Add antigen detection to nucleic acid detection
Written by | Wang Hang
Source | "Medical Community" public account
"If community residents have self-testing needs, they can purchase antigen detection reagents for self-testing through retail pharmacies, online sales platforms and other channels."
On the afternoon of March 11, the National Health Commission issued a blockbuster document, the "Application Plan for The Detection of New Coronavirus Antigens (Trial)" (hereinafter referred to as the "Plan").
The notice pointed out that in order to further optimize the new crown virus detection strategy and serve the needs of epidemic prevention and control, after research, the comprehensive group of the joint prevention and control mechanism of the State Council in response to the new coronavirus pneumonia epidemic decided to add antigen detection as a supplement to nucleic acid detection.
How do individuals and primary healthcare facilities conduct antigen testing?
The Plan includes two annexes, namely, the basic requirements and procedures for the detection of new coronavirus antigens in primary medical and health institutions, and the basic requirements and procedures for self-testing of new coronavirus antigens.
Antigen testing is indicated in the following populations:
Persons who go to primary medical and health institutions for treatment, accompanied by respiratory tract, fever and other symptoms and have symptoms within 5 days;
Quarantine and observation personnel, including personnel in home isolation observation, close and sub-close contact, entry isolation observation, sealing and control area and control area;
Residents of communities with antigen self-testing needs.
At the same time, the "Plan" also clarifies the main conditions to be met by the above three types of people for antigen detection, the channels for obtaining testing reagents, and formulates the disposal management process after the test is found positive, so as to promote the connection between antigen detection and nucleic acid detection.
Both positive and negative antigenic results in suspected populations should be further nucleic acid testing, and positive results can be used for early triage and rapid management of suspected populations, but cannot be used as a basis for confirming the diagnosis of new coronavirus infection.
Personnel in home isolation observation, close and sub-close contact, entry isolation observation, sealing and control areas, and control areas are to be organized and managed by the relevant management departments (such as communities, villages, towns, isolation points, etc.). During the isolation and observation period, nucleic acid testing is carried out in accordance with the requirements of the current relevant prevention and control programs, and antigen self-testing is carried out once a day for the first 5 days.
Community residents who have self-testing needs can purchase antigen detection reagents for self-testing through retail pharmacies, online sales platforms and other channels. In order to ensure the quality of sampling and testing, residents need to carefully read the instructions and carry out sampling, sampling, and result interpretation in a standardized manner in accordance with the prescribed requirements and procedures.
The disposal of antigen test results of community residents is divided into the following two points:
1. If the antigen test is positive, regardless of whether there are respiratory tract, fever and other symptoms, residents should immediately report to the community (village or town), and the community (village) shall contact the emergency center to transfer the residents to the medical institution that has set up a fever clinic for nucleic acid testing in accordance with the guidelines for the transfer of personnel related to the new crown pneumonia epidemic. After the positive person uses the sampling swab, sampling tube, test card, etc., into a sealed bag and transported to the medical institution for medical waste disposal.
2. Antigen-negative, asymptomatic residents can be closely observed, and then carry out antigen detection or nucleic acid testing when necessary; symptomatic residents are recommended to go to the medical institution that sets up fever clinics as soon as possible for nucleic acid testing; if it is inconvenient to seek medical treatment, they should self-isolate at home, avoid outdoor activities, and conduct antigen self-testing once a day for 5 consecutive days.
In addition, the "Plan" standardizes the requirements and processes for antigen testing carried out by grass-roots medical and health institutions from seven aspects: basic requirements for technical personnel, specimen collection, specimen management, basic requirements for testing, feedback of test results, safety management of antigen detection and information management of antigen detection.
The collection methods for antigen testing in primary medical and health institutions include nasopharyngeal swabs, oropharyngeal swabs and nasal swabs, if the result is negative, a negative report is issued to the patient and reported immediately according to the prescribed process. Biosafety-related management for antigen testing is the same as for COVID-19 nucleic acid testing.
Finally, under the overall planning of the health administrative department, the grass-roots medical and health institutions shall do a good job in the information docking of specimen collection, antigen testing, and testing reports, to ensure that the personal information collected by the specimens is smoothly connected with the information system of the health care institution, and the information exchange, mutual absorption and mutual recognition between medical and health institutions should be achieved.
Reminder: Nucleic acid testing is still the basis for confirming the diagnosis
It should be noted that nucleic acid testing is still the basis for confirming the diagnosis of new crown virus infection, and antigen detection as a supplementary means can be used for screening of specific populations, which is conducive to improving the ability of "early detection". Where primary level medical and health establishments have nucleic acid testing capabilities, nucleic acid testing shall be preferred; those that do not have nucleic acid testing capabilities may conduct antigen testing, and do a good job of medical personnel training and patient communication and guidance. Isolation observers and community residents conducting antigen testing shall carefully read the instructions and standardize operations, and once the antigen test is positive, they should immediately report to the relevant departments; when necessary, nucleic acid testing should be carried out to confirm.
Source: Medical community
Editor-in-charge: Zheng Huaju
Proofreader: Zang Hengjia
Plate making: Xue Jiao