Test like Denmark? Portugal needs to test more than a lot well (and quickly) coronavirus

“A strong and aggressive response” when testing: this was Denmark’s strategy, which epidemiologist Manuel Carmo Gomes said should serve as a model for Portugal. During the meeting on Tuesday at Infarmed headquarters in Lisbon, the expert believed that testing is the “main weapon” in combating Covid-19 (as opposed to restriction) and that Portugal is behind the pandemic on this matter.

The fact is that the number of tests has increased steadily since the beginning of the pandemic, and the peak is around Christmas. On December 23, 59,249 tests were carried out in the country, which translates to a seven-day average of 4.05 tests per thousand residents. In January it was even above the average of five tests per thousand inhabitants.

Denmark, for its part, is one of the countries with the highest test rate per thousand inhabitants. As in Portugal, the tests also peaked at Christmas, albeit on a much larger scale: on December 22nd, 23.71 tests were carried out on an average of seven days by thousands of residents – a much higher number than in Portugal.

That peak came just days after the Nordic country saw a surge in new cases of 610.94 per million people on December 18. This increase dictated a stronger pulse during the holidays, with special measures to restrict it to Christmas: most shops closed, as did schools. Family gatherings were allowed, but with a maximum of ten people at the table, as long as it was possible to keep their distance.

The test criteria can also help explain the high number of tests in the country: for example, a person who has had high-risk exposure (that is, someone who tested positive before symptoms appeared) should do a standard test you twice. In most cases, the first test takes place four days after exposure to risk; The second, two days after the first, is read regardless of the result in the documents of the Danish Health Authority (corresponds to the Portuguese General Directorate for Health).

In certain cases (where there is constant contact with an infected person, such as someone living in isolation) the same person may be tested three times. The first test takes place “as soon as possible”, the second “four days after contact with the infected person” and the third “two days after the second test” – always maintaining isolation.

“Quite a Waste”

Is that the best strategy? In the Portuguese case, “balance” and “efficiency” must be prioritized. According to Elisabete Ramos, President of the Portuguese Association for Epidemiology and researcher at the Institute of Public Health of the University of Porto (ISPUP), the high number of tests in Denmark can be reduced by the “policy of free testing without the need for a prescription” Land has applied – a measure can be used to “diagnose earlier” but has the disadvantage of having “a lot of waste” and having to do a lot of testing on people who may not necessarily be those who tested the most had to be.

“The logic is to be tested, but with rationality,” he says. It is the line that Portugal, as a “country that cannot waste resources”, must and must follow. And so far nothing has gone wrong: “Worldwide we are among the countries that test the most” per million inhabitants in Europe, says the expert.

On the other hand, it is important not to forget that the number of tests is always linked to the epidemic curve of each country: “Whenever the cases increase, the tests will increase because they correspond to the tests that follow the epidemiological screening”.

Carlos Martins, doctor and researcher at Porto Medical School, points out that Denmark “was one of the first countries to discover the new variant of the United Kingdom” and achieved it as early as December, a “remarkable” result to achieve. Answer from the perspective of “speed of action and organization of the reaction”.

“In this phase he distanced himself very much from most countries,” such as Portugal, which went “the opposite way”. “We heard about the new variant in December. We already had data that this new variant had the potential to increase Rt (Portability Index) and instead of taking action we decided to “open” Christmas, he illustrates.

Accessible tests and greater fluidity of procedures

What lessons can Portugal learn from the Danish strategy? Not only do you need to test a lot, you also need to test well – but preferably test quickly. At this point Carlos Martins repeats an old mantra: “In order to be able to fight this pandemic effectively, we have to identify infected people very quickly in order to isolate them, track contacts and block the chains of transmission. There is no going back. It has to work, ”he says. To achieve this, it is important to facilitate access to the test, which must be done as quickly as possible – preferably by implementing a system that makes it “very economical” or even “free”.

In the opinion of this doctor, “it can make sense” to test asymptomatic people in a school context or in factories, for example, as recommended by the new DGS standard announced this Wednesday, but as long as this does not serve as a motto Relax.

Elisabete Ramos, on the other hand, believes that in addition to implementing new measures, there is the potential to “improve some of the procedures we have on the ground”. “There is no single measure that is the solution to all of this,” he says. We need to test quickly and efficiently in order to “make all tests profitable”.

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