Albany GP reacts to WA’s ban on finger-prick COVID-19 because of potential for “false negatives”

The State Government has banned the use of finger-prick COVID-19 tests as a diagnostic tool in WA because of the potential for “false negatives”. However Dr James Turner from Pioneer Health Albany, which has ordered 1500 of the finger-prick tests, says the conventional “swab” tests also have a margin of error. Federal Health Minister Greg Hunt announced last week that the “point-of-care” finger-prick testing kits had been approved and would be rolled out to GP clinics across Australia. The typical testing method involves a swab of mucus and saliva which is tested in a lab for COVID-19’s genomic sequence. A serological finger-prick tests determine whether the patient has COVID-19 antibodies, with results available within about 15 minutes. But the WA Health Department has moved to ban the use of the finger-prick tests as a diagnostic tool because of the possibility that a person could not yet have produced antibodies in the early days of infection. The prohibition on the serology tests, which came into effect across WA today under the Public Health Act, was signed off by Dr Clare Huppatz. “The purpose of these directions is to prohibit a person from using a point of care serological test as an acute illness diagnostic tool for COVID-19, as their use may adversely affect the prevention, control and abatement of the serious public health risk present by COVID-19,” the prohibition direction says. “Unless otherwise directed under the Act, a person must not use a POC Test as a tool to detect or diagnose COVID-19.” Health Minister Roger Cook told Parliament this afternoon blood-based tests only checked for antibodies, which take time to build up in people infected with COVID-19. “One of the great evils of this particular virus is that someone can carry the disease for up to five or six days without having produced any antibodies,” Mr Cook said. “So what this test kits does is potentially provide false negatives, that is provide someone with a false sense of security that they do not have the virus and then they go about their life but they are highly infectious and they continue to spread the disease.” Any individual who breaches the prohibition could face fines of up to $20,000, while businesses would face fines of up to $100,000. Earlier this week, Pioneer Health Albany opened a drive-through COVID-19 testing clinic — the first in WA — that relies on blood-based tests. Mr Cook said the kits used by PathWest as part of the Health Department’s testing regime were the “rolled gold standard”, particularly for detecting COVID-19 early on in the progression of the illness. Pioneer Health Albany, which is running a drive-through COVID-19 testing clinic, expects to receive the 1500 finger-prick testing kits this month. Dr Turner said they would comply with the State Government’s prohibition on using the tests as a diagnostic tool. However he said every testing method had its limitations, including the “PCR” swab tests, which he said could also produce false negatives. He said it was his understanding that the swab tests were about 80 per cent sensitive. He had concerns about one particular patient in Albany who had returned two negative swab tests despite a suspicious illness and recent high-risk travel. While the finger-prick tests only detected antibodies, and therefore could miss an early-stage infection, he believed they still had a role to play. Once the patient had started producing antibodies in response to the initial infection, he understood the tests were quite sensitive. “At this stage in the pandemic we need to be testing a lot of people,” Dr Turner said. “We had 20 people come through today (for testing) who would not have met the criteria yesterday.”