South Africa rolls out rapid antigen tests for SARS-CoV-2 detection at all ports of entry!

The Government of South Africa yesterday (08 October 2020) announced that rapid antigen tests for SARS-CoV-2 detection will be rolled out at all ports of entry in the country with immediate effect. Rapid antigen tests (different from antibody tests) are immunoassays that detect the presence of a specific viral antigen, which implies current viral infection. Results of antigen tests are typically available within 15 minutes – as opposed to the roughly 48-hour turnaround time for polymerise chain reaction (PCR) tests. The cost for a rapid antigen test is R150-R170, while a PCR test usually costs R850. Please note that the cost of the antigen test has to be paid by the traveller and not South Africa or their country of origin. Also note that PCR tests have a much higher sensitivity and specificity than rapid antigen tests. The purpose of the rollout of rapid antigen tests for SARS-CoV-2 detection is to effect the provisions of the level one travel regulations, which stipulate that all travellers that arrive at a South African port of entry without a certified negative SARS-CoV-2 PCR test result (not older than 72 hours) must be tested at the point of entry before entering the country.

In the event of a traveler arriving at a port of entry without a certified negative PCR test, this shall be the procedure:

• The traveller will be screened for signs and symptoms on arrival
• Upon failure to produce a certified polymerise chain reaction (PCR) test result, the traveller will be directed to a testing facility at the port of entry
• A staff member from National Health Laboratory Service (NHLS) will collect the samples and conduct the test immediately
• The cost shall be borne by the traveller and the NHLS shall be remunerated upon testing. Travellers must be prepared to pay out of pocket (approximately R150 - R170) and claim the fees from their health insurance service provider (pending the relevant insurance agreement)
• If the traveller tests negative, he/ she will be allowed to proceed through the port of entry provided they have been cleared of red flags at the screening phase
• If the traveller tests positive he/ she will be required to quarantine at a facility designated by that particular port of entry. They will not be permitted to travel across provinces. Contacts of a traveller testing positive at the point of entry, including those who were in proximity of the traveller within the conveyance, will also be tracked and traced.
• Travellers who arrive without a certified PCR test and who refuse to test at the port of entry will not be permitted entry into South Africa and will be required to quarantine at a designated facility [src.]
  

The World Health Organisation (WHO) has recently approved the use of rapid antigen tests as a point of care diagnostic for COVID-19 for screening and surveillance tool in the community where a rapid result is required at low cost. Rapid antigen tests have been commonly used in the diagnosis of respiratory pathogens, including influenza viruses and respiratory syncytial virus (RSV).