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WHO Public Health Laboratories Webinar #23 – Immunity & Seroprevalance of SARS-CoV-2 infections (EN)

This WHO webinar,  part of its Health Emergencies Programme, is a public health laboratory that focuses on immunity against SARS-CoV-2 infections and seroprevalence surveys.

WHO technical officer Dr Céline Barnadas and research scientist Dr Sheick Oumar Coulibaly  introduced panelists who spoke on the following topics:

  • WHO technical officer Dr Lorenzo Subissi presented an update on COVID-19 natural immunity.
  • WHO technical officer Dr Isabel Bergeri gave an overview on the global Unity Studies WHO has conducted in 97 countries. She discussed transmission dynamics, severity, risk factors and immunity/serological surveillance.
  • WHO South Sudan country preparedness and IHR (CPI) officer Dr Joseph Wamala spoke on seroprevalence of SARS-CoV-2 in Juba, South Sudan, 2020, highlighting the country’s experiences and lessons learnt.
  • Professor Dejan Bokonjić, of the University of East Sarajevo, Bosnia Herzegovina, spoke on the seroprevalence of COVD-19 infection of the population of the Republika Srpska area.

Translations of the September 2021 presentation are available in Arabic, French, Portuguese, Russian and Spanish.

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Update on WHO COVID-19 testing guidance and experiences integrating antigen RDTs with testing strategies and deploying the tests

This is an overview of World Health Organization training provided in 2021, with links.

The training touches on the importance of testing and how to prioritize who must be tested within available resources. 

Guidance includes prioritizing symptomatic patients, those who are high-risk owing to COVID-19 exposure and people with frequent exposure to possible COVID-19 cases.

It also links discussions on lessons learned from the field in Ghana and the Democratic Republic of Congo. In the DRC, a successful rollout of rapid antigen testing, for example, saw more people tested, with rapid tests, within 24 hours than were tested within 3 days with PCR tests.

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Key considerations for SARS-CoV-2 antigen RDT implementation

WHO and FIND have collaborated on a new online training course, Key considerations for SARS-CoV-2 antigen RDT implementation. 

This course is based on the ‘SARS-CoV-2 Antigen Detecting Rapid Diagnostic Tests, An implementation guide’, released in December 2020, and is complementary to the policy guidance issued by WHO. It provides an overview of the major elements that must be considered before, during and after the implementation of antigen-detecting rapid diagnostic tests, or antigen-RDTs, for SARS-CoV-2 in order to support the implementation of RDT testing across the diagnostic network. This course is aimed at laboratory stakeholders, notably those involved in planning at central level but also other health stakeholders as well as all relevant professionals tasked with the implementation of RDT testing, including ministries of health, donors, public and private organizations.

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The SARS-CoV-2 Antigen RDT Training Package

It is aimed at trainers and health workers who will be using the tests in the field in both the theoretical and practical components of rapid antigen testing.

This training package can be used for face-to-face or remote training.

This training does not intend to address the implementation of Antigen RDT testing across the diagnostic network.

The material is free to download.

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New online course: Implementation of SARS-CoV-2 antigen-detection rapid tests

To support the response to COVID-19 and appropriate use of diagnostics in particular, WHO developed interim guidance and technical briefs to assist policy-makers and laboratories on testing for the virus that causes COVID-19, including using SARS-CoV-2 Ag-RDTs. In addition, WHO developed training packages such as the  training package on SARS-CoV-2 Ag-RDTs, released in November 2020, in collaboration with WHO collaborating center, FIND. In addition, an online self-learning course ‘SARS-CoV-2 antigen rapid diagnostic testing’ was published on the OpenWHO training platform in July 2021.

Building on these key milestone releases, WHO and FIND are now making available an online learning course to help countries to strengthen the roll-out of Ag-RDTs. The course is based on the SARS-CoV-2 Ag-RDT implementation guide developed by WHO in partnership with global health stakeholders through the Access to COVID-19 Tools (ACT) Accelerator. The course provides an overview of the major elements that must be considered before, during and after the implementation of Ag-RDTs for SARS-CoV-2 in order to support the implementation of RDT testing across the diagnostic network

The course has been launched in English on Monday 31st January 2022 and is freely available to all interested via the OpenWHO platform.  It is hoped that this course will facilitate the roll out of Ag-RDTs by national level implementors.

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ECOVAM/ECOVAN – Improving Covid-19 screening with antigenic tests

A project to implement a COVID-19 testing strategy using rapid antigen tests was implemented in Niger and Mali in July 2021. 

This was after it became clear that case numbers were vastly underestimated. 

Background

In Mali and Niger, seroprevalence studies showed that the number of COVID-19 cases in the region was underestimated because many people were asymptomatic or showing very few symptoms.

Both countries also had very limited screening capacity, and insufficient triage to allow for efficient screening. 

PCR-testing (the gold standard for testing, but only available where there are laboratory facilities) was only available to a few facilities. 

But rapid antigen tests have provided an opportunity for health workers to detect, isolate and manage COVID-19 cases.

New project

The ECOVAM – ECOVAN project implemented a screening strategy using rapid antigen testing for patients at different levels of healthcare. 

It also evaluated the cost-effectiveness and acceptability of this screening strategy among patients, caregivers, and government decision makers. 

The project was launched in Mali and Niger and started with the procurement of 10 000 antigen tests funded by FIND.

It will evaluate the capacity of healthcare workers to perform rapid antigen tests and also use the data generated by the tests to provide information to the respective governments to make a decision on integrating antigen testing into their national COVID-19 strategies.

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Testing for COVID-19 using antigen rapid diagnostic tests (Ag RDTs) in Ethiopia

FIND is working closely with the Ethiopian Public Health Institute and other ACT-Accelerator partners to make access to quality, affordable COVID-19 rapid tests a reality.

This video illustrates the value of rapid testing to strengthen national COVID-19 responses through decentralized, community-based testing approaches.

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Current testing tools uncompromised by new COVID-19 variant of concern Omicron (B.1.1.529)

Available diagnostics do pick up Omicron infections

In November 2021 a new variant of the SARS-CoV-2 virus was identified. 

The World Health Organization declared it a variant of concern, especially as it is more transmissible than the variants that preceded it. 

There were initial concerns that Omicron would also evade testing, as some PCR tests did not pick up the virus because it had a deletion in one of its genes. 

However, the other PCR gene targets were still identified. 

At the time FIND conducted a rapid assessment of available evidence and also confirmed that rapid antigen tests would still pick up an Omicron infection. 

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New FIND partnerships make COVID-19 rapid tests available to refugees and internally displaced people in the Middle East

In March 2022, FIND announced two new partnerships with the International Organization for Migration (IOM) and the International Rescue Committee (IRC) to implement rapid antigen testing among vulnerable groups in the Middle East.

Rapid antigen tests detect a protein that is produced by the body in response to infection with SARS-CoV-2. 

It is a low cost tool that produces fast results in low-resource settings, but access to these tests has been limited in some parts of the world.

In areas such as the Middle East, for example, there has been considerable displacement due to conflict and humanitarian emergencies .

The Syrian crisis has forced 6.9 million people from their homes within the country and created 5.7 million refugees in the wider region. This fragile situation was compounded by the COVID-19 pandemic and  a shortage of testing capacity in an already vulnerable community of refugees and displaced people.

Access to rapid antigen tests was urgently needed.

The new partnership deployed 100,000 COVID-19 rapid antigen tests to Iraq, Jordan, Lebanon and northern Syria. 

The project will build local capacity to use the tests effectively and train healthcare workers, and also aims to develop testing algorithms.

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FIND and Unitaid invest US$ 50 million to speed lifesaving testing and treatment solutions to the COVID-19 pandemic’s frontlines

To strengthen the frontline response against COVID-19 in several low- and middle-income countries, FIND and Unitaid made grants available in November 2021 to enhance testing and treatment. 

The grants aimed to contain the ongoing spread of the SARS-CoV-2 virus, improve access to diagnostic tests and treatment and build capacity for programmes to test, trace and isolate patients with COVID-19. 

The grants also addressed access inequality to tests and treatment and targeted countries in Africa, Southeast Asia, Latin America and the Western Pacific, where testing capacity was insufficient and life-saving treatments were practically unavailable. 

Another aim of the grants is to generate evidence to strengthen World Health Organization (WHO) policies and guidelines. 

The grants will generate high-quality evidence to inform  WHO  guidelines and national policies addressing the optimal approaches to scaling new testing and treatment solutions.

The importance of combining testing and treating was underscored by the development of new oral antivirals, such as molnupiravir, as these are simple to use and deliver to healthcare settings, and less expensive to produce. Developing this strong link is essential when effective medication becomes available. 

The grants will use existing laboratory and testing networks to offer additional testing options, such as simple, accurate, and affordable antigen-detection rapid diagnostic tests (Ag RDTs) and COVID-19 self-tests.