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In the period between the years, hundreds of thousands of people in Germany flock to the rapid antigen test stations at doctors and private providers - or take the unpleasant smear on their own.
When visiting family and friends, many want to be on the safe side.
Andreas Bobrowski, head of the Laboratory Doctors Association, can only warn against this:
Not only are many tests carried out incorrectly, control over the pandemic is also threatening to slip.
And some doctors enriched themselves in an emergency at the expense of the patient.
In the interview, Bobrowski looks back on the crisis year 2020 - which in his opinion also had positive developments.
WORLD:
Mr. Bobrowksi, around the holidays there is a great rush for antigen rapid test providers, and many people also test themselves. Do you think that makes sense?
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Andreas Bobrowski:
I'm very careful there.
One is less rough with oneself than with others, which means: The risk is high that as a layman one does not wipe deep enough in the throat or nose and thus not enough material is obtained for the antigen determination - which leads to false-negative results can lead.
By the way, statistical control over the pandemic will be given up if you only do quick tests, because the results are not recorded anywhere.
This is dangerous.
Dr.
Andreas Bobrowski, 64, is a specialist in laboratory medicine from Lübeck and has been the first chairman of the Professional Association of German Laboratory Doctors (BDL) since 2004
Source: Andreas Bobrowski / BDL / Jan Klauth
WORLD:
Why are you so vehemently against rapid tests?
They deliver results in a few minutes, do not have to go to the laboratory and are cheaper than the PCR variant.
Bobrowski:
Mainly because the quality of many rapid tests is still insufficient.
Especially in vulnerable groups, such as in old people's and nursing homes, a smear must deliver reliable results.
A false negative result even though someone is infectious can be devastating.
Only a doctor can guarantee a reasonable anamnesis with a specific test indication.
Anyone who gets tested somewhere in the kiosk - and suffers health or economic damage due to incorrect results - does not have the same legal security as if the test is carried out under medical supervision.
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WELT:
But it's not about playing the PCR process against rapid antigen tests, but about preventive testing, for example in homes.
Bobrowski:
This is exactly where rapid tests should be used, especially for visitors and employees, as this is the route that most infections are brought in.
But you should know its limits.
I have the impression that politics convey that frequent testing offers absolute security.
A bad test doesn't get better if I do it ten times.
And financial interests certainly also play a major role in the glut of rapid tests that we are now experiencing.
However, especially when there is a high incidence of infections, you need clear results, which is why positive rapid tests have to be confirmed in the laboratory using PCR - and there are often deviations.
WORLD:
Rapid tests have been on the market in South Korea since April, they could have been used here much earlier.
Why was it not possible to test in the homes for so long?
Dozens of people die there every day.
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Bobrowski:
The homes don't have enough staff, so many quick tests are of little use.
Well-trained specialists work on a safety cabinet in the laboratory.
If semi-skilled workers carry out the tests at the test centers and in the homes without these safety standards, there is an increased risk of infection through aerosol formation.
WORLD:
That's good when, for example, medical students are pragmatically trained and hired.
Bobrowski:
You can do that with appropriate training, but these are processes that take time.
WORLD:
Amazingly long.
Bobrowski:
It's slowly getting underway, but the personnel problem remains.
WORLD:
Companies like Lufthansa buy hundreds of thousands of rapid tests.
Many homes, on the other hand, have problems with procurement and spoke of chaotic conditions on the market.
Don't you see an imbalance there?
Bobrowski:
As it is now with the vaccination, the federal government could have stipulated which groups had priority.
There may have been bottlenecks, but around 300 rapid tests are now approved.
As I said, what is missing is staff.
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WELT:
Now anyone can do a quick test with private sellers and spend up to 100 euros for it - the market value is around five euros each.
What's wrong with that?
Bobrowski:
The ordinance only covers the costs for certain groups and does not provide for any compromises.
If you leave this area, there are no fixed prices and no security, you have to be clear about that.
In the current test hysteria that is going under.
WORLD:
Why does the state not intervene?
That's a rip off.
Bobrowski:
Absolutely.
All the worse for our profession when doctors do that.
Anyone who enriches themselves at the expense of the patient in an emergency situation crosses boundaries and should be advised.
The medical associations would have to intervene here.
WORLD:
There has been a shortage of materials in laboratories for months, which makes it increasingly difficult to get a PCR test.
This shortcoming has long been indicated.
Why wasn't countermeasures taken early on?
Bobrowski:
All the laboratories have tried that by buying stocks from many different manufacturers and securing quotas.
But some things are unpredictable: there is currently a shortage of latex gloves because factories in the Far East have problems with production and global demand is constantly growing.
Nobody would have expected that a few weeks ago.
WORLD:
Companies like Centogene, which does mass tests at airports and in cities, do not have this shortage by their own account.
What is the company doing that other laboratories are doing wrong?
Bobrowski:
Well, maybe Centogene doesn't talk about it so openly.
Ultimately, we are all dependent on the same market.
Some can afford to put more in storage than others.
Of course, that depends on a company's economic strength.
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WORLD:
So Germany is too dependent on producers from China and other countries.
Bobrowski:
Yes, of course.
The pandemic has not changed that.
WORLD:
Shouldn't the state have to support the procurement as it did with the masks?
Bobrowski:
At first we wanted that, and there were also approaches in the Ministry of Health that were not thought through to the end.
In any case, it makes sense to create national reserves.
Manufacturing supply-relevant medical items in Europe would be the best solution - but that is quite an illusion.
WORLD:
And this can continue in the next few weeks with the shortage of materials?
Bobrowski:
The situation is stabilizing.
The number of tests decreases slightly and the positive rate increases.
This is the right way and, by the way, also saves resources.
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WORLD:
So after almost a year of the pandemic, does it not make sense in your opinion to test preventively instead of just "afterwards" when you already have symptoms?
Bobrowski: In
my opinion, the mantra “test, test, test” is more of a popular political requirement and not a medically sensible strategy.
This also includes preventive testing, but then according to the national test strategy developed by the RKI.
Many now see vaccination as a silver lining.
I assume that the test numbers will decrease as soon as people are vaccinated.
WORLD:
There are numerous other alternatives to the PCR test, for example gargle tests.
Why don't they prevail?
Bobrowski:
Basically that's a good idea, we also experimented with it.
The risk, however, is that aerosols can easily spread if gargled for 30 seconds.
In addition, there is a problem of space: it is difficult to move thousands of beakers with up to 20 milliliters of liquid around the area, and in the laboratory we would face additional infrastructural problems with the acceptance and storage of the samples.
WORLD:
Or they won't get through because they don't have a lobby.
Bobrowski:
That may be.
But it remains the second best solution with significant problems in preanalytics and logistics.
WELT:
There is also the allegation that the laboratories prevent other tests from being used more widely.
Bobrowski:
That's not true.
Due to the high number of tests, it would even be good to relieve the laboratories.
But I'll stick to it: Corona tests should take place under medical care and must be as reliable as possible.
WORLD:
Laboratories forward the test results to the offices by fax.
Have you missed digitization too?
Bobrowski:
On the contrary, many laboratories are technically well equipped and digital pioneers.
However, it is of no use if we digitally transmit results to the offices that cannot be processed there.
It was a step backwards into the digital age when they said we had to work with forms and fax again.
Many health authorities are far behind when two worlds collided.
WORLD:
So you were forced to step backwards?
Bobrowski:
Yes, you could say that.
That's why we had to hire additional staff because the work became more complex and the mountains of paper grew.
We brought a lot of problems back into the house that had long been resolved.
The reporting process could be much faster if the public health service had not been neglected so financially in recent years.
WORLD:
Are the laboratories actually doing something else besides corona tests in 2020?
Bobrowski:
You could get the impression from outside, but the usual diagnostics continue to run in full.
Nothing was left out, as was the case with operations in hospitals, for example.
However, the normal laboratory business at times also fell by up to 30 percent - because many patients no longer dared to go into the practice for fear of infection.
WORLD:
And have you increased your staff?
Bobrowski:
Yes, and massive, although strict distance and hygiene rules also apply in the laboratory.
So far there have not been any major outbreaks.
WORLD:
But will that change after the pandemic?
Bobrowski:
There will certainly be consolidation.
We have hired a lot of assistants who sort and stick samples, for example.
We were satisfied that the high school generation 2020 could not do work and travel.
Young, well-motivated school leavers worked in laboratories instead of on Australian fruit farms before they started their studies - it was a good experience for many.
Dr. Andreas Bobrowski, 64, is a specialist in laboratory medicine in Lübeck and has been the first chairman of the Professional Association of German Laboratory Doctors (BDL) since 2004. The association emerged in 1984 from the working group of laboratory doctors in Germany founded in 1965.