When it comes to the cost of a nucleic acid test, it should be a concern for many people. In particular, some time ago there was a news report that the United States to do a new crown pneumonia nucleic acid test, deducted in addition to insurance, individuals need to pay 1600 U.S. dollars. Seeing this news, undoubtedly stunned many small partners, nucleic acid test is really so expensive? So how much does it cost to do a new crown pneumonia nucleic acid test in China? In response to the question of nucleic acid test, we will say together below.
I. How much does it cost to do a nucleic acid test in our country?
We have actually come out with a corresponding notice on the issue of the cost of nucleic acid test a long time ago. Roughly, it can be divided into two cases:
●1. Confirmed cases as well as suspected cases of nucleic acid test costs with the treatment costs, all by the state underwriting, personal zero payment
For the new coronary pneumonia nucleic acid test costs, in fact, the country has long been out of the relevant notice. The Ministry of Finance, on January 22nd, jointly issued the "Emergency Notice on Doing a Good Job in the New Coronavirus-infected Pneumonia Epidemic Medical Protection", which clearly states that the treatment costs of the suspected and confirmed patients, in addition to the reimbursement from the medical insurance, are all covered by the government, and that the patients can rest assured that they will receive the treatment.
Simply put: for suspected and confirmed patients in the treatment process costs, in addition to health insurance reimbursement, the individual part of the burden by the financial subsidies, personal zero payment. In this case, it will include the nucleic acid test.
Then some people ask, I am neither a suspected patient nor a confirmed patient, just a fever or unit back to work required to test the nucleic acid of the virus, then the cost is how to calculate, is also free of charge? For this question, in fact, in some provinces and regions have issued a relevant notice. Here we are again to understand.
●2. For those who do the nucleic acid test at the fever clinic, the cost of the test varies from place to place, so let's take a look at the cost of the test in two places, Hunan and Guangdong.
The cost of nucleic acid testing in Hunan Province
To do nucleic acid testing in Hunan, there is a difference between the fees charged by public medical institutions and third-party testing organizations, according to the "Notice on the Temporary Establishment of the Price of New Crown Pneumonia Nucleic Acid Testing Program":
★Public Medical Institutions: Public Medical Institutions belonging to the province's new Crown Pneumonia Nucleic Acid Setting Temporarily established The price of medical services for the "C.N.C.P. nucleic acid test" is set at 40 yuan per visit, excluding the cost of nucleic acid test reagents. The costs incurred are reimbursed by the medical insurance, the patient's personal "zero out-of-pocket".
★Third-party testing organizations: the province's new crown pneumonia nucleic acid designated testing third-party testing organizations to carry out the new crown pneumonia nucleic acid testing fees at no more than 160 yuan/personal implementation (including reagents, consumables, and other costs), to encourage further reductions in testing prices.
From the Hunan Province, the new crown pneumonia nucleic acid test price standards, if it is in the public medical institutions test, although the charge of 40 yuan / person, but ultimately can be reimbursed by the medical insurance, so as to realize the individual free of charge. And if you go to a third-party test, then the maximum charge is no more than 160 yuan per visit.
Guangdong Province nucleic acid test costs
Guangdong for the new crown pneumonia nucleic acid test costs implemented by the standard is much better than Hunan. On February 28, the Guangdong Provincial Government Information Office held the 34th epidemic prevention and control press conference, Guangdong will be the new crown pneumonia screening subjects in the fever clinic nucleic acid test, lung CT examination into the scope of special medical care, to achieve the new crown pneumonia nucleic acid test, CT screening zero charge. Even in the third-party testing, such as Guangzhou Jinwei Medical Laboratory Center, Guangzhou Daan Clinical Laboratory Center, Guangzhou Huayin Medical Laboratory Center, etc., the cost of testing does not need to be borne by the patient, and all of them are underwritten by the government.
Shenzhen, Guangdong Province, also based on the implementation of standards in Guangdong Province, and the introduction of the Shenzhen Municipal "on increasing efforts to do a good job in the new crown pneumonia epidemic medical protection work notice", which pointed out in the third article: during the epidemic period, the new crown pneumonia screening subjects in the fever clinic outpatient screening costs (including but not limited to chest CT, nucleic acid testing, etc.), according to the provisions of all temporary included in the scope of payment of the medical insurance fund. In addition, Shenzhen has a special program for some self-isolation patients at home. In addition, Shenzhen for some home self-isolation personnel, test virus nucleic acid is also free of charge.
That is to say, in Guangdong Province, during the epidemic, as long as you are the new crown pneumonia screening object, in the fever clinic to do the new crown pneumonia nucleic acid test, chest CT screening, etc., the costs incurred are zero charge.
Two, above said the new crown pneumonia nucleic acid test cost, the following we will say do a nucleic acid test need to go through what process
The current nucleic acid test is generally in the Laboratory Department of the molecular biogenetic room test, and as a member of the Laboratory Department, the nucleic acid test is the most familiar. Except for the pre-sampling which is not in the Laboratory Department, the virus inactivation, nucleic acid extraction and gene amplification are all carried out in the laboratory. Here we are on these processes to briefly introduce, I will try to say a little easier to understand, so that everyone is easier to understand.
●Step 1: Pharyngeal Swab Sampling
The first step in this new C.pneumoniae nucleic acid test is to take a pharyngeal swab from the patient. This is mainly done by CDC staff or fever clinic staff, and only requires the patient to remove the mask and open their mouth to make an "ah" sound, exposing the entire back wall. After that, the sampling staff will extend the sampling rod to the patient's posterior pharyngeal wall, rub the sample, and finally put the sample into a reagent tube to seal, so that the sampling is completed.The patient will feel a sense of vomiting during the sampling, because the sample is taken from the posterior wall of the pharynx, which can cause some irritation. And there will be a period of time after taking a bit of foreign body sensation, after all, the sampling pump in the back wall of the pharynx around the back of the smear back and forth, but these are normal.
Sampling is actually very important for the accuracy of the test results, and if the sampling is not up to snuff, and the virus is not coated, then the results will be affected. In addition, sampling is also more dangerous, after all, in the sampling face patients, if it is a confirmed patient then it is directly facing the virus. So the sampling personnel bucket is all armed, from head to toe to be wrapped tightly, is to do a good job of protection.
When the sampling is completed, there are specialized personnel through the sample handover special channel, will have just collected the throat swab specimens and test room inspectors for sample handover.
●The second step: virus inactivation
(put into a 56℃ water bath for 30 minutes to inactivate)
When the collected pharyngeal swab specimen is sent to the test department, the staff of the test department will carry out the inactivation of the sample.
Why inactivate the virus? Because it is the first step in nucleic acid extraction. We place the sample in a water bath and perform a 56 degree, 30-minute viral inactivation.
Why is it necessary to go through a 56 degrees 30 minutes virucidal operation? This is because the virus can be inactivated after the 56 degrees 30 minutes water bath treatment, which can ensure the safety of the testing personnel without affecting the test results, so that the risk of infection of the operator will be greatly reduced.
In addition, when the sample has been inactivated for 30 minutes, it also needs to be left at room temperature for 20 minutes, which prevents high temperature opening of the cap and thus aerosol contamination.
●Step 3: Nucleic Acid Extraction
After the virus is inactivated, it's time for the nucleic acid extraction step, which is very dangerous and must be done in a biosafety cabinet because it's the closest thing to the virus, and also where the risk of infection is the greatest. When you open the lid of the sample to extract nucleic acid in the safety cabinet, you need to be very careful to open the lid, because if you are not careful, an aerosol may be formed, which will not only contaminate the safety cabinet, but also may allow other samples to be cross-infected, forming "false positives".
The so-called nucleic acid extraction is to extract the viral RNA, or nucleic acid, from the sample. But because RNA is structurally unstable, it needs to be converted into DNA, a process that involves PCR, which is a process of reverse transcription that separates the two strands of RNA through denaturation, annealing, and extension, so that the viral message is transmitted to a single strand of DNA, and the viral nucleic acid can be extracted.
●Step 4: Gene amplification
After the nucleic acid is extracted, the amount is so small that it cannot be detected by machines. At this time, it is necessary to use the extracted viral nucleic acid as a template, so that the DNA is constantly self-replicating, and after 20 to 30 times of replication, the template DNA can be expanded to more than 1 million times. After amplification, the presence of the new coronavirus nucleic acid can be detected. Just like when we check for bacterial infections in the microbiology room, we need to culture the bacteria before we can perform identification and drug sensitivity tests. It's all the same thing, that the number has to be high enough to be detectable.
In a nutshell, the whole point of nucleic acid testing is to keep the DNA replicating itself and accumulating fluorescent signals so that in the end it can be detected by the instrument and thus interpreted.
Ideally, if there is new coronavirus in the patient's sample, an S-shaped curve will form between the number of cycles and the amount of fluorescence, and a positive nucleic acid test will be determined. If there is no or a small amount of new coronavirus, then there is no similar curve and the nucleic acid test is negative.
In summary, the entire process of nucleic acid testing in the laboratory, from sample inactivation, nucleic acid extraction, gene amplification, analysis of the results to the final report, lasts about six hours. If the test result is "positive", you need to do it again for review. So it takes at least 12 hours to produce a positive report for a new crown nucleic acid.
Third, after the question:
The above is about the cost of the nucleic acid test and the process of doing a nucleic acid test. Through my explanation above, I believe we all have a general understanding. I hope my answer can satisfy everyone.