The doctors, most of whom also work in the health sciences faculty at the University of Cape Town, said testing people with symptoms came at a cost to other health services during previous waves “when severe Covid-19 threatened to overwhelm acute hospital services”.

However, it was questionable now that only 6% of patients were requiring admission — about a third of the number in the first wave.

“To preserve the integrity of primary healthcare services during Covid-19 surges, testing strategies must change,” said Andrea Mendelsohn, Angela de Sá, Erna Morden, Benjamin Botha, Andrew Boulle, Masudah Paleker and Mary-Ann Davies.

“Options could include ramping up testing stations that are delinked from primary healthcare facilities in which public sector patients with mild disease could obtain a Covid-19 test, affordable home-based self-testing, or, if neither of these are feasible, restricted testing to severe Covid-19 patients requiring hospital admission.”

The doctors said only 6% of Covid-19 patients admitted to Western Cape hospitals during the fourth wave had been tested at primary healthcare facilities.

The rest were tested on admission, “suggesting those with severe Covid-19 are seeking care only when they are very ill”.

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