Twenty coronavirus self-diagnosis tests have been sold by Amaia, from the Beaskoa-Amezaga pharmacy, in the town of Etxebarri (Bizkaia), in just one morning. “There has been more demand than expected,” he acknowledges. Other pharmacists visited attribute this interest to the media exposure that the subject has had and believe rather that, after the first moment of enthusiasm, the tests will end up remaining in their drawers.
From this Wednesday you can buy these tests that you do yourself without a prescription, a demand for months from the pharmaceutical community and some autonomous communities to which the Government has finally agreed. With the publication of this royal decree in the Official State Gazette (BOE) this Wednesday, July 21, the pharmacies will join the National Health System in its work to support the early detection of citizens.
“It is a very simple procedure, similar to that of pregnancy tests,” explain the pharmacists. Once the battle to sell without a prescription has been won – although much later than they would have liked – the following is already beginning: to ensure that the results of these self-tests have official validity to count the positives, something that the Government refuses in principle .
The General Council of Pharmacists considers that this measure facilitates access to tests and makes them safe. And they influence that “one more step” must be taken, according to Jesús Aguilar, president of the organization. “We are working with the Ministry and the autonomous communities so that the pharmacist can incorporate the results into the epidemiological surveillance system to increase the effectiveness of early detection,” adds Aguilar. With the new announcement by the Government for these products, on the one hand “the healthcare pressure on health centers will be reduced to a certain extent”, but it will also contribute to the “rapid identification of suspected positive cases.”
“I would not trust the dexterity of people”
The problem that some pharmacists see is that, despite the fact that the way to use the self-diagnostic tests is “very simple”, as Pedro, an apothecary from Madrid explains, not all professionals are clear that it will be something simple for everyone. world. “I believe that it is not bad that each one can have proof of whether they are infected or not, but I would not trust much of the skill of people when it comes to doing it,” says Elvira, head of pharmacy in Madrid, who considers that it can be a bit more complicated with older people, especially when it comes to “inserting the swab well”.
The method of use is, on paper, simple. The person who wants to undergo the test must take the swab –the cotton swab–, insert it into the nostril until the end, move from left to right and repeat the process in the other hole. Then, the utensil should be placed in the serum cylinder, and finally this liquid on a plate. Then, the first control line will come out and we will have to wait for the second one to come out. If it comes out and there are both lines, it means that the result is positive. “The basis is the same as that of the pregnancy test, although the sample is a bit more complicated to take,” clarifies Pedro, an apothecary in Madrid, who still does not have the tests in the pharmacy. All this procedure must be explained to the clients who are going to buy the tests in order to favor the “supervision and accompaniment” of the citizen that Jesús Aguilar speaks of, the pharmacists consulted agree.
“Nobody does it to isolate themselves”
The Government takes these difficulties into account, so for the moment it rejects that the results of the tests have official validity. Just as true is that he also opposed the sale without a prescription of these tests (he said then that they were not reliable and now they are) until he approved it. In any case, the Government spokesperson, Isabel Rodríguez, insisted after the Council of Ministers on July 20 that if it tests positive, they must go to the Health System to confirm it, so that it counts for the total calculation.
Pharmacists like Pedro explain that, according to their experience, people do not use them exactly to know if they are infected and consequently to isolate themselves as indicated by the protocol. “If it is positive, you have to isolate yourself and go immediately to the outpatient clinic to be certified and followed up,” he explains. “I wish it were like that, but the cases I have had go the other way,” he says from the other side of the screen of the counter. “The people who come to ask me want it to visit their parents or relatives, nobody thinks to do it to isolate themselves,” he continues.
The same thing happens in the Aurora González Calvo pharmacy, in Etxebarri (Bizkaia), where “for a couple of days customers have come in to ask about the tests constantly”. In their case, most are fathers and mothers between 55 and 60 years old “who come because their children have been in contact with a positive” or people in their 30s or 40s who plan to visit their relatives of legal age and “want to do it safely. ” They are concerned that not all tests are carried out correctly, as each person has to collect their own sample, and that is why they remind their customers at each purchase that “they have to follow the instructions written on the box to the letter.”
Other pharmacists, such as Pilar, from Madrid, also point out that these products act on the viral load, so if it is low, the test may be negative, and “it does not mean that you can be calm. First, because you may have taken it later, and secondly, because there may be false negatives, especially in vaccinated and asymptomatic patients, such as young people, “emphasizes the professional, who has not sold any test for now.
In Vitoria, in a pharmacy in the Adurza neighborhood, they have several drawers filled with the new self-diagnoses and an advertising sign on the door. There are individual ones but also in packages of three and five. They also sell serologies at 25 euros. The only concern of the apothecaries is that the population knows the limits of this product: it is not an official test – it is not homologated for travel, for example – and you have to be careful when taking samples to be conclusive.
In the same vein as the Basque pharmaceutical companies, in Madrid, Valentín indicates that reliability increases from the fifth day of illness, as he has more antibodies, but “if it is negative, it is not valid either to enter a disco, or to go on a trip It has no legal validity, it only serves to reassure the person and isolate, if positive. It is not a certificate of being healthy, “the apothecary says.
“It is a good measure”
At Etxebarri, the pharmacist Amaia trusts that with the packs of five they have bought “it will be enough for the rest of the week” after the success of the first day. Most of the people who have approached your pharmacy are between 30 and 40 years old, although “for days” there has been a constant trickle of people of all ages asking if the tests had already arrived and when they would be able to to buy. “It is important that they can come here, buy the test and do it at home. It involves a small screening in the town population, without having to wait, queue or saturate the primary care services,” says Amaia, adding that “it is a good measure. ”
As happens to her colleagues in the profession, at Pilar’s establishment in Madrid they have also asked a lot about tests these days. She, like Valentin, attributes it to the fact that people are listening to it and seeing it in the media, which generates a “boom“Initial demand, especially in view of the summer trips.” I think we will stay with many of them here in the pharmacy, “adds the worker from Madrid with laughter.
“It will happen the same as with the masks, to see who has the cheapest test,” says Elvira from the counter of her pharmacy in Madrid. Although the price of these products, which will be exempt from VAT and covered by Social Security, is still unknown, there are already different estimates, such as that of the company Rypo, which estimates that it will be between three and seven euros.
In a fifth wave epidemiological context of COVID-19, in vitro diagnostics can help control the disease even if there has not been close contact with a positive person, especially in young people, “if they have been to a party with positive cases or in a bar. For the price you have, you stay calm “, concludes Pilar.