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Test criteria for coronavirus
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The following should be tested*:
- Everyone with acute respiratory tract infection or other symptoms of COVID-19
- Contact tracing:
- Close contacts at the start and end of quarantine
- In the case of outbreaks; widened testing of other contacts
- People who have been notified by Smittestopp
- Arrival in Norway
- Mandatory testing at borders
- Mandatory test 7 days (from the day after you left your home country) after arrival in Norway
- Other screening after infectional control assessment:
- When moving in/being admitted to certain healthcare institutions
- Regular testing in certain situations
- Anyone who suspects that they have COVID-19
*Supplementary information further down the page.
Recommendations for testing are not changed by vaccination status.
COVID-19 consultations and testing are free in the public health service for everyone who is staying in the country, regardless of residence status
- There is usually no basis for forcing people without symptoms to be tested, according to the Infection Control Act.
Supplementary information about who should be tested
1) Test with newly arisen respiratory tract infection or other symptoms of COVID-19
Everyone with symptoms of COVID-19 should be tested as soon as possible. This includes anyone with a newly arisen respiratory tract infection or other symptoms of COVID-19. COVID-19 often has the following symptoms; fever, cough, shortness of breath, loss of taste or smell, sore throat, or feeling unwell.
For residents of nursing homes, there should be an extremely low threshold for testing at the least suspicion of COVID-19.
Children should also be tested, in consultation with their parents. Children with a runny nose as the only symptom, who are otherwise in general good health without other signs of a newly arisen respiratory tract infection, do not need to be kept at home or tested.
Everyone who is tested should stay at home until a negative test result is available. With a negative test, they can return to work/school when their general condition is good (they feel well and have no fever), even though they still have a few symptoms after the respiratory tract infection.
For deaths in healthcare institutions where a doctor suspects that the patient had COVID-19, postmortem tests for COVID-19 should be performed.
2) Contact tracing
a) Close contacts at start and end of quarantine
All close contacts should be tested. Testing should preferably be done both at the start of the quarantine and again at least 7 days after the last exposure. With limited test capacity, it is recommended to prioritise the last test. It is recommended that children also be tested, but this must be done in consultation with parents / guardians.
Testing at the start of the quarantine will make tcontact tracing efforts more efficient, to quarantine any close contacts more quickly and isolate people who test positive. The first test can be either a rapid antigen test or PCR.
Tests at the end of the quarantine are taken to identify infected people with few or no symptoms. Shortened quarantine with tests taken no earlier than 7 days after exposure is considered to be better than 10 days in quarantine. PCR is required for shortened quarantine.
b) With outbreaks: widened testing of other contacts
In situations with large, complex outbreaks, it is recommended to also test other contacts than those defined as close contacts. This may, for example, apply to others in the workplace or in the school grade than those defined as close contacts. Such testing can be useful to quickly find other infected people and form a situational analysis of transmission and extent of the outbreak.
Both rapid antigen testing and PCR are appropriate test methods.
c) People notified by the Smittestopp app
People who receive a notification from the Smittestopp app that they may have been exposed to infection, are encouraged to be tested. As it is unknown when transmisson may have occurred, and because a few days after exposure will have passed, they should be tested as soon as possible.
Both rapid antigen testing and PCR are appropriate test methods. Rapid tests are especially useful for infection clarification where response time to PCR is long (> 24 hours). More about this can be found in the chapter about antigen testing (in Norwegian):
3) Arrival in Norway
a) Mandatory testing at border crossings
The main rule is that everyone who arrives in Norway from areas or countries with a high incidence of COVID-19 must be tested on arrival, at the border crossing point in Norway. Children under the age of 12 must also be tested, but not if it is unreasonably demanding to take the test. Do not use force. When testing children, take the sample from the front part of the nose.
Usually rapid tests are taken. All positive rapid test results must be confirmed by a PCR test taken within 24 hours.
b) Mandatory testing 7 days after arrival
All travellers shall be tested with PCR 7 days after the day they arrive in Norway. Shortened quarantine with a negative test taken no earlier than 7 days after arrival is considered a better alternative than 10 full days in quarantine because asymptomatic cases can be identified.
4. Other screening after infection control assessment
a) When moving in / being admitted to certain health institutions
Before moving into a nursing home, new unvaccinated residents should be tested. Retesting after 3-5 days should be considered.
Before admission to certain health institutions, testing may be relevant. The health institution's infection control officer will provide advice on this.
PCR is the recommended test method.
b) Regular testing in certain situations
After a specific infection control assessment, advice can be given about testing different groups more regularly for better control in certain situations with widespread transmission. Regular testing can be as effective and less intrusive than, for example, closing upper secondary schools.
In such situations, rapid antigen testing will be most appropriate.
5) Anyone who suspects they are infected with COVID-19 should be given the opportunity to get tested
A person who believes or suspects that they are infected with COVID-19 should be offered a test, if there is sufficient capacity.
Other people who want a test for other reasons, for example because they need a health certificate before leaving the country, can also be tested, but the test will then usually not be covered by the public sector.
Recommended order of priority with a lack of testing capacity
If there is a lack of testing capacity, testing should be carried out in the following order of priority.
(Since testing is mandatory at the border after arrival from a country with quarantine duty, this is no longer included in the order of priority.)
A) People with symptoms
- Patient in need of hospital admission
- Patient / resident in a nursing home or other healthcare institution
- Employee in the healthcare service with work that puts them in the vicinity of patients
- Person in a risk group, see risk groups and their relatives
- People who have been exposed to infection
- Other people with symptoms
B) People without symptoms who have been exposed to infection:
- Outbreak situations in healthcare institutions
- A close contact to a confirmed case of COVID-19
Interpreting the test results
The PCR-test for COVID-19 is a good test with very high specificity and good sensitivity.
The clinical sensitivity of PCR from the nasopharyngeal sample during the disease period is estimated at around 80 %. The sensitivity of the test depends on where in the course of the disease the infected person is. It is highest in the days around the start of symptoms, when it is probably over 90 %.
The clinical specificity is very high (99, 999%), but be aware that PCR only detects the genetic material, and not whether the virus is contagious or able to multiply. People who have undergone COVID-19 may excrete virus residues for 2-3 months after undergoing infection (usually 20 days after the onset of symptoms). This means that a positive result may represent a past, and no longer contagious, infection. During the first 3 months after infection, a new PCR test should rarely be performed.
If re-infection is suspected after 3 months, a new test can be taken but the result should still be interpreted with caution. Contact the NIPH for advice.
No test is completely accurate and the result must be interpreted according to the probability that the person is infected.
In the current infection situation, the probability is high that a positive test is correct, even in those cases where the person has no symptoms or known exposure, and does not need to be confirmed by a new test. If the test result is considered to be unlikely, a new test should be considered to confirm the result. If the result is slightly positive (CT value above 33) in an asymptomatic person without an increased risk of infection, a new PCR and possible antibody test can help to clarify where the person is in the course of the disease.
If the test result is negative, and there is still a strong clinical suspicion of COVID-19, a new sample should be taken. The probability of a false negative test result should be assessed on the basis of whether the person is known to have close contact, the clinical suspicion, time since the onset of symptoms and the CT value.
Test results from other localisations such as saliva, anterior nose, throat or bronchioalveolar lavage (BAL) have different test properties.
Waiting for test results
The main rule is that anyone who has been tested must stay at home until their test result becomes available. Household members do not have to be in quarantine.
There are three exceptions to the main rule:
- People who have been tested even though they have no symptoms or have not been exposed to infection, do not have to stay at home awaiting a test result.
- People who are in quarantine who have symptoms compatible with COVID-19 are considered as "probable COVID-19" pending test results. This means that the person who is sick is in isolation and household members and equivalent close contacts are in quarantine until test results become available.
- In some large outbreaks with confirmed highly contagious virus variants, household members of close contacts should also be in "waiting quarantine" until the close contact received a negative result from the first test.
Test results at helsenorge.no
As soon as coronavirus tests are analysed, the laboratory sends the test results to:
- NIPH laboratory database
- The doctor - the result is shown in the electronic summary care record that healthcare personnel can access on helsenorge.no
- The patient's test results page at helsenorge.no
The patient can log on to Helsenorge.no with electronic ID to see their test result.
Notification by mobile phone or e-mail about test results
You may now receive notification by SMS or e-mail when the test result is ready. To receive an SMS or e-mail notification, you must have created a user account on helsenorge.no. Over 4 million inhabitants already have a user account there. Those who are unsure whether they have a user account can go to helsenorge.no and choose to log in.
People who have not previously used Helsenorge will be asked if they want to consent to use. The user can decide whether they want notification by SMS, e-mail, or both. This is done by changing the settings at helsenorge.no/contactinformation.
The user will have access to their own test results, and those of their own children aged under 16 years.
Many viruses and bacteria can cause respiratory tract infections. In the search for the correct diagnosis, it may be necessary to request other analyses for respiratory tract infections. Analysis results from the additional tests will be available to the patient on the test results website on Helsenorge.no and for the doctor in the summary care record.
A list of these additional tests is approved by the Ministry of Health and Care Services, see below. It is important that the person ordering the tests should explain to the patient about the different tests that are being sent for analysis.
The following are defined by the Ministry of Health and Care Services as COVID-19 related test results, this means both different tests for SARS-CoV-2 and additional tests for viruses and bacteria that can cause similar symptoms.. The list is updated as of 2nd July 2020, and will be continuously updated at helsenorge.no:
- SARS-CoV-2 antibodies
- Influenza A / Influenza B
- Parainfluenza virus
- RS virus (Respiratory syncytial virus)
- Human metapneumovirus
- Mycoplasma pneumonia
- Chlamydia pneumonia
- Bordetella pertussis (whooping cough)