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What to know about Germany’s planned PCR test restrictions

According to a recent decision by the German federal and state governments, PCR tests will soon be restricted to high-risk groups and people who work with vulnerable people. But how does this affect things like quarantine rules and measuring infection rates? Here's what we know so far.

Covid test centre in Hamburg
A sign in Hamburg advertises free antigen tests and paid-for PCR tests to the public. Photo: picture alliance/dpa | Daniel Bockwoldt

Why are tests being restricted? 

Germany’s infection rates have been spiralling over the past few weeks, hitting new all-time-highs on a daily basis. At the time of writing on Wednesday, the 7-day incidence of Covid infections was 940 per 100,000 people – a massive jump from the figure of 584 recorded just a week ago. 

In Berlin, the current Omicron hotspot, the 7-day incidence of infections is currently almost 1,800 per 100,000 residents. 

These high incidences are matched by record daily cases. On Wednesday, around 164,000 new Covid infections were reported within a day. But due to limited testing capacities and staffing issues at local health authorities, this could be an underestimation.

Though severe courses of Omicron are believed to be rarer than with the previous dominant variant Delta, experts say that current wave is nowhere near its potential peak. Health Minister Karl Lauterbach (SPD) believes that the country could record as many as 400,000 new cases a day by February. 

Against this backdrop, the government wants to restrict the availability of PCR tests in order to ensure that there are enough tests for people who need them. 

What’s the current testing capacity? 

According to recent data from the Association of Accredited Laboratories in Medicine (ALM), 2.4 million PCR tests were carried out in Germany last week. One in three tests were positive, they confirmed, and the proportion of positive samples is rising week-on-week.

Currently, the laboratories are working at around 95 percent capacity, meaning that just a small increase in infections or staff shortages could lead to testing centres becoming overwhelmed. 

The government has promised to expand these testing capacities to cope with the Omicron wave, but it also wants to introduce restrictions. 

OK, so can I still get a free PCR test? 

Currently, anyone with Covid symptoms, a positive antigen test or a red alert on their Corona Warn app can get one for free on their health insurance or by visiting a state testing centre. 

But this looks set to change. 

In future it will depend on your profession and your health. Only people who fall into a ‘risk’ category – i.e. someone who is elderly or has pre-existing condition – and those who work with vulnerable groups will be able to get a PCR test for free. 

Specifically, the new ordinance mentions staff “in hospitals, in surgeries, in nursing and in institutions for integration assistance”. 

Of course, if you’re happy to pay for one, you may be able to still get a PCR test with a private provider – these tend to cost upwards of €40 per test. 

READ ALSO: KEY POINTS: How Germany will tackle latest phase of the Omicron wave

How does this affect quarantine and self-isolation rules?

That’s a tricky one to answer, since normally a PCR test is required to confirm an infection – but a potential rule-change could be on the cards. In future, people who don’t belong to a risk group could require two positive antigen test results to confirm a Covid infection and self-isolate. 

The same is likely to apply for proving a past Covid infection, though once again nothing concrete has emerged yet. 

Corona Warn App red alert

The Corona Warn App shows a red alert. Photo: picture alliance/dpa | Julian Stratenschulte

In addition to rapid tests, the government is pinning its hopes on so-called Poc-NAAT tests to help bolster its testing capacity. There should soon be one million more of these tests – which are allegedly around 10 times more accurate than rapid tests – available per week. The use of these may be restricted to people with Covid symptoms, but again nothing firm has been worked out yet.  

In terms of getting released from self-isolation, the government is making a tweak to its recently changed quarantine rules. This will mean that people who work in hospitals and care homes will soon be able to use a rapid test to release themselves from quarantine after a week – just like everyone else. Previously, the government had required a PCR test for this group. 


Can we still track Covid figures if we are restricting tests?

That’s a very good question. According to information obtained by the Redaktionsnetwerk Deutschland (RND), the Federal Ministry of Health is currently working with the Robert Koch Institute (RKI) on a new system for calculating infection rates.

Antigen test results are currently forwarded onto the RKI, but are only included in official statistics if accompanied by a positive PCR test result. 

“Whether and in what form antigen tests will be included in the statistics in future is currently being examined,” the RKI told RND.

In other words, it is possible that antigen test results will also be used to help calculate the Covid incidence in future – though the RKI would have to take into account the lower accuracy of these tests in its modelling. 

When are the changes coming into force?

That we don’t know yet. The Health Minister and his state colleagues are still working out the details at the moment so keep in mind that there could be room for slight changes in the finished legislation. 

It is then likely that states would adopt measures, and there can be variations among state regulations. 

Member comments

  1. >Can we still track Covid figures if we are restricting tests?

    That’s a very good question. According to information obtained by the Redaktionsnetwerk Deutschland (RND), the Federal Ministry of Health is currently working with the Robert Koch Institute (RKI) on a new system for calculating infection rates.

    They will just guess. And the numbers will always be going up at alarming rates. Even when they fall. They are just going up in reverse.

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German doctors say Covid testing is too ‘expensive and bureaucratic’

Doctors in Germany have slammed the new Covid testing regime, which involves partly charging for rapid tests.

German doctors say Covid testing is too 'expensive and bureaucratic'

The German Health Ministry announced on Thursday that most people would have to pay a contribution rate of €3 to get a Covid rapid test, while they would remain free of charge for certain vulnerable groups.

But chairman of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen, called for an end to so-called Covid Bürgertests. 

“These nonsensical tests must be abolished,” Gassen told Bild newspaper. “They are far too expensive, the bureaucratic effort is huge and the epidemiological significance is zero.”

It is a “completely pointless exercise to test healthy people with (tests of) questionable quality for no reason,” Gassen said.

Gassen said, however, that PCR tests carried out on patients with symptoms are important to detect Covid infections.

If people in Germany have Covid symptoms, they can contact their GP who can arrange for a PCR test that is covered by health insurance. 

According to the new test regulation, which came into force on Thursday, the Bürgertests, which were previously free of charge for everyone, will now only be available for free to a limited extent.

READ ALSO: The new rules on getting a Covid test in Germany 

For instance, people who can’t get vaccinated for medical reasons can still get a free rapid test, as well as children up to five-years-old and some at-risk groups. 

Other people will be charged €3 per test, and under the new rules people have to state why they are getting the test.

Health Minister Karl Lauterbach said he hoped this would help combat fraud as well as cut down on the cost to the taxpayer. 

However, in a letter to Lauterbach, the heads of the 17 associations of statutory health insurance doctors said they “do not want to be responsible for making payments on invoices whose accuracy they cannot even begin to check”.

They said they “will no longer be able to bill and pay for the Bürgertests in the future”.

According to research by Spiegel, more than €1 billion was taken by fraudsters for Covid tests that never took place – or test centres that did not even exist.

READ ALSO: Germany starts charging for Covid tests 

On Thursday, Health Minister Lauterbach defended the new test regulation. He told broadcaster ZDF that he would have liked to keep the tests completely free of charge, “but we could no longer afford that”.

He said the additional bureaucratic effort for the tests is “manageable”.

Lauterbach also told RTL Direkt that the tests would now be more meaningful. “If everyone can just get tested as often as they want, without there being a reason for it, then too many tests will also be negative, or if they are positive, then often false positives.

“We have limited that so that the tests are more meaningful.”

In a tweet on Friday morning, Lauterbach said the Health Ministry was “already in constructive talks” with the the Association of Statutory Health Insurance Physician on the billing of tests. 

“The tests will remain, and will be invoiced correctly as of today,” he said, adding that they were “not pointless but help to prevent infected people from infecting others”.

A spokesperson for the Health Ministry told Bild: “The tests are not nonsensical, but save lives by breaking chains of infection. We assume that the KVs (associations) as corporations under public law, will continue to fulfil their mandate to bill and spot-check the test centres.”