asking them to make their capacity available for the public testing program.

New types of tests could win approval

De Jonge said the Ministry is still looking at methods for pooling together several test samples all at once and checking them for the virus simultaneously, which could give return negative results much faster to more people. He said new methods of checking samples for the virus, like breath testing and isothermal testing, are both under consideration at an official level.

The two types of tests can dramatically reduce the wait time for results, and as fewer pieces of equipment are needed for the tests, could conceivably be carried out at more facilities. “I am currently having a selection of these investigated so that, if proven suitable, they can be used from the end of 2020 / early 2021.” De Jonge also said that five new versions of rapid antibodies tests were also being considered between now and November, though all previous rapid blood tests were ruled out as being inaccurate.

Coronavirus detection app update

De Jonge said that the national coronavirus app, CoronaMelder, will be revised over the weekend with an updated version due out on Tuesday. The app has been tested in five regions of the country, but its nationwide rollout was delayed. The app was designed to notify people when they have been in contact with someone who tested positive for the virus, and instructs them to get tested.

However, the app's functionality was not opened up to the entire public because the system to get tested would not be able to cope with an expected influx in testing requests. The app is being revised to instruct people who have had contact with a contagious person to only get tested if Covid-19 symptoms arise.

"This brings the trial in line with the general guidelines," he said. It was not clear if the app would be available for use nationally from Tuesday, though previously the minister had said it would likely be ready by mid-September.