Guide to getting tested in Monaco

Rapid antigen tests are set to roll out in Monaco as soon as health professionals are given the all clear to administer them – which could be any day now. It will be the third Covid screening option available in Monaco. So, which test should you choose, where can you get it, and how much should you expect to pay?
With the number of coronavirus testing options increasing in the Principality, Monaco Life has put together this useful guide for residents and workers.

Rapid Antigen Test

As reported in Monaco Life earlier this month, the government has acquired 10,000 rapid antigen tests which will, in theory, cover a quarter of the population. A ministerial order is now needed to allow health professionals in Monaco to administer the tests – which is an international requirement – and it is likely to happen within the week.
At that point, pharmacists, private nurses and doctors will be able to carry out the antigen test, which involves taking an uncomortable nasal swab. A few drops of the reagent are mixed with the sample and placed on a strip that shows one line for negative, two lines if the patient is positive for CoV-2-SARS, much like a home pregnancy test. A positive result means that the virus is active in the patient’s body.
Antigen tests are useful because they do not need to be sent to a laboratory for analysis and results can be obtained within 20 minutes. It is therefore a quicker alternative to PCR testing and has a positive sensitivity rating of between 84-98%, according to the Centre for Disease Control (CDC).
While PCR tests look for genetic material from the virus, the antigen test looks for molecules on the surface of the virus. Therefore, rapid antigen tests perform best when the person is tested in the early stages of infection when viral load is generally highest.
Unfortunately, that means the tests often fail to identify people who are positive but are in the later stages of infection.
As a result, people who receive a negative antigen test will still need to take a more sensitive PCR test anyway.
Patients with a positive result will also need to take a PCR test for confirmation.
So why are they being used?
By providing results quickly, the new test will give authorities a better chance to manage cases by isolating patients quickly to prevent further spread and to begin treatment immediately.
According to a pharmacist contacted by Monaco Life, the rapid antigen test will cost around 40€, which can be reimbursed through Monegasque health insurance.
People will be required to make an appointment before getting a test. A list of participating pharmacies will likely be released soon by the government, although a simple phone call or visit should reveal if they are authorised to administer the antigen test.
Positive antigen test results are relayed to the Monaco Health Department.
Some people will be able to use their antigen test results to enter a country with travel restrictions, such as Italy. However, rules vary depending on the country.

PCR test

PCR testing requires a nose swab which is sent to a lab to find even tiny amounts of the virus. It does this by amplifying a virus’ genetic material to a level where it can be detected.
Results will confirm whether or not a person was infected with the virus at the time the test was carried out.
Espace Léo Ferré: Faced with a resurgence of positive cases of Covid-19, the Monaco government set up a National Screening Centre at the Espace Léo Ferré in September. This centre is open to all Monegasque residents, anyone who has social insurance in Monaco and all schoolchildren in Monaco.
However, there are conditions. People can not simply turn up to get tested – they must make a prior appointment and come armed with a prescription from their doctor.
Therefore, only people who are symptomatic or “contact cases” can be tested there.
Appointments can be made at the following number: +377 92 05 55 00.
The test is quick to administer and it takes between three and six hours to analyse a sample, not including the time required to transport it.
Laboratories: Asymptomatic or non-contact cases who want to be tested in order to travel or for personal reasons can make an appointment with a private laboratory for a PCR test. No prescription is needed.
PCR tests are available free of charge upon presentation of a prescription at the Espace Léo Ferré.
In private laboratories, the cost of a test appears to vary anywhere between around 100€ and 200€, depending on the lab. However the majority of this can be recovered from health insurance.
Positive PCR test results are relayed to the Monaco Health Department.
Negative PCR tests can be used to enter a country with travel restrictions

Rapid finger prick tests (serological)

These tests look for antibodies in a blood sample to show if a person has been exposed to the virus and are immune to it, despite not having any symptoms. It requires a small finger prick of blood and is not painful, or a blood test can be undertaken in a laboratory.
The finger prick test can be obtained from a pharmacy, private nurses or doctor, and results are available in around 10 minutes.
The fee should be no more than 15€ at a pharmacy, and 10€ plus consultation fee at a private doctor.
A serological test undertaken in a laboratory is not covered by Monegasque health insurance.
If the rapid diagnostic test is positive, a doctor will issue a prescription for a more sensitive blood test from a laboratory – the results of which will be provided to the Department of Health Affairs.
Rapid diagnostic tests can not be used to enter a country with travel restrictions.
Saliva tests
As reported in Monaco Life in early October, the Principality has ordered and received non-invasive saliva tests which it is currently trialling and, pending the outcome, will possibly make available to the public as a supplement to the PCR and rapid diagnostic tests.
However, the saliva tests are only beneficial when a person is showing signs of the disease and fail to detect coronavirus in 75% of cases when the patient is asymptomatic, according to the Haute Autorité de Santé.
If introduced in Monaco, saliva tests will be particularly useful for detecting the virus in symptomatic people who have difficulty with the nasal swabs, such as children, elderly people or those with mental health conditions.
We will update this screening option if/when it becomes available.
Photo © Government Communication Department / Stéphane Danna
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