Saliva tests will finally be able to be used in France, with the hope of reducing the time taken for Covid-19 screening tests, a big black spot in the current policy to fight the rebound of the epidemic.
But they will be offered only to people with symptoms, according to an opinion from the High Authority of Health (HAS) issued this Friday, September 18.
Seven questions to understand what it is.
What are saliva tests?
They allow you to answer a question: am I or not infected with the coronavirus?
Today, the PCR technique consists of inserting a large cotton swab into the nose, which is considered unpleasant.
With the saliva method, all you have to do is spit into a tube and bring it to the laboratory, where the presence of the virus will be looked for on the same machines as the PCR machines.
Who are they aimed at?
The High Authority for Health has given the green light to their use, but only for symptomatic cases, even if the saliva test is a little "less effective" than the nasopharyngeal sample.
"Their performance is sufficient to be acceptable," declared its president, Professor Dominique Le Guludec, preferring not to give the reliability rate.
This saliva test is recommended for those for whom the cotton swab test in the nose is difficult or impossible to perform.
That is to say ?
Children, vulnerable people, very old or with cognitive disorders who accept it very badly.
For the others, even if they have symptoms, it is preferable to take the reference test, which is more effective.
What if I don't have symptoms?
"This is bad news," said the president, disappointed.
The Haute Autorité de santé does not recommend saliva tests for this category, in other words for all those who have neither fever, nor cough, nor great fatigue or loss of smell and taste.
Why ?
Because "we would miss three out of four patients," specifies Dominique Le Guludec, ie an error rate of over 75%.
So it is not reasonable.
"
How it works ?
All health professionals but also patients, and this is the interest, can do it themselves.
To do this, just go get a tube in a pharmacy or a laboratory and spit inside.
"It's not complicated," said the president of the High Authority for Health.
You should try to cough a little and collect as much saliva as possible.
»Should it be done on an empty stomach, in the morning or in the evening?
No rule, no matter what time of day, what you ate or drank, it doesn't change a thing.
Then, each patient will return their saliva sample as quickly as possible, within 48 hours, to any lab that already performs nasopharyngeal samples.
“As they have symptoms, they should be analyzed as a priority,” continues Dominique Le Guludec.
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When will they be reimbursed?
Now that the High Authority for Health has issued a favorable opinion, it is up to the Health Insurance to decide on reimbursement in the coming days.
“It should be extremely fast,” said Dr Cédric Carbonneil, head of the HAS professional acts assessment service.
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Why did it take so long to evaluate them?
"France is not slower than other countries", defended the president of the HAS, explaining that the opinions of the body are based on reliable data.
For the saliva tests, we therefore had to wait for the first data from 700 patients out of 1,200 from the Covisal study, conducted in Guyana this summer.
Everyone did the PCR and saliva test and then the results were compared.
"To pronounce without a scientific basis leads to doing stupid things", affirmed the professor, taking the example of the Italians.
In March, a "poor quality" PCR test was released, leading to misdiagnosis, many false negatives and the spread of the epidemic.
How can these tests help us?
Screening will be easier, patients will be able to do it alone and thus relieve the labs on the verge of explosion.
Then, if a child has a cold, we can quickly tell if he has the Covid or not, without going through a binding sample.
Finally, the most vulnerable will not have to queue for hours in front of medical centers.
And if a week later, the symptoms persist, again, this saliva screening can be repeated.