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PCR, ART, or Antigen: Where to get COVID-19 related tests?

COVID-19 has upended our daily lives. However, recent developments in healthcare have given us essential tools to tackle the pandemic. Testing and vaccination are two crucial tools to keep the virus in check and prevent clusters from growing beyond control. To know about vaccine updates in Singapore, check out our previous article on the topic

In this article we cover the various COVID tests available in Singapore, how they help you, and where can you get them done.

Commonly available types of COVID-19 tests

There are 3 commonly used tests for COVID-19, each with its own advantages and disadvantages: 

Polymerase Chain Reaction (PCR) test

PCR test is the most important test for screening of COVID-19 infected individuals. PCR tests can detect the presence of the genetic material for SARS-CoV-2, the coronavirus that causes COVID-19. It is usually tested from the nasal pharyngeal area, where the sinuses meet the throat, as it has the highest volume of the virus. The test is able to detect the presence of a virus if it was done while you were infected. It can also detect traces of a virus even when you have recovered.

The accuracy and reliability of the PCR tests have led this to become the "Gold Standard" test for diagnosing COVID-19. However, since it is more reliable and accurate, it is costlier than the other tests and may take some time for the results to be out. In addition, as it is able to detect minute amounts of virus material, it may still test positive if you were infected in the distant past.

Antigen Rapid Test (ART) 

ART provides a diagnosis of the active SARS-CoV-2, the coronavirus that causes COVID-19. It looks for fragments of the virus without amplifying or replicating it in the lab. It is also tested from the nasal pharyngeal area.

ART provides fast results since it only needs 15 to 30 minutes after the sample is collected and is inexpensive. It is highly specific and sensitive for positive results. However, it is less reliable for negative results than PCR and less sensitive for COVID-19, therefore it often needs confirmation from PCR tests.

Antibody Test

The antibody test is different from PCR and ACT as it is not used for the diagnosis or screening of COVID-19. Antibody test checks for past SARS-CoV-2 infections. They are primarily used to identify individuals who might have been infected with the SARS-CoV-2 virus or have recovered from COVID-19 infection.

Blood samples for antibody tests are taken from a finger prick or venous blood draw. However, the accuracy cannot be determined since it can take 1–3 weeks after infection for the body to develop enough antibodies to be detected in a test. On top of that, not everyone will have antibodies if the infection is not severe. For individuals who have received COVID-19 vaccination, an antibody test is NOT recommended for the purpose of determining if the individual is protected or immune from COVID-19.

Where can I get COVID-19 related tests done in Singapore?

Polymerase Chain Reaction (PCR) test

PCR test bookings for COVID-19 are administered in PHMCA-licensed HCIs and at approved offsite premises. This list provides a full range of test providers approved by the Ministry of Health. However, PCR only diagnoses for active infection at the time of testing. PCR tests do not detect people with infections in the past or predict the infections within the next 2 weeks for those who were exposed to COVID-19. 

Test Results Explanation

Positive

Most likely infected with SARS-CoV-2.

Negative 

No active SARS-CoV-2 virus was detected. However, it doesn’t rule out infection prior to the virus being at a detectable level.

Antigen Rapid Test (ART) 

This list provides a full range of antigen rapid test providers approved by the Ministry of Health. There are multiple test providers in Singapore that conduct pre-event ART testings as well. Free antigen rapid self-test kits are also provided for people who visited or live near the specified list of centers. ART kits are also available in Guardian and Watsons for anyone to test conveniently. They have been stocked with two antigen rapid test (ART) kits: the Abbott PanBioTM Covid-19 Antigen Self-test and the QuickVue At-Home OTC Covid-19 Test. Alternatively, this list shows all of the ART self-test kits that are authorized for use in Singapore.

Test Results Explanation

Positive

Most likely infected with SARS-CoV-2 and need PCR testing to confirm.

Negative

Most likely not infected, however, stay vigilant. Continue to observe safe distancing measures and practice good personal hygiene.

Antibodies Test

Some medical groups like Mount Elizabeth Hospitals and Parkway Health Laboratories provide antibodies testing. There are multiple explanations for different test results for antibodies test. The below table summarizes the explanations:

Test Results Explanation

Positive

Infected with SARS-CoV-2 at some point in the past.
Antibodies were developed from earlier infections relating to SARS-CoV-2 and were unable to distinguish between the other virus antibodies and those that were generated for SARS-CoV-2.
Antibodies were developed from earlier infections relating to SARS-CoV-2 and were unable to distinguish between the other virus antibodies and those that were generated for SARS-CoV-2.

Negative

Not infected with SARS-CoV-2.
Infected with SARS-CoV-2 but antibodies have not reached a sufficient level for the test to detect them.
Infected with SARS-CoV-2 but insufficient time for antibodies to develop.

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