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FACTCHECK

Debunked: No, the HSE hasn't said its coronavirus testing method is useless

The PCR test is globally recognised as the gold standard method for detecting the coronavirus.

A NUMBER OF posts being shared on social media in recent weeks claim the HSE has ‘admitted’ the coronavirus test used in Ireland is “useless” or “not accurate”.

These posts include a photo of an information leaflet given to people who attend for a coronavirus test. The leaflet states that there are limitations with the test as “no test is 100% accurate” and lists some of these limitations.

The viral posts all highlight one line in the leaflet which states: “The coronavirus testing method cannot be guaranteed as accurate, up-to-date, reliable, error-free, suitable, effective or as having any specific result or outcome.”

One post claims this equates to the HSE admitting the test is “useless”.

Another claims the HSE has “confirmed” the test is not accurate or reliable and that there is no specific result from the test. 

The leaflet

First of all, TheJournal.ie checked with the HSE and this is a legitimate leaflet, given to people who attend an appointment for a coronavirus test when it is suspected they may have Covid-19 or if they are a close contact of a confirmed case. 

The HSE said it is just one of the wide range of Covid-19 information resources developed by the HSE.

“It provides information on what the test involves, test results and also the limitation of testing for Coid-19.

“The leaflet is provided to people attending for a Covid-19 test, together with another leaflet on self-isolating at home. By providing information on the test, including its limitations, people attending for testing can make an informed choice and decide if they wish to be tested or not for Covid-19.”

How accurate is the test?

The test we use in Ireland uses the the reverse transcription polymerase chain reaction method, known as RT-PCR, or PCR for short.

PCR test methods are considered by the World Health Organization and the European Centre for Disease Control (ECDC) as the gold standard for diagnosing suspected cases of Covid-19.

It generally involves taking material samples through nasal and throat swabs. The test in the laboratory after a swab is taken looks for viral generic material.

Speaking to TheJournal.ie, Dr Cillian dr Gascun, director of the National Viral Reference Laboratory (NVRL) said it is “the most accurate test we have, the most sensitive test we have and the most specific test we have”. 

“It’s widely uses in the diagnostic laboratories for virology and indeed for bacteriology as well. It’s not something we just developed for SARS-CoV-2, it’s been in use for many years for herpes, for the likes of HIV, hepatitis C, and we know that it’s incredible sensitive.”

The HSE said “all tests have limitations”, including diagnostic testing for Covid-19. It said extensive validations have been carried out in our laboratories to ensure that the test used shows high sensitivity.

The test is estimated to have a sensitivity of between 71 and 98%. 

The limitations

De Gascun said there are two main issues that may arise with a PCR test. The first relates to the quality of the specimen – there has to be viral material on the swab to test. 

The second issue, he said, can relate to the presence of the virus in the upper respiratory tract (nose/throat) – which is where the swab is taken from – at the time of sampling.

“We’ve seen reports from our colleagues in hospitals that people can be admitted with respiratory illness and at the time of admission the virus isn’t present in the respiratory tract, so the PCR doesn’t detect anything,” he said.

De Gascun said if a person gets a negative result but doctors in a hospital still believe they have Covid-19 because they are displaying symptoms of the disease, a test using a sample from the lower respiratory tract may detect the virus. The lower respiratory tract consists of the trachea down to the lungs.

More invasive processes than a swab, such as a bronchoalveolar lavage – liquid injected into a segment of the lung through a bronchoscope – can be used to collect these samples. 

He said this is why it is important that people “don’t get caught up in the test results”.

“If you have a high index of suspicion and it is not detected then we would encourage people to get a follow-up sample and ideally a lower respiratory tract sample. But we’re trying to balance the logistics, obviously a lower respiratory tract sample can be quite unpleasant so we’re not going to subject everybody in communities to that,” he said.

“If people have symptoms, despite an undetected test result, we would need them to continue to follow public health advice because the test is just one component.”

De Gascun said it is important for health services to make people aware of the limitations of testing, as the HSE has done in this case, because of “trust in the system and awareness and education.

He said these limitations are not confined to laboratory medicine, there are limitations with routine medical tests such as x-rays and blood tests.

“I think people have grown up watching things like House or ER where test results are black and white and that’s not the way it is in the real world. We know that the majority of our tests work well the majority of the time. There’s also an uncertainty of measurement there and it’s really important to education people and say these are the limitations but the test works very well.”

The claims

The posts that have been shared on social media claim the HSE, by informing people of the limitations of testing, has admitted the testing method is “useless”. The posts also claim the HSE has “confirmed” the testing method is not accurate and not reliable.

The HSE has never said the PCR testing method is “useless”. It is globally recognised as the most sensitive method to use to detect the coronavirus and this is why the National Public Health Emergency Team (NPHET) recommended its use. 

Further, in its information leaflet on the limitations of testing, the HSE did not say the test was “not accurate”. It stated that it could not be guaranteed as accurate. As the HSE stated in its leaflet – and as explained by Dr de Gascun – no testing method, whether it’s a Covid-19 test, a blood test or an x-ray, can be described as 100% accurate. 

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There is a lot of false news and scaremongering being spread in Ireland at the moment about coronavirus. Here are some practical ways for you to assess whether the messages that you’re seeing – especially on WhatsApp – are true or not.

STOP, THINK AND CHECK

Look at where it’s coming from. Is it someone you know? Do they have a source for the information (e.g. the HSE website) or are they just saying that the information comes from someone they know? A lot of the false news being spread right now is from people claiming that messages from ‘a friend’ of theirs. Have a look yourself – do a quick Google search and see if the information is being reported elsewhere. 

Secondly, get the whole story, not just a headline. A lot of these messages have got vague information (“all the doctors at this hospital are panicking”) and don’t mention specific details. This is often – but not always a sign – that it may not be accurate. 

Finally, see how you feel after reading it. A lot of these false messages are designed to make people feel panicked. They’re deliberately manipulating your feelings to make you more likely to share it. If you feel panicked after reading something, check it out and see if it really is true.

TheJournal.ie’s FactCheck is a signatory to the International Fact-Checking Network’s Code of Principles. You can read it here. For information on how FactCheck works, what the verdicts mean, and how you can take part, check out our Reader’s Guide here. You can read about the team of editors and reporters who work on the factchecks here

Have you gotten a message on WhatsApp or Facebook or Twitter about coronavirus that you’re not sure about and want us to check it out? Message or mail us and we’ll look into debunking it. WhatsApp: 085 221 4696 or Email: answers@thejournal.ie