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WHO interim guidance: antigen-detection in the diagnosis of SARS-CoV-2 infection

This is an interim guidance published by the World Health Organization on how to select rapid antigen tests and when and where to use them.

Rapid antigen tests for SARS-CoV-2 are less expensive and faster. They should be used for primary case detection in symptomatic individuals and asymptomatic individuals who are at high risk of COVID-19, such as health workers. 

The tests should also be used for contact tracing, conducting outbreak investigations, and to monitor trends of disease incidence in communities. 

There are some variations in test performance, but these tests are very much suitable in track, trace, and isolate programmes aimed at interrupting community transmission.

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WHO interim guidance: Recommendations for national SARS-CoV-2 testing strategies and diagnostic capacities

In June 2021, the World Health Organization issued recommendations for SARS-CoV-2 national testing strategies.

At the time, the deadly Delta variant was the dominant variant globally.

WHO recommendations highlight the importance of diagnostic testing for SARS-CoV-2 as a critical component for both preventing the spread of the virus and controlling outbreaks. 

It advised that countries should have testing strategies in place that are context specific and that testing must be connected to other public health strategies like tracking, tracing, and treatment.

WHO’s list of who should be tested

  • Everyone with symptoms meeting the case definition for COVID-19, regardless of vaccination status or prior infection. 
  • Symptomatic individuals must be tested first and if there are not enough tests, those who are at high risk of severe disease must be tested first. 
  • Others for whom testing must be prioritized include health workers, hospitalized patients, and those who first showed symptoms in congregate settings.

Asymptomatic individuals should be tested if they were in close contact with  patients with a confirmed SARS-CoV-2 infection, health workers or long-term care workers.

What tests must be used?

PCR tests remain the gold standard. 

High-quality antigen tests can be used to scale up testing programmes fast.

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SARS-CoV-2 antigen-detecting rapid diagnostic tests: An implementation guide

This guide, produced by FIND and the World Health Organization, provides information on implementing diagnostic programs using rapid antigen tests. 

It shows how rapid antigen testing can be implemented to support individual case management, contact tracing, surveillance and outbreak investigations.

The guide stresses the use of strict testing protocols and clear communication, and the need to protect healthcare workers against transmission. 

It outlines the different types of available testing  and where rapid antigen testing fits in. Rapid antigen tests are used to find a protein the body produces in response to an infection with the SARS-CoV-2 virus.

It produces fast results and is easy to use in low-resource settings where laboratories are unavailable. 

The guide provides step-by-step instructions on the use of these tests and how best to communicate and follow up on patients after a test result is obtained. 

It also explains the best practice of testing within 5 to 7 days of the onset of symptoms. 

While rapid tests are easy to use in most instances, the guide lists where they should not be used. 

This includes testing patients without symptoms unless they are a close contact of a confirmed case; where there are no appropriate infection control measures in place; where test results will not influence the treatment of the patients and for screening at points of entry.

The use of rapid antigen tests is also not advised  prior to elective surgery or blood donation.

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Global genomic surveillance strategy for pathogens with pandemic and epidemic potential, 2022–2032

Looking at the decade 2022-2032, WHO presents a global genomic surveillance strategy for pathogens with pandemic and epidemic potential.

The goal is to strengthen and scale surveillance of these pathogens to enable quality, timely and appropriate public health actions across local to global surveillance systems.

WHO’s strategy outlines five objectives with accompanying actions that need implementation plans.

It also highlights considerations to build global genomic surveillance over the next 10 years, as well as monitoring and evaluation mechanisms.

The report includes two annexes:

  • Strategy development and stakeholder engagement
  • Key WHO assets for the strategy.

Read report here

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Genomic sequencing of SARS-CoV-2: a guide to implementation for maximum impact on public health, 8 January 2021

WHO released its publication, Genomic sequencing of SARS-CoV-2: a guide to implementation for maximum impact on public health, on 8 January 2021.

As the genomes of SARS-CoV-2 are able to be sequenced almost within real time, this enables increased speed to inform public health responses.

This has led to more laboratories investing in viral genome sequencing. Before starting such a programme, however, the intended goals of sequencing must be understood and a strategy for analysis in place, as well as a plan for how findings will be used.

Decisions about sequencing goals should be made in a multidisciplinary framework that includes representatives of all stakeholders. Funding sources must also be identified, and ethical aspects evaluated.

To maximize public health impact, usable and timely results need to be produced and communicated.

This document, available in English and Portuguese, provides this type of guidance for laboratories on maximizing the impact of SARS-CoV-2 sequencing activities now and in the future.

Read the guide here

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The Global Fund Quality Assurance Policy for Diagnostic Products

Implementers of Global Fund-supported programs must ensure the diagnostic products they purchase meet our partnership’s quality standards.

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