Questions Raised About Test Efficiency As COVID-19 Slips Through the Cracks
Questions Raised About Test Efficiency As COVID-19 Slips Through the Cracks
  • Son Go-eun
  • 승인 2022.04.17 20:09
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▲ People waiting to be tested for COVID-19 (source= www.news1.kr)
▲ People waiting to be tested for COVID-19 (source= www.news1.kr)

I'm worried that I'll get infected while waiting for the test.

 A person is waiting to be tested for COVID-19. Fortunately, the person tested negative, but the people in front of and behind him in the queue tested positive. In the crowd waiting to be examined, the person is at risk of infection at the place the person went to check for presence or absence of infection. As of March 16, the number of daily confirmed cases reached about 620,000 as the spread of Omicron has increased rapidly. Compared to the fact that hundreds of people were infected during the “groundless suspicions” (신천지) mass infection period, which caused great confusion in society at that time, the current figure is enormous. Therefore, the COVID-19 test rate has also soared, causing many people to be confused about the inspection system. 


▲ (source= yna.co.kr)
▲ (source= yna.co.kr)

 The government has reorganized the COVID-19 test system since February 3. The main goal is to focus on Rapid Antigen Detection Test (RADT) and drastically reduce the number of existing Polymerase Chain Reaction (PCR) test showing limitations of amount of inspection as the number of subjects to be tested rapidly increases due to a surge in Omicron confirmed patients. RADT is divided into a specialist kit for hospital and for home. The test method for checking the presence or absence of antigenic protein of the virus is the same, but the sample collection areas and cotton swab length are different. If RADT is positive, an additional PCR test must be taken for a positive result to be finally confirmed.

 According to the Central Disease Control Headquarters (CDCH), far more than 300,000 RADTs are currently conducted every day, which are received at screening clinics, local hospitals, and clinics or conducted by individuals themselves. The rate at which RADT is positive was finally determined to be positive in PCR was 78%. Eight out of ten people have been confirmed, which is highly accurate. According to the CDCH evaluation, "In response to Omicron variant, we introduced RADT so that the public can be sufficiently tested while focusing on high-risk groups such as the elderly aged 60 who need early diagnosis and treatment. Finally, it contributed to the discovering of infected people."

 However, as more and more people raise questions about the accuracy of RADT, complaints about RADT, which lose credibility, are also growing. RADT products (kits) have been approved as "*Sensitivity 90% and *Specificity 99%" in regulated laboratory environments. However, in an unregulated environment, the sensitivity is significantly lowered, and infected people are more likely to be missed. Since RADT results can be obtained in 15 minutes, the accuracy is inevitably lower than that of  PCR, which takes 6 hours for the test results. This false negative result poses a risk of the infected person walking around the community without being isolated.


*Sensitivity 90%: 90% of people who resulted positive for PCR tested positive for RADT.

*Specificity 99%: 99% of people who resulted negative for PCR also did for RADT.



 More than 300,000 RADTs are conducted each day, but there are no accurate false-negative cases. This is because it is not possible to confirm the possibility at the test site that "negative" will be "positive" as a result of the test. Instead, the authorities said that the negative test of the RADT was likely to be treated as the final negative. However, since most of RADTs are currently negative, even if only 1% of fake negative judgments are found here, the figure is not small.

 Nevertheless, the reason why the government has no choice but to endure the false-negative problem is that PCR testing capabilities has virtually reached its limit. As the demand for PCR tests exceeds its current capability, there are cases in which the results are delivered only after two to three days, depending on the region. Compared to the only 20,000 cases in the early days of the COVID-19 outbreak in 2020, 850,000 PCR tests, the current maximum capacity, are also the result of steadily growing capabilities over two years. Due to the significant increase in the number of confirmed patients, the number of tests and the treatments of confirmed patients are creating great difficulties for public health workers.

 As PCR tests, the first step in diagnosing COVID-19, have been delayed, quarantine authorities prepared measures to recognize "RADT for experts" as a final means of confirmation. Lee Ki-il, a controller of CDCH, said, "For a month starting from March, if PCR and symptomatic patients are tested positive on "RADT for experts", they will be considered positive under the judgment of the doctor and managed the same as positive PCR test." It is expected that the improvement of the system will reduce the waiting time for PCR tests and prevent delays in patient management due to administrative procedures, enabling early treatment and rapid management of confirmed patients.

 In this situation, the Ministry of Education expanded the implementation of face-to-face classes to address learning deficits in the third year of COVID-19 pandemic. However, The Catholic University of Korea (CUK) students are complaining that they are confused because non-face-to-face classes and methods vary from class to class. In addition, confirmed students who are inevitably self-quarantined are infringed in their right to education because they cannot join dormitories and provide online classes properly. Substantial measures need to be taken to enable students to feel the change.

 When schools started back up in March, the government eased measures to manage close contacts and facilitated school attendance. The medical community is concerned that it will raise the number of hidden infected people. Among students, face-to-face classes have been expanded under the guidelines of the Ministry of Education, but voices are rising that the response to the surge in confirmed cases is poor. The Catholic University Forum (CUF) hopes that CUK will do its best to create an environment where students can fully focus on their studies in a situation where society is confused.



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