Mass testing clinics should be reopened and GP referrals for PCR tests should be removed as Queensland faces its third wave of COVID-19, health experts say.
The calls from the Australian Medical Association Queensland (AMA), infectious disease expert Paul Griffin and the Royal Australian College of General Practitioners Queensland (RACGP) follow 8,209 COVID-19 cases and 19 deaths being recorded over the past 24 hours.
There are now 64,011 active COVID-19 cases in the state, 1,023 of which are in hospital and 26 of which are intensive care.
The surge amid questions about the accuracy of rapid antigen tests and concerns PCR testing is not accessible enough for vulnerable people.
In Queensland, people must get a referral from their GP to get a free PCR test at a participating private pathology laboratory.
The appointment to get a PCR referral could be bulk-billed or carry a fee, depending on the particular general practice, and pathology labs can also charge fees for patients without a referral.
AMA Queensland president Maria Boulton said there was no additional funding for appointments for a COVID-19 referral from a GP.
She said general practice clinics were "fielding hundreds of phone calls a day from people with COVID" and there was "no mechanism for patients to get a rebate for that" unless the clinic bulk-billed.
"I think that there are people who have negative RATs, who have COVID symptoms, who may be eligible for the antivirals, who definitely need to access a PCR test," Dr Boulton said.
"For the government to make that more accessible, we will always support that.
"I think we need to do anything to facilitate people getting a PCR test at the moment who may be eligible for the antivirals, and if that means opening testing centres so that people can access those test, then yes, absolutely."
Dr Boulton said PCR access needed urgent attention, but mass testing clinics were not the only answer, because people in some regional and rural areas would still not be able to access them.
"People used to be able to go to a private pathology lab and not need a referral, for example," she said.
"So there are other ways to do it … it's looking at what is applicable for those areas locally.
'False reassurance'
Infectious disease expert Paul Griffin said access to PCRs was a "huge issue at the moment" and was not just limited to cost or the logistics of getting a referral and a test.
"There are so many anecdotes of people doing multiple rapid antigen tests that are negative and going and getting a PCR that's positive," he said.
"So that false reassurance by a false negative RAT is actually quite a concern and probably driving a little bit of what we're seeing at the moment.
"Also, access to antivirals is linked to medically supervised tests, so it's much better that people have access to a reputable test to be able to access those."
He said either establishing mass testing facilities or removing the need for a referral – or both – would be best.
Eligible people who are vulnerable or have a higher risk of severe illness with COVID-19 can access antiviral COVID-19 medication if they have taken a medically supervised RAT or PCR.
Dr Griffin said ensuring better access to antivirals for those people would alleviate the burden on the health system.
"So not only will they improve outcomes in those people, but it will greatly reduce the burden on our healthcare system, which … is overwhelmed at the moment and predicted to get worse," he said.
Antiviral access
RACGP Queensland chair Bruce Willett said there could be an advantage to reopening testing clinics.
"I do think we are back in that situation where that would be useful, and as a minimum that would be useful if that was provided for people who qualify for antivirals, as it could expedite the process by which they get antivirals," he said.
Dr Boulton, Dr Willet and Dr Griffin said people with symptoms but negative RAT results should get a PCR.
For a RAT to be approved by the Therapeutic Goods Association (TGA) it must to have at least 80 per cent clinical sensitivity to COVID-19 detection.
Dean Whiting, the chief executive of the peak body for PCR and RAT manufacturers, Pathology Technology Australia, said he believed RATs were effective at detecting the new COVID-19 sub-variants.
"The TGA does request manufacturers to verify that the tests do detect the new variants of concern and manufacturers have around six months to provide that evidence," he told ABC Radio Brisbane's Rebecca Levingston.
"If they cannot provide that evidence then they have the option of withdrawing their product from the market or mounting the right clinical trials to demonstrate that they do," he said.
"These tests always need to be used in accordance with the manufacturer's instructions.
