Policy responses for Portugal - HSRM

Portugal


Policy responses for Portugal

1.5 Testing

The results of the expansion of testing capacity were already observed in September 2020: during that month, the NHS performed an average of 8,750 daily tests (compared to an average of 5,603 daily tests in June 2020). Overall, Portugal performed an average of 18,867 daily tests in September (compared to an average of 11,830 daily tests in June).

Between March 2 and September 6, Portugal performed 2,736,473 tests for diagnosis of SARS-CoV-2 in public and private laboratories, which places the country in 8th place among the EU countries regarding testing rate, with 268,582 tests per million population (https://covid19.min-saude.pt/ponto-de-situacao-atual-em-portugal/).

The current testing policy in Portugal includes testing for all suspected cases of infection by SARS-CoV-2 (https://www.dgs.pt/directrizes-da-dgs/orientacoes-e-circulares-informativas/orientacao-n-0152020-de-23032020-pdf.aspx). Testing can be carried out in a hospital lab, a private lab or in the National Institute of Health Dr Ricardo Jorge, which is the national reference laboratory in Portugal. Laboratory testing of SARS-CoV-2 is done by real-time PCR (RT-PCR), as recommended by WHO.

Initially, suspected cases had a very strict pathway for referral: they had to call SNS 24 Contact Centre, be validated by the Medical Support Line, and be sent to a reference hospital for sample collection and testing. Also, the National Institute of Health was the only laboratory performing tests for SARS-CoV-2. However, even before the first confirmed cases in Portugal were identified, a network of hospital labs was established, making it possible to be tested at the reference hospital. As the epidemic evolved, and although the SNS 24 Contact Centre is still the preferable way of entering the pathway of identification of cases, other options are available. Home testing is possible for mild cases that do not fulfil criteria for hospitalization. Additionally, many testing centres (especially, drive-throughs) are being set up in several Portuguese cities, improving access to testing, as long as the person holds a medical prescription. Hence, not only suspected cases but also close contacts and even asymptomatic persons have been tested for COVID-19. 

Testing capacity has been strongly increased across the country as more hospital labs became prepared to perform testing and private labs were included as part of the national response. Currently, the National Institute of Health, the Military Laboratory, the National Institute for Agriculture and Veterinary Research, 37 labs in public hospitals (including the autonomous regions of Azores and Madeira), 22 university labs and 27 private groups (with more than 100 posts across the country) are performing SARS-CoV-2 diagnosis. Monitoring and surveillance of cases (and deaths) include long-term care facilities and/or home care.

Results usually take 5-6 hours to be delivered, depending on the hour the samples are delivered in the lab and the number of swabs to be processed. However, 5,000 PCR testing kits became available in mid-April, which deliver results in around 45 minutes. Those are reserved to particular situations, including testing suspected cases in health care settings or pregnant women.