Who can use them?
French pharmacies began selling Covid-19 self-tests after the government authorised their use in a decree published on April 11th, but only for over-15s as recommended by the Haute Autorité de Santé (HAS) national health body in its first opinion
On Monday, April 26th, HAS published a revised opinion stating that they should be allowed for children younger than 15 years old and be rolled out large-scale in schools in a bid to trace viral spread more efficiently.
These rapid testing kits, already in use in several European countries, are designed to detect whether or not a person is positive for the virus at the time of taking the test.
According to the government’s rules, only asymptomatic people should use these tests. Those who have been identified as a contact case should get a PCR-test or antigen test in a lab or pharmacy, not a self-test, even if they are asymptomatic.
What are self-tests?
Known as autotests (self-tests) in French, these tests are in reality antigen tests, those rapid nasal swab tests that most pharmacies offer.
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France has two types of nasal swab tests: PCR and antigen tests. Both check whether a person is positive for Covid-19 at the time of the test, but the PCR tests are subject to a higher accuracy requirement (minimum 98 percent) than the antigen tests (minimum 80 percent).
PCR tests have to be sent to a laboratory for analysis and the results generally come back within 48 hours. Antigen test results come back on the spot, generally within 30 minutes.
The new self-test kits are antigen tests, but with a shorter, more user-friendly Q-tip. However the process is the same, it’s a nasal swab followed by self-developing results strip – similar to a pregnancy test – and the results come back within 30 minutes.
Where can you buy them?
The French government confirmed to daily Le Parisien that some 1 million self-tests would arrive in around 6,000 pharmacies – a quarter of the total – from April 12th, and then increase in the coming weeks.
Initially the public health chief Jérôme Salomon said these tests would likely be approved for sale in supermarkets, but the government has scrapped that idea for the time being, saying a health professional needs to be present during the sale in order to correctly to explain their usage.
How do you use them?
As with the regular nasal swab tests, the self-tests are done by inserting a Q-tip into the nose – although not as far up as the traditional tests – and swiping it around.
HAS specifies that users should insert the Q-tip between 3 and 4cm into the nose and then rotate five times before removing.
After carefully extracting the Q-tip, mix it together with the liquid supplied in the test pack in the tube that comes with the kit.
After that, close the tube and press a few drops of the mixed liquid onto the cartridge in the kit, on the right hand side of the device, which is marked by a circle.
Similar to a pregnancy test, the device will then show either one strip (negative) or two strips (positive).
It may happen that no line appears. If so, the result is invalid and you have to take another test, the government manual instructs.
What to do if the result is positive?
If the tests turns out to be positive (two strips), you have to book a PCR-test appointment in order to confirm the result.
While awaiting your PCR-test, you should self-isolate and alert your contact cases that they have to get tested and self-isolate as well.
How much do they cost?
France is one of the only European countries to offer its inhabitants Covid tests that are free whatever the circumstances (symptomatic people, contact cases, pre-travel tests etc) and is currently doing around 4 million tests a week.
The self-tests, however, are not free, but capped at maximum €6 in pharmacies until May 15th, according to the Health Ministry decree.
After that date the price will drop down to €5.20.
Certain professional groups will be able to get the cost refunded via their social security, such as carers for elderly or disabled people. They must present an ID card and a proof of their professional status when purchasing the tests.
Schools will also stock up on these tests to increase checks of teachers and pupils.
Are self-tests valid for travel?
Self-tests are merely a supplement to the other tests, not a replacement. For international travel, countries generally require a negative PCR-test (France too – see the rules on travel in and out of France HERE).
However, if you have to travel to a different part of France without the possibility of taking a PCR-test, getting a self-test before departure is an option as a precautionary measure. It also gives extra peace of mind if you are visiting someone in a vulnerable group.
The idea of the self-test is simply to extend the testing mechanisms already in place, reaching out to more people who would not get tested otherwise and ramping up regular testing in exposed parts of society such as schools and the care sector.
How safe are the self-tests?
Several European countries practice self-testing, including the UK, Portugal, Germany and Austria.
But France has been hesitant, keen to ensure the self-test had high enough accuracy rate before rolling them out.
HAS said in its revised opinion that the latest data showed an accuracy rate of 81 percent in symptomatic patients and between 50 and 58 percent in asymptomatic people. That meant the self-tests met the 80 percent minimum rate required of regular antigen tests.
However, as with regular antigen tests, the HAS stressed that all positive results should be backed up by a PCR test. This is also the government’s rule.
Yet the scientific community is torn. Some have welcomed the idea as a great way of giving people easy access to Covid tests, pointing out that one of France’s main problems is that people who have the virus self-isolate too late.
“Better to take a test with an 80 percent performance rate with a fast, simple and ten times cheaper result than a PCR than a 100 percent reliable result in two days,” Xavier Guérin, vice president of Emmea-Innova Medical Group, told the French weekly Le Journal du Dimanche last week.
Others fear a “false sense of security”, like epidemiologist Yves Buisson, who told the daily Libération that a PCR test would be “necessary to confirm or debunk the result” the self-tests provided.
“The self-tests will undoubtedly make it possible to detect some positive cases but they will not be the weapon of our victory against this epidemic,” he said.