posts: 30687

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                        "text": "One of the most important things that countries need to be doing to help understand and stop the spread of COVID-19 is ",
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                                "text": "testing",
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                        "text": ". Here we explain why testing is important, what it involves, and how many tests countries are doing based on available data from official sources.",
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                        "text": "It\u2019s important to remember that these numbers change very quickly, so they\u2019re provisional and uncertain; but data about testing is extremely important, and at the moment there is no central database compiling them, so we are bringing together the best available numbers, after reviewing a large number of data sources from individual national reports, country by country.",
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                        "text": "Why is testing important?",
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                        "text": "Testing allows infected people to",
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                                "text": " know",
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                        "text": " that they are infected. This can help them receive the care they need; and it can help them take measures to reduce the probability of infecting others. People who don't know they are infected might not stay at home and thereby risk infecting others.",
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                        "text": "Testing is also crucial for an appropriate response to the pandemic. It allows us to understand the spread of the disease and to take evidence-based measures to slow down the spread of the disease.{ref}For example, the report of the WHO-China Joint Mission on Coronavirus Disease, 16-24 February 2020, online ",
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                        "url": "https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf",
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                                "text": "here",
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                        "text": ", explains on page 34: \u201cDevelopment of rapid and accurate point-of-care tests which perform well in field settings are especially useful if the test can be incorporated into presently commercially available multiplex respiratory virus panels. This would markedly improve early detection and isolation of infected patients and, by extension, identification of contacts.\u201d{/ref}",
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                        "text": "Unfortunately, the capacity for COVID-19 testing is still low in many countries around the world. For this reason we still do not have a good understanding of the spread of the pandemic.",
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                "text": [
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                        "text": "How are COVID-19 tests done?",
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                        "text": "The most common tests for COVID-19 involve taking a swab from a patient\u2019s nose and throat and checking them for the genetic footprint of the virus. They are called \u201cPCR tests\u201d. The first PCR tests for COVID-19 were developed very rapidly \u2013 within two weeks of the disease being identified \u2013 and they are now part of the World Health Organisation (WHO)\u2019s recommended protocol for dealing with the disease.{ref}The report of the WHO-China Joint Mission on Coronavirus Disease, 16-24 February 2020, online ",
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                        "url": "https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf",
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                                "text": "here",
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                        "text": ", explains that in addition to PCR tests, there are other diagnostic methods that remain less common, including serological diagnostic tests that rely on antibody assays using a blood sample. According to the WHO-China Joint Mission, the timeline for the development of the PCR tests was as follows: (i) On 29 December 2019 Chinese authorities identified a cluster of similar cases of pneumonia in the city of Wuhan in China; (ii) on 7 January, the virus found to cause COVID-19 was initially isolated from a clinical sample; (iii) on 16 January, the first PCR assays for COVID-19 were distributed to Hubei, China. You can find more information on the WHO protocols for COVID-19 laboratory testing in humans here: ",
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                        "url": "https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance",
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                                "text": "https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance",
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                        "text": "{/ref}",
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                        "url": "https://youtu.be/tgyzdgf66eM",
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                                "text": "Here",
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                        "text": " you can find an explainer video on how the tests for coronavirus disease work.",
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                        "text": "What information about test coverage do we currently have?",
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                        "text": "Ideally, we would like to have as much detail about COVID-19 tests as possible. We would like to know how many people in the world are being tested for COVID-19 every day, and in which countries. We\u2019d like to know what the results of these tests are, and how the available tests are being used \u00a0\u2013 are countries testing only people in hospitals? People with symptoms?",
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                        "text": "Unfortunately, the WHO does not have a centralized database for COVID-19 testing data, so at the moment it is very hard to know.",
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                        "text": "That said, several countries do publish statistics on the total number of tests performed.  But these reports are published across individual websites, statistical reports and press releases \u2013 often in multiple languages and updated with different periodicity.",
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                        "text": "Because a global overview was not available from a single source, at Our World in Data we are bringing together a large number of data sources from individual national reports, in order to provide a global picture with the best available estimates.",
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                        "text": "Below we show the most recent data ",
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                                "text": "as of 20 March 2020, 18.00 GMT",
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                        "text": ". This requires a lot of careful work, but we will do our best to expand and update these estimates regularly.{ref}Note: The Wikipedia page on",
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                        "url": "https://en.wikipedia.org/wiki/COVID-19_testing",
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                                "text": " COVID-19 Testing",
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                        "text": " also compiles available estimates. These often cover more countries, but they are sometimes inaccurate or out of date; the estimates are often incorrect, or trace back to unreliable sources. That\u2019s why we use official reports, and do not rely on Wikipedia as our source.{/ref}",
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                "text": [
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                        "text": "Current COVID-19 test coverage estimates",
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                        "text": "Total tests by country",
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                        "text": "These two charts show the most up-to-date estimates of testing levels that we\u2019ve been able to find (",
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                        "children": [
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                                "text": "as of 20 March 2020, 18.00 GMT",
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                        "text": "). You\u2019ll see that some countries\u2019 data is older than others, meaning that they can\u2019t be directly compared. For instance, the estimate for the province of Guangdong in China has not been updated since 24 February.",
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                        "text": "The first chart plots the total number of tests against the total number of confirmed cases. The more tests a country has done the higher it is; the more confirmed cases it has, the further it is to the right.",
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                        "text": "Naturally, since you can only get a positive test if you carry out a test in the first place, countries that have performed more tests will tend to have more confirmed cases. In other words: there is a positive correlation between tests performed and cases confirmed. That doesn\u2019t necessarily mean that countries that have done more tests really have more cases, although in many cases they will.",
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                        "text": "However, the differences between countries can tell us important things. For instance, we can see that some countries have done more tests per confirmed case. The UK, for example, has done many more tests than other European countries with a similar number of confirmed cases.",
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                "url": "https://ourworldindata.org/grapher/tests-vs-confirmed-cases-covid-19",
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                        "text": "The second chart plots the number of tests performed in each country. The most obvious point is that the data shows South Korea has done many more tests than other countries. That means we can expect that in South Korea the number of confirmed cases \u2013 positive tests \u2013 is closer to the real number of infected people than it is in other countries.",
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                        "text": "That makes it encouraging to see that the number of daily confirmed cases in South Korea has gone down. (",
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                        "url": "https://ourworldindata.org/grapher/daily-cases-covid-19-who?time=1..59&country=KOR",
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                                "text": "Here",
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                        "text": " you find our chart that shows the decline of confirmed new cases in South Korea.) South Korea was able to quickly manufacture and use a huge number of tests, showing that it is possible. Testing is crucial, so it is vital that other countries follow South Korea\u2019s lead.",
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                        "text": "A note about the chart: There are now too many countries in our dataset to show them all at once, so not all countries with available data are shown by default. If you want to see a different country, you can select the option 'add country' to find it.",
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                "url": "https://ourworldindata.org/grapher/covid-19-tests-country?country=AUS+AUT+BRA+BEL+COL+FRA+FIN+DEU+PAK+RUS+NOR+VNM+USA+GBR+KOR",
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                                "text": "[NB. We provide two estimates for the US. The estimate labelled \"US - CDC samples tested\" is from the Centers for Disease Control and Prevention, and refers to the number of tests conducted, not the number of individuals tested. The estimates labeled \"United States\" correspond to estimates of people tested, according to data gathered by the",
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                        "url": "https://docs.google.com/spreadsheets/u/2/d/e/2PACX-1vRwAqp96T9sYYq2-i7Tj0pvTf6XVHjDSMIKBdZHXiCGGdNC0ypEU9NbngS8mxea55JuCFuua1MUeOj5/pubhtml#",
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                                "children": [
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                                        "text": " COVID Tracking Project",
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                                "text": " \u2013 these estimates are updated more frequently.]",
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                "text": [
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                        "text": "Per capita tests by country",
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                        "text": "These two charts show the most up-to-date estimates of testing levels that we\u2019ve been able to find (",
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                        "children": [
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                                "text": "as of 20 March 2020, 18.00 GMT",
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                        "text": "). You\u2019ll see that some countries\u2019 data is older than others, meaning that they can\u2019t be directly compared. For instance, the estimate for the province of Guangdong in China has not been updated since 24 February.",
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                        "text": "The first chart takes the size of the population into account. It plots the total number of tests per million people, against the total number of confirmed cases, also per million people. The higher the dot representing a country is, the more tests per million people it has carried out; the further right it is, the more tests per million people have come back positive.",
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                        "text": "We see that countries with higher rates of confirmed cases tend to be also countries where a larger share of the total population has been tested. Again, since you can only get a positive test if you carry out a test in the first place, countries that have performed more tests will tend to have more confirmed cases.",
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                        "text": "But again there are important differences between countries. Vietnam, for example, shows a much higher testing rate than Indonesia, although at this point in time (20 March 2020) both have a similar number of confirmed cases per million people.",
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                        "text": "From this perspective, it is clear that the US is lagging behind. The number of tests per million people in the US is almost 10 times lower than in Canada, and about 20 times lower than in South Korea. The US has had",
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                        "url": "https://www.theatlantic.com/health/archive/2020/03/how-many-americans-have-been-tested-coronavirus/607597/",
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                                "text": " big problems",
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                        "text": " rolling out their testing strategy, although they seem to be slowly catching up.",
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                "url": "https://ourworldindata.org/grapher/tests-vs-confirmed-cases-covid-19-per-million",
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                        "text": "The second chart plots the number of tests per million people, country by country. Not all countries with available data are shown by default \u2013 you can select the option 'add country' to see the available estimates for other countries.",
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                "url": "https://ourworldindata.org/grapher/covid19-tests-per-million-people?country=DEU+AUS+AUT+BRA+FIN+FRA+COL+KOR+ZAF+GBR+USA+VNM+ARE+JPN+IRN",
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                "text": [
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                        "text": "The full documentation of our sources on testing data",
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                        "text": "We list estimates country by country, including exact dates and links to the underlying source, in a companion page",
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                        "url": "https://ourworldindata.org/coronavirus-testing-source-data",
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                                "text": " here",
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                        "text": ".",
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                                "text": "The tests are not perfect: sometimes, people who have the disease will be wrongly told that they do not",
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                        "text": "Some people require more than one test because of false-negative outcomes",
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                        "text": "The number of COVID-19 tests carried out will be similar to the number of people tested, but they won\u2019t be quite the same, because some people may need to be tested multiple times. The reason for this is that there are \u201cfalse-negative\u201d test outcomes.{ref}Arashiro T, Furukawa K, Nakamura A (2020). ",
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                    },
                    {
                        "url": "https://doi.org/10.3201/eid2606.200452",
                        "children": [
                            {
                                "text": "COVID-19 in 2 persons with mild upper respiratory tract symptoms on a cruise ship, Japan",
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                        ],
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                    {
                        "text": ". ",
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                    {
                        "children": [
                            {
                                "text": "Emerging Infectious Diseases",
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                        "text": ".{/ref}",
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                                "text": ",",
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                        "text": "{ref}Tang A, Tong Z-d, Wang H-l, Dai Y-x, Li K-f, Liu J-n, et al. (2020). ",
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                    },
                    {
                        "url": "https://wwwnc.cdc.gov/eid/article/26/6/20-0301_article",
                        "children": [
                            {
                                "text": "Detection of novel coronavirus by RT-PCR in stool specimen from asymptomatic child, China",
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                        ],
                        "spanType": "span-link"
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                    {
                        "text": ". ",
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                        "children": [
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                                "text": "Emerging Infectious Diseases",
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                        "text": ".{/ref}",
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                                "text": ",",
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                        "text": "{ref}Ai, T., Yang, Z., Hou, H., Zhan, C., Chen, C., Lv, W., ... & Xia, L. (2020). Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. ",
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                        "children": [
                            {
                                "text": "Radiology",
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                        "text": ".{/ref}",
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                                "text": ",",
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                        "text": "{ref}Huang, P., Liu, T., Huang, L., Liu, H., Lei, M., Xu, W., ... & Liu, B. (2020). ",
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                    },
                    {
                        "url": "https://pubs.rsna.org/doi/10.1148/radiol.2020200330",
                        "children": [
                            {
                                "text": "Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion",
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                        "text": ". ",
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                        "children": [
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                                "text": "Radiology",
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                        "text": ".{/ref}\u00a0",
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                        "text": "A \u201cfalse-negative\u201d outcome is when someone is tested and found to be clear of the disease, but when tested again, are found to have it. The WHO\u2019s guidelines for laboratory testing of COVID-19 say that negative results \u201cdo not rule out the possibility of COVID-19 virus infection.\u201d{ref}WHO (2020).",
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                        "url": "https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117",
                        "children": [
                            {
                                "text": " Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases",
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                    },
                    {
                        "text": ". World Health Organization.{/ref}",
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                "value": [
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                        "text": "This means that even in countries that have done lots of tests, the true number of COVID-19 cases is still uncertain, although of course more testing still means more certainty.",
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                        "text": "There haven\u2019t been many studies into how common false negatives are, so it\u2019s hard to know how big an impact they have on our understanding \u2013 but research is going on.{ref}See for example Wang, W., Xu, Y., Gao, R., Lu, R., Han, K., Wu, G., & Tan, W. (2020).",
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                        "url": "https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Detection+of+SARS-CoV-2+in+Different+Types+of+Clinical+Specimens&btnG=#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AN2W9QCS1u-8J%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den",
                        "children": [
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                                "text": " Detection of SARS-CoV-2 in Different Types of Clinical Specimens",
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                        "text": ". ",
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                                "text": "JAMA",
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                        "text": ". {/ref}",
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                "text": [
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                        "text": "Why might COVID-19 tests fail?",
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                        "text": "There are several reasons why someone infected with COVID-19 may produce a false-negative result when tested:{ref}WHO (2020).",
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                        "url": "https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117",
                        "children": [
                            {
                                "text": " Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases",
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                    },
                    {
                        "text": ". World Health Organization.{/ref}",
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                                "text": ",",
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                    {
                        "text": "{ref}Hao, Q., Wu, H., Wang, Q. (2020).",
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                    {
                        "url": "https://www.researchsquare.com/article/rs-17319/v1",
                        "children": [
                            {
                                "text": " Difficulties in False Negative Diagnosis of Coronavirus Disease 2019: A Case Report",
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                        "text": ". ",
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                        "children": [
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                                "text": "Research Square",
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                        "text": ".{/ref}",
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                        "value": [
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                                "text": "They may be in the early stage of the disease with a viral load that is too low to be detected.",
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                            }
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                        "type": "text",
                        "value": [
                            {
                                "text": "They may have no major respiratory symptoms, so there could be little detectable virus in the patient\u2019s throat and nose.",
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                        ],
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                    {
                        "type": "text",
                        "value": [
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                                "text": "There may have been a problem with sample collection, meaning there was very little sample to test.",
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                        "type": "text",
                        "value": [
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                                "text": "There may have been poor handling and shipping of samples and test materials.",
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                        "type": "text",
                        "value": [
                            {
                                "text": "There may have been technical issues inherent in the test, e.g. virus mutation.",
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                        "text": "The WHO suggests that these issues should be taken into account and that for some people, tests should be carried out several times.{ref}This advice from the WHO is also implemented at national and local levels for testing. For example, the Centers for Disease Control and Prevention in the US publishes a Fact Sheet for testing COVID-19, explaining the following :",
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                    },
                    {
                        "children": [
                            {
                                "text": " \u201cA negative test result for this test means that SARSCoV-2 RNA was not present in the specimen above the limit of detection. However, a negative result does not rule out COVID-19 and should not be used as the sole basis for treatment or patient management decisions. A negative result does not exclude the possibility of COVID-19. When diagnostic testing is negative, the possibility of a false negative result should be considered in the context of a patient\u2019s recent exposures and the presence of clinical signs and symptoms consistent with COVID-19.\u201d",
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                            }
                        ],
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                    },
                    {
                        "text": " CDC (2020)",
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                    {
                        "url": "https://www.cdc.gov/coronavirus/2019-ncov/downloads/Factsheet-for-Healthcare-Providers-2019-nCoV.pdf",
                        "children": [
                            {
                                "text": " Fact sheet for healthcare providers",
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                            }
                        ],
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                    },
                    {
                        "text": ", CDC - 2019-nCoV Real-Time RT-PCR Diagnostic Panel,\u00a0March 15, 2020.{/ref}",
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                    }
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        "type": "article",
        "title": "COVID-19 Testing [Archived]",
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    "createdAt": "2020-03-13T16:01:03.000Z",
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    "updatedAt": "2020-05-07T17:35:44.000Z",
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