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Speaker 1: Three sixty with Katie Wolf. Join the conversation with Katie Wolf.

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Speaker 1: You are our eyes and ears in the Territory Mixed

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Speaker 1: one oh four point nine.

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Speaker 2: It's been an incredibly busy weekend for our health professionals

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Speaker 2: as those international flights from India return. But as you've

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Speaker 2: probably heard, almost half of the one hundred and fifty

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Speaker 2: people that were due to catch the Quanta's repatriation flight

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Speaker 2: out of India were not allowed to board that flight

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Speaker 2: to Darwin after forty eight of them tested positive for

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Speaker 2: coronavirus before boarding. Now, Territory health officials confirmed that because

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Speaker 2: many of those have close contacts, it meant seventy were

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Speaker 2: no longer able to fly. There is no discussion though

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Speaker 2: about the testing regime, and well calls for standby lists

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Speaker 2: for those flights to ensure that the flights are filled

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Speaker 2: next time around. But here in the Northern Territory and

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Speaker 2: specifically here in Darwin. It's also, i guess sparked well

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Speaker 2: some further discussion about another new testing regime, this one

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Speaker 2: out at Howard Springs that the quarantine facility.

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Speaker 1: Now.

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Speaker 2: On Friday, we spoke to the Police Commissioner Jamie Chalker

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Speaker 2: and asked about those changes. But joining us on the

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Speaker 2: line right now is University of New South Wales epidemiologist

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Speaker 2: and also advisor to the World Health Organization, Mary Louise mcclaus.

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Speaker 2: Good morning to you. Good morning, Mary Louise, Thank you

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Speaker 2: so much for your time this morning, well as plenty

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Speaker 2: of our listeners would have heard on the show. On Friday,

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Speaker 2: the Northern Territory government scraped the use of daily rapid

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Speaker 2: antigen tests for our quarantine staff out at Howard Springs,

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Speaker 2: anti health authorities telling the media on Friday that the

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Speaker 2: gold standard PCR testing would be used instead. Firstly, are

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Speaker 2: you able to tell We'll talk us through the difference

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Speaker 2: between these types of tests.

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Speaker 1: That'd take a while, So let me just explain that

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Speaker 1: a PCR test is not without its own problems. Certainly,

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Speaker 1: all tests perform differently depending on the level of infection

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Speaker 1: in society, so as the rates go up or down,

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Speaker 1: the accuracy will also change. The PCR test is done

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Speaker 1: for diagnosing and is particularly good at diagnosing somebody with

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Speaker 1: symptoms or about within two days of getting symptoms. Yes,

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Speaker 1: Whereas and also that diagnostic test it goes for a

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Speaker 1: target on the virus that also is the spot for mutation,

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Speaker 1: so that just needs to be kept in mind as

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Speaker 1: well for its false negatives. The rapid antigen test has

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Speaker 1: a different target that can't mutate. It looks for the

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Speaker 1: virus itself, and don't forget PCR tests can give you

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Speaker 1: a false positive in that yes, they've detected the virus,

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Speaker 1: are remnants of the virus, but you're no longer infectious

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Speaker 1: to anybody. So that positive test can remain positive for

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Speaker 1: quite some time where the rapid antigen tests will pick

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Speaker 1: up the virus itself way before you are anywhere near

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Speaker 1: having symptoms. So it performs extremely well in that situation.

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Speaker 1: And that's where you want to pick up any idea

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Speaker 1: of any of the live virus in staff so that

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Speaker 1: they don't take it in adversiency back into the community.

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Speaker 2: So, in your opinion, what would be a better test

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Speaker 2: to be using for the health staff out at Howard Springs.

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Speaker 1: I think that there should be a test that tests

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Speaker 1: people with a great deal of certainty that when you're

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Speaker 1: labeled negative, you truly are. Now. I did hear that

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Speaker 1: the chief epidemiologists defended the choice of using only PCR

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Speaker 1: because rapid antigen tests have a reputation that's not necessarily

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Speaker 1: accurate anymore for having false positives, but I put it

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Speaker 1: to the epidemiologists that that's better in this situation than

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Speaker 1: a false negative. That if if somebody turns to have

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Speaker 1: a positive result, it gets checked by a PCR test,

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Speaker 1: and that might put a staff member out a bit

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Speaker 1: for a number of hours, so they might have to

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Speaker 1: stay on campus overnight while they're waiting for that result

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Speaker 1: to come back. But the difference between a PCR and

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Speaker 1: a rapid atagen test is when I'm talking rapid, it's

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Speaker 1: real time fifteen minutes, where a PCR test can take,

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Speaker 1: if you're lucky, many hours and mostly a day. So

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Speaker 1: it's historic information, it's not information about what's happening right now.

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Speaker 1: And this was brought up at the World Health Organization

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Speaker 1: on Thursday night about using rapid antigen tests and the

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Speaker 1: algorithm of what happens when you have a positive you

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Speaker 1: confirm it anyway, and all tests should be confirmed and

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Speaker 1: not just taken as carte blanche, that it really is

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Speaker 1: a positive test.

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Speaker 2: And Mary Louise, when you look at what's happening in

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Speaker 2: other locations, what are the large majority doing? Are those

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Speaker 2: rapid rapid antigen tests being utilized or is it the

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Speaker 2: other type that are being utilized, the PCR.

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Speaker 1: That's a very good point. In Australia, the only test

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Speaker 1: that I'm aware of that has that's on the Medicare

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Speaker 1: rebate scheme A the PCR tests, and so by and

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Speaker 1: by large they're using a PCR test now I think

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Speaker 1: in Victoria they're using the one that was developed by

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Speaker 1: the Dougherty that is a Saliba test. It also has limitations,

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Speaker 1: like all the tests where I believe the accuracy for

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Speaker 1: picking up positive cases about eighty four percent, and these

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Speaker 1: rapid andigen tests are matched that and are even mostly

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Speaker 1: higher than that. So all the twelve that I know

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Speaker 1: of rapid antigen tests that are approved by TGA really

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Speaker 1: have very high levels of accuracy that you want right

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Speaker 1: at the beginning of the journey into being positive. So

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Speaker 1: a day that you're exposed it can pick it up.

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Speaker 1: PCR can't, and so this should be changed around Australia.

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Speaker 2: Yeah, So Marylois, do you think that in some cases

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Speaker 2: people are going down the path of not using the

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Speaker 2: rapid antigen tests because it so it cost efficiency thing.

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Speaker 1: Well, yes, because they're getting a rebate from through the

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Speaker 1: Medicare system except for all remind your listeners or these

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Speaker 1: rapid aagen tests are a fraction of the price. So

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Speaker 1: I believe that the rebate is about one hundred dollars,

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Speaker 1: but these tests may cost an American dollar on average

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Speaker 1: five five dollars, so they're a fraction of the price.

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Speaker 1: But I understand that most states and territories don't want

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Speaker 1: to use them because they'll have to pay for that

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Speaker 1: extra cost if they mix and match with a rapid

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Speaker 1: antigen test and a PCR test, because it's not on

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Speaker 1: the rebates system. I believe because you think about it.

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Speaker 1: As soon as you get travelers from overseas touching their

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Speaker 1: feet on Australian ground, that's when you want to know

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Speaker 1: are you dealing with somebody that's positive or not. A

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Speaker 1: rapid engigen test will tell you while they're waiting for

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Speaker 1: their bags in se minutes. If they're positive and it's

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Speaker 1: a false positive, no big deal, because you're going to

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Speaker 1: test them with a PCR. You just might cohort them

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Speaker 1: in a better facility right from the get go.

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Speaker 2: And so taking all of that into account, do you

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Speaker 2: feel that realistically, you know? Not? Just when we're talking

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Speaker 2: about the health staff out at Howard Springs, but also

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Speaker 2: when we're talking about the arrival of repatriated Australians to

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Speaker 2: the Northern Territory, that they should be having those rapid

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Speaker 2: antigen tests once they arrive.

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Speaker 1: Definitely, in outbreak management, you put in layers of protection

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Speaker 1: because if the virus or human nature can get through

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Speaker 1: one layer, it's picked up by another. And these rapid

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Speaker 1: antigen tests can be done in batches, can be done

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Speaker 1: singularly often, and they can be done rapidly so they

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Speaker 1: don't put people out for you waiting order six hours

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Speaker 1: for the saliva PCR or overnight for the regular PCR test.

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Speaker 1: This is fifteen minutes at a very low cost and

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Speaker 1: adds an extra layer of care.

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Speaker 2: Mary Louise, we are running out of time. But I

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Speaker 2: know some people listening this morning might be thinking to themselves, well,

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Speaker 2: you know, so long as we're testing the staff out there,

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Speaker 2: and so long as we are testing people when they arrive,

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Speaker 2: it should be okay. I mean, to anybody out there

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Speaker 2: that is thinking that this is sort of fear mongering,

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Speaker 2: what would you say to them?

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Speaker 1: I say to them, the twenty fourth breach in a

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Speaker 1: hotel quarantine that occurred in South Australia. Occurred because the

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Speaker 1: PCR test couldn't pick up this man's infection early. I

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Speaker 1: believe he was tested around day thirteen. He had a

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Speaker 1: negative test. He then left on day fourteen and went home.

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Speaker 1: He then got symptoms five days later. PCI didn't pick

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Speaker 1: it up. If he hadn't had a rapid atagen test,

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Speaker 1: it is more than likely that he would have been

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Speaker 1: picked up and there would have been no anxiety and

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Speaker 1: no threat of a three day knockdown.

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Speaker 2: Well, it is certainly some real food for thought. Marie

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Speaker 2: Louise mclaus. I really appreciate your time this morning. Thank

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Speaker 2: you so much for chatting with us. I know that

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Speaker 2: you're struggling a bit with your voice there this morning.

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Speaker 2: Thank you.

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Speaker 1: It's a pleasure say well.

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Speaker 2: Thank you. That is epidemiologist there, Mary Louise mcclaus. She

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Speaker 2: is with the University of New South Wales but also

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Speaker 2: with the World Health Organization on that advisory board with

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Speaker 2: the World Health Organization,