U-turn on Covid testing in pharmacies: Health minister 'open to discussion'

SPAIN'S health minister has relented in his refusal to consider testing for Covid-19 in high-street pharmacies, and is now open to considering doing to – especially after the European Union recommended mass antigen testing and training staff to be able to perform them.

Although a PCR test is the 'gold star', according to Brussels, an antigen test is much quicker and can detect the presence of the SARS-CoV-2 virus in the organism within 10 to 15 minutes, is highly effective and could be extremely useful in the event of outbreaks in 'cluster' organisations such as hospitals, schools, workplaces and care homes where a handful of people are known positives and all others have to be checked to ensure they are clear before they can come out of quarantine.

A petition on Change.org started by a pharmaceutical worker says Spain has around 22,000 high-street chemists', typically several in every town and with opening hours that cover a 12-hour period at least, whilst not every town even has a GP surgery and the larger municipalities, which do, may only have one or two in total, sometimes only open until lunchtime.

This means pharmacies have the time and resources to carry out mass tests without encroaching on valuable health service hours, which are stretched at present due to dealing with the Covid crisis on top of the public's usual medical issues – and the pending 'flu season.

Pharmacists in the Greater Madrid region, one of the most densely-populated in Spain, have said if one's local chemist's is allowed to carry out tests, 'the whole of the region could have one within 10 days'.

One of the downsides to an antigen test, as opposed to a PCR, is that its reliability reduces a week after Covid symptoms start to appear, and does not give enough information to allow for a correct clinical monitoring and intervention if a positive result is given.

But it has a sensitivity rating of 93%-plus and is over 99% specific – the highest possible – meaning it is very unlikely anyone will get a false positive or, worse, a false negative.

Antigen tests could be useful for those who want to 'prove they are negative' – who have no symptoms and do not believe they have caught the virus, but want to reassure friends and family members before meeting up.

They can also detect the virus in asymptomatic people who believe they may have been in contact with an infected person.

And their greatest asset is their price: Unlike a PCR, which is only free of charge via the public health service for those with symptoms or known contacts, and costs in region of €100 at a private clinic, an antigen test costs around €4.50 – a price which most of the population would be able and willing to pay in exchange for peace of mind.

This, of course, only means they are not infected at the moment of the test, but in theory, a person could pay for a test whenever they wanted, even every day if enough were available, enabling them to more or less get on with their lives as long as they took the usual social distancing and mask-wearing precautions. 

Madrid had already arranged, at the end of last month, to buy antigen tests for a total sum of €22.5 million from the laboratory Abbott Rapid Diagnostics Healthcare.

Health minister for Spain, Salvador Illa, is said to be working on 'detailed planning' with regional governments to ensure pharmacy staff are trained in antigen test use and given full guidelines as to when they should be employed.

Brussels, which recommends mass antigen testing of the general population, with or without symptoms, has said antigen tests – which take a matter of seconds and follow the same procedure as a PCR test – should be used where diagnosis backlogs are likely.

Although PCR results typically come through within 24 to 36 hours, where test needs are widespread and carried out by the public health service, they can take longer, meaning more working hours lost and general inconvenience and worry for those forced to maintain quarantine until they get the all-clear.

A straw poll in Spanish media site 20minutos has revealed that 75% of readers are in favour of antigen tests being conducted in high-street chemists'.