Policy responses for Poland - HSRM

Poland


Policy responses for Poland

1.5 Testing

MEASURES INTORDUCED IN 2020

JANUARY-AUGUST:

Poland follows WHO recommendations and uses the RT-PCR molecular test for COVID-19 testing. In line with national laboratory diagnostic testing regulations, testing should be performed by laboratories with at least a BSL-2 classification. State sanitary inspection units authorise cases for testing but physicians can also order a test as a part of the treatment process.
 
On the 15th April Poland launched national the production of coronavirus detection tests, starting with 100,000 units. The test was developed by the Institute of Bioorganic Chemistry of the Polish Academy of Sciences in Poznań, with financial support from the Ministry of Science and Higher Education, which further donated PLN 15 million for the production of the first tests.
 
Since the distribution of the laboratories is not equal across Poland, the Deputy Minister of Health is planning to introduce provincial (voivodship) coordinators to better manage testing. By 17 August 183 laboratories were carrying out testing for COVID-19. Their distribution by provinces (voivodeships) is available at the website of the Ministry of Health (https://www.gov.pl/web/zdrowie/lista-laboratoriow-covid). Current total testing capacity in the country exceed.
 
By 28 August 2,522,949 tests had been performed. The average number of tests per 1000 population is estimated at 66.99. Currently, the rolling 7-day average number of tests for each new confirmed case is estimated at 32.2. The WHO suggested around 10–30 tests per confirmed case as a general benchmark of adequate testing.
 
From 23 March fast-track COVID-19 testing has been available for medical and laboratory staff meeting specific criteria, particularly those displacing symptoms and/or have had exposure to confirmed cases.
 
County (local) sanitary stations send special ambulances (called ‘swab buses’) to collect smear samples from people who are quarantined and are waiting to be tested. Decisions on who gets tested are taken by the sanitary inspection units on the basis of epidemiological investigation. For people with symptoms, tests can be performed in dedicated hospital facilities.
 
In addition, the National Health Fund has progressively set up a network of 180 drive-thru testing points across all voivodships. All tests performed in these points will be reimbursed by the Fund. People who have been in quarantine for 12 days can be tested in the drive-thru points and they are notified about such possibility via a text message when they approach day 11 of quarantine.  On 4 May, the first military ‘TEST&GO’ swab point was opened in Krotoszyn, in the Greater Poland (Wielkopolskie) voivodeship, with Territorial Defence soldiers taking samples for the presence of coronavirus. The swab point is organized as a ‘drive-thru’ point, with people being able to provide swab samples without getting out of the car. Test results will be available via the websites of the sanitary stations (by entering a unique code) and over the phone. Positive test results will be communicated over the phone. Swabs will be collected from persons previously designated for testing by the Sanitary and Epidemiological Stations. Five more ‘TEST&GO’ swab points will be opened from 11 May. Further military ‘TEST&GO’ swab points will be opened depending on the demand in the voivodeships.
 
Sources:
http://naukawpolsce.pap.pl/aktualnosci/news%2C81301%2Cmfipr-sprzet-z-uczelni-medycznych-pomoze-leczyc-chorych-na-covid-19.html. [access online: 17.04.2020]
https://www.gov.pl/web/koronawirus/wojskowe-testgo-ruszaja-od-poniedzialku [access online 30.04.2020
Sosnowiec: testy drive-thru na koronawirusa. https://medycynaprywatna.pl/sosnowiec-testy-drive-thru-na-koronawirusa/.[access online: 04.05.2020]
[access online: 04.05.2020]
https://katowice24.info/wymazobus-w-katowicach-zaden-mieszkaniec-nie-czeka-juz-na-test-na-koronawirusa/. [access online: 04.05.2020]
https://serwisy.gazetaprawna.pl/zdrowie/artykuly/1475875,punkty-nfz-drive-thru-dla-osob-na-kwarantannie.html [access online: 12.05.2020]
https://www.gov.pl/web/zdrowie/lista-laboratoriow-covid [access online: 19.05.2020]
https://ourworldindata.org/coronavirus-testing#tests-per-confirmed-case (access online:5.10.2020)

SEPTEMBER:

Since September 2, patients who have been in quarantine for at least 10 days, during which time they had no symptoms, may be released from quarantine without having to undergo testing. This means that testing is mainly conducted in people who are symptomatic.
 
From September 9, general practitioners may order tests for SARS-CoV2 infection during direct and remote consultations using a special application (gabinet.gov.pl). They then inform the patient about the location of the drive-thru points where the test can be performed. They are also required to inform the patient of the need to avoid public transport. They must report suspected cases of infection to the County Sanitary and Epidemiological Station SARS-COV-2 by completing a special form (ZLK1), which can be done via a special application (office.gov.pl). Detailed guidelines on ordering of tests and on patients’ pathways depending on the patient's condition were published on September 23 (https://www.gov.pl/attachment/88929166-8a5c-47ad-a02f-72a18d452293).
 
Source:
https://www.gov.pl/web/zdrowie/strategia-walki-z-pandemia-covid19 [access online: 14.11.2020]

OCTOBER:

Since October 31, according to the new definition of COVID-19 case, antigen tests have been approved for diagnosing of new cases. Positive test result is officially registered and attributed to the citizen’s ID (PESEL) in dedicated IT system called EWP.

NOVEMBER:

By November 9, 241 laboratories were carrying out testing for COVID-19. Their distribution across the provinces (voivodeships) can be seen at the website of the Ministry of Health (https://www.gov.pl/web/zdrowie/lista-laboratoriow-covid).

Swabs are collected in 465 drive-thru points. At the beginning of November, total testing capacity in the country exceeded 60,000 tests per day.

At the beginning of November, the Ministry of Health published a strategy for fighting the pandemic during the autumn months (the so-called ‘Strategy 3.0’). In terms of testing, the aim is to continue with testing of symptomatic patients. Testing is mandated for the following population groups and/or settings:
1) People with symptoms suggestive of COVID-19 infection;
2) People before the start of a spa treatment or spa rehabilitation and before admission to long-term care facilities;
3) Testing of asymptomatic patients if this is necessary as part of the epidemiological investigation in case of major outbreaks (e.g. in large workplaces);
4) Testing of symptomatic patients in the emergency wards using rapid tests, including antigen tests, in order to establish a diagnosis.
5) Implementation of antigen tests in COVID-19 diagnosing.

The updated version of the strategy (3.0) released by Ministry of Health in early November does not change testing guidelines.

Source: https://www.gov.pl/attachment/49536e92-3aca-4df8-bd3c-2bf22915564f

By November 14, 5,563,521 tests have been performed, of which 990,347 were ordered by the general practitioners. The cumulative number of tests is estimated to be 635.5 per 1000 people. On November 13, the rolling 7-day average number of daily tests was 1.52 per 1000, while the WHO suggested around 10–30 tests per confirmed case as a general benchmark of adequate testing. The value in Poland is much lower and has had a declining tendency.

The share of positive COVID-19 tests showed a sharply increasing tendency from September. In early September, this share was around 2.5% but it approached 7.1% by the beginning of October. On November 13, the 7-day rolling average of positive tests exceeded 44%. The WHO recommends that the share of positive tests should be kept below 5%. The number of performed antigen tests is unknown due to the lack of registering procedures for such tests.

Sources:
https://www.gov.pl/web/zdrowie/lista-laboratoriow-covid [access online: 14.11.2020]
https://ourworldindata.org/coronavirus-testing#tests-per-confirmed-case [access online:14.11.2020]

MEASURES INTRODUCED IN 2021

JANUARY-FEBRUARY:

By January 29, 276 laboratories were carrying out testing for COVID-19 and swabs were collected in 625 points. In the beginning of February, total testing capacity in the country can exceed 80,000 tests per day.

By February 5, 8,794,269 tests had been performed, of which 2,053,309 were ordered by family physicians. The cumulative number of tests is estimated at 224 per 1000 people. The rolling 7-day average number of daily tests was  1.05 per 1000 and the rolling 7-day average of the number of tests per confirmed case was 5.5, which remains very low compared to the WHO suggested benchmark of around 10–30 tests per confirmed case. This low figure could be attributed to the testing strategy in Poland which continues to be aimed at symptomatic cases. From the beginning of December, the rate of positive tests decreased to 34% and a further decline to 18% was observed at the beginning of February.