Initially, all suspected cases are tested in order to classify and report them based on standard procedures. Testing is also performed for the following categories:
- suspected and probable cases whether admitted to hospital or in the community,
- symptomatic medical workers (including emergency services and non-clinical staff) regardless of whether they are a contact of a confirmed case
- the first 3-5 symptomatic individuals in a closed setting (e.g. schools, long term residential facilities, prisons, hospitals)
Testing is by referral from medical workers in hospitals or primary care doctors, self-referral is only available for private laboratory testing.
Laboratory testing strategy was changed in May 2020 and three main groups were prioritised: 1) people who are at risk of developing severe disease and vulnerable populations, who will require hospitalization and advanced care for COVID-19; 2) health workers (including emergency services and non-clinical staff) regardless of whether they had a contact of a confirmed case (to protect health workers and reduce the risk of nosocomial transmission); 3) the cases in a closed setting (e.g. schools, long-term care facilities, prisons, hospitals) to quickly identify outbreaks and ensure containment measures. All other individuals with symptoms related to the close settings may be considered probable cases and isolated without additional testing if testing capacity is limited.
COVID-19 testing is performed in four public laboratories (National Reference Laboratory of the National Agency for Public Health in Chisinau – 600 tests/day; Regional NAPH lab in Balti – 160 test/day; Diagnostic Center in Chisinau – 100 test/day; Hospital for Dermatology and Communicable Disease in Chisinau – 70 test/day) and three private laboratories in Chisinau with a total testing capacity of ~470 tests per day.
Routine confirmation of COVID-19 includes the detection of unique sequences of virus RNA by nucleic acid amplification tests (NAAT) such as real-time reverse-transcription polymerase chain reaction (rRT-PCR) with confirmation by nucleic acid sequencing when necessary. The viral genes targeted so far include the N, E, S and RdRP genes. WHO guideline and protocols are used.