Testing change cuts off PCR access to symptomatic close contacts

After his partner tested positive for COVID-19 a fortnight ago, Matt Nevett began experiencing symptoms. He did a rapid antigen test, which came back negative. But before he returned to work, he wanted to have a PCR test – just to be sure.

Matt Nevett was turned away from a PCR testing site even though he was a close COVID-19 contact and had symptoms.Credit:

He went to Cohealth, a testing site in Collingwood, but was turned away because he didn’t fit the new eligibility criteria.

“Once I said that I’ve tested negative on RAT, they said: ‘Oh, no, we’re not doing PCRs for you any more, the rules changed on July 1’,” he said.

“I said to them, that when I had COVID earlier in the year, I tested negative on the RATs, but I was positive on my PCRs, and they said it doesn’t matter.”

Nevett was handed a few rapid tests to take home, and was not told to isolate. He said he was the only person lining up for a test at the facility.

“It’s frustrating,” he said. “Why would I not be able to get a PCR? There’s no real answer.”

The Sunday Age has been told of five symptomatic close contacts of people with COVID-19, each who returned negative rapid tests before trying to get a PCR test to confirm their diagnosis, but were turned away at a testing site recently.

The scenario has raised concerns among public health experts, who question the quality of testing in Victoria as the state confronts yet another Omicron wave, fuelled by subvariant BA.5. On Saturday, 820 people were admitted to hospital with the virus.

Victoria tightened its testing eligibility criteria on July 1, restricting PCR access to clinically vulnerable people, those in an at-risk group, or other “specific circumstances” like being a household contact without access to a rapid antigen test or being due for surgery.

It means people who are symptomatic and testing negative on rapid tests, including those who are close contacts, are unable to access a PCR.

The Victorian government is continuing to back rapid tests as the “preferred means” for testing most Victorians, even though experts say they are only accurate 60 per cent of the time when used on people who are infected with the new Omicron subvariant.

Those presenting to a testing facility who want a PCR, but do not fit the criteria, must have their case approved by a clinician.

Head of Monash University’s epidemiological unit, James Trauer, said providing accurate testing to those at high risk of COVID-19 should remain a constant – even if the virus had become endemic and health authorities were less focused on reducing transmission.

Ensuring symptomatic people were being tested accurately was a higher priority than asking asymptomatic people to wear face masks, he said.

“I guess we can pull back on a few things, but that’s really the last thing to fall back on,” he said. “We do need to be doing PCRs broadly on people who have symptoms in particular because while there are a lot of asymptomatic cases, symptoms is one of the clearest indications that you might have COVID.”

James Trauer says accurate testing of those at high risk of COVID-19 should remain.Credit: Scott McNaughton

Australian Medical Association vice president Chris Moy said rapid tests had a high fail rate, especially early in the infection, with the US Food and Drug Administration putting the test’s sensitivity rate at 60 per cent for the new Omicron subvariant.

Delaying access to accurate testing would hamper attempts to curb the spread of the outbreak, especially if symptomatic close contacts who were testing negative on a rapid test were not being instructed to isolate, he said.

It would also make it more difficult for eligible people to access antiviral medication within the five-day timeframe, he warned.

Deakin University’s epidemiology chair, Catherine Bennett, said she didn’t think it was necessary for PCRs to be available to all symptomatic people, arguing two rapid tests spread over a few days should provide an accurate result.

But Bennett said the limitation on PCRs was a concern if it meant someone sick with the virus couldn’t access the $750 COVID-19 pandemic leave payment because they were ineligible for a PCR and had tested negative on rapid tests.

While clinicians deployed to testing facilities can ultimately decide whether a person should get a PCR, Dr Mukesh Haikerwal, head of the Altona North Respiratory Clinic, said there was no clear advice on when it was appropriate to make this call. Doctors receive official warnings from the federal government if they inappropriately authorise Medicare-funded PCR tests, he said.

PCR testing eligibility was tightened during the summer Omicron wave to manage queues at testing sites and long waiting times for results.

A Victorian government spokesman said symptomatic Victorians could access PCRs if this was deemed appropriate by the clinician on-site.

On Sunday, the state government will announce that Victorians with disabilities will get 20 free rapid antigen tests per visit, from state-run testing sites and from Disability Liaison Officers, until the end of September.

The free rapid tests program, announced in April, was initially to run for three months. But with case numbers and deaths continuing to rise, it has been extended following a review.

“Early detection of COVID-19 helps protect people from serious illness by ensuring earlier diagnosis and treatment – and this is especially so for the most vulnerable in our community,” Disability Minister Colin Brooks said.

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