Frequently asked questions
Go or stay home as soon as you experience symptoms of upper respiratory diseases (cough, sore throat, temperature over 38°C, difficulty breathing) as you may be potentially infectious.
Call your family doctor. Emergency clinics set up during an emergency situation help patients when their family doctor is not working. The family doctor or emergency clinic physician assesses whether the testing is indicated for you and provides health advice according to the recommendations created by the Health Board and the Estonian Society of Family Doctors.
If your family doctor decides that testing is necessary, he or she will send an electronic referral letter to the testing call centre set up by SYNLAB and Medicum. They will call you within one day to agree on a time and place for the testing. Please wait for the call!
NB! When communicating with your family doctor, make sure you have your correct phone number on the referral letter, or the testing call centre will not be able to reach you.
To get tested, you must have a referral letter from your family doctor for a coronavirus test. Start by contacting your family doctor.
After the referral letter sent by your family doctor has reached the information system of a public testing organisation, you will receive a short text message (SMS). Then the public testing call centre operated by the public procurement partner Medicum will get in touch with you.
According to the agreement between the state, the Health Board and the Estonian Society of Family Doctors, mobile sampling sites have been established all over Estonia. You can find their exact coordinates HERE.
The nasopharynx or pharyngeal washings sample for PCR testing can only be given by the person who received the electronic referral letter on the basis of their identification document. More information is available HERE. Further information about close contacts can be found HERE.
It is recommended that you use your personal car to arrive to the sampling site. This ensures the highest level of safety for you, the person scheduled before and after you, and the healthcare professionals taking the sample, who are currently working bravely at the forefront and are so critical to us all. Though potential carriers of the virus must avoid using public transport or taxi, they can arrive on foot, if necessary.
When you come from quarantine to give a sample, you should get into your car right after you have left home, give a sample and return home immediately afterwards.
Please arrive to the agreed place on time to avoid crowds. Make sure you dress according to the weather, as in most cases you will need to wait outside (relevant information is available at the individual testing sites). Please turn off your car engine while giving the sample.
We recommend that you blow your nose before sampling. If you choose sampling from pharyngeal washings, please refrain from eating and drinking for 1 hour before giving the sample. Please also wear a mask when arriving to the testing site.
A referral letter is personal and is created for each person individually. Thus, if an entire family wants to get tested, each family member needs to obtain an individual referral letter. A single referral letter is not sufficient for the entire family or household.
Once all family members have obtained their referral letters, the next step is to book a testing time, which again needs to be done for each family member separately (consecutive times, if possible). With a single reservation, only the person for whom that specific time was reserved can get tested.
If you have a referral letter from your family doctor and have agreed on a time and place for the testing, drive there even if you arrive a little later. Your sample will still be taken and the queue will be arranged on site.
For people with special needs or without a car, a coronavirus PCR sample taken from the nasopharynx or pharyngeal washings will be arranged at home, and a specific time is agreed for this.
If a mobile unit is coming to your home, you will be called in advance, and the exact time of arrival and your location will be agreed upon. Please be sure to stay home or come to the agreed site on the day of sampling!
Taking a test at home is many times more expensive!
Each home visit takes time to arrive to your location and the sampler has to leave their testing site, which means that they can serve fewer people on this day. Therefore, home testing is only possible to a limited extent. If possible, we ask you to come to the mobile sampling site by car and leave the possibility of testing at home to those who really need it. We thank you in advance for your understanding!
In the context of public testing, there is no desire to favour people who own a car, but such testing is designed to ensure a maximum ability to test and at the same time not spread the virus.
Coming by public transport or by taxi allow for the virus to be spread widely by its carriers. In addition, car sampling is safer for people working at mobile points as well as for the previous and next patients in line, as there is less human contact and virtually no contact with surfaces.
The Government Crisis Committee has clearly stated the following: people with symptoms of upper respiratory diseases must be quarantined at home! This means not using public transport and not going to the grocery store or elsewhere, as this constitutes extremely risky behaviour.
In accordance with the agreement with the Health Board, the SYNLAB Eesti laboratory will issue PCR test results on average within 24 hours from giving the sample. In case of a positive SARS-CoV-2 result, you will be contacted by the callbot on the phone number indicated on your referral letter.
From January 2022, anyone in Estonia requesting a referral-based SARS-CoV-2 test will qualify for SYNLAB’s testing panel, which can issue three results: in addition to SARS-CoV-2, the influenza A and B (not distinguished from one another) and RS virus will be detected from a single sample at SYNLAB’s Tallinn laboratory. This doesn’t entail any additional costs for the state.
Those who gave a referral-based sample can view all three results in the digilugu.ee environment using an identity document with an Estonian personal identification code.
In addition to the possibility to view the result on digilugu.ee, the test takers who paid for the test can agree with the institution that took the sample on how to obtain the additional result (usually encrypted by e-mail).
All results are also forwarded from the laboratory to the family doctor who made the referral, to the Health Board and to the health information system.
The test result “Borderline” can refer to two states of health:
- The early phase of the infection where the quantity of the virus is not clearly detectable but is increasing in the respiratory tract and thus the person is still potentially infectious;
- The healing phase where, after being recently infected, the person has already recovered and most probably is no longer infectious but viral RNA is still detectable in a minor quantity.
In this case, retesting is recommended after two days. Those who took a referral-based test need to contact their family doctor to obtain a new referral letter. Those who used the paid coronavirus testing option have to contact their service provider again.
If your test is positive, stay home and follow your family doctor’s recommendations. If you feel unwell, contact your family doctor or call 112 for an ambulance. The recommendations of the Estonian Society of Family Doctors can be found HERE: https://koroonatestimine.ee/patsiendile/positiivne-tulemus/.
To reduce the risk of people falling ill at work and to deduct the cost for the employee, and thereby limit the spread of COVID-19, the procedure for reimbursing the benefits for incapacity for work was temporarily changed from 1 January 2021. The employee’s deductible is the first day of illness, the employer pays the benefit from the second to the fifth day and the Estonian Health Insurance Fund pays the benefit from the sixth day. This procedure will continue also in 2022. Further information is available HERE.
- From the crisis hotline 1247, you can receive instructions for dealing with emergencies and issues related to the coronavirus (available 24/7, free of charge). Hotline 1247 also offers psychological first aid to people in need.
- If you have any health-related questions, call the family doctor hotline at 1220 or +372 634 6630 (you can also call from abroad).
- In case of breathing difficulty or shortness of breath, call the emergency number 112.
- If you have any questions, please contact the Health Board by e-mail: info@terviseamet.ee
Detection of SARS-CoV-2 RNA from respiratory tract material using the real-time polymerase chain reaction (PCR) method is recommended by the World Health Organisation (WHO) as well as other international organisations and clinical practices as the co-called gold standard for coronavirus testing.
The PCR method has also been regularly used by doctors for many years to detect other viral infections of the respiratory tract (e.g., influenza).
In Estonia, all referral-based SARS-CoV-2 testing will qualify for SYNLAB’s testing panel, which can issue three results: in addition to SARS-CoV-2, the influenza A and B (not distinguished from one another) and RS virus will be detected from a single sample at SYNLAB’s Tallinn laboratory. This doesn’t entail any additional costs for the state. All three results can be viewed on digilugu.ee
The PCR test allows detecting only the presence of the genetic material of the virus, not its ability to infect other people. The presence of a viable virus can only be detected by growing the virus in the cell culture; however, this method is unsuitable for regular diagnostics due to its high cost and time-consuming nature (the process takes several weeks).
The SARS-CoV-2 PCR test does not allow exact detection of the amount of virus particles, but their amount can be measured indirectly in the patient’s sample material through the Ct value.
- Ct (cycle threshold) is the number of RNA replication cycles, starting from which the specific test result is considered as positive. The Ct value is often confused with the number of cycles; however, these two are different values. A low Ct value indicates high viral load, which is associated with an increased risk of infecting others.
- A high Ct value indicates low viral load in the analysed material, which may be due to the following:
- Beginning of the infectious phase where the viral load is not yet clearly detectable and thus a person is already potentially infectious;
- Convalescent phase (end of infection), where the person has recently been infected and the risk of him/her infecting others may already be lower.
The Ct value is not specified in the response; it is part of the technical data not the response, and it is not validated for clinical use.
Ct values are not standardised and different tests used in laboratories may yield different values from the same sample material. Therefore, comparing these values and drawing conclusions solely based on these values is not clinically justified.
With a view to avoiding false interpretations, laboratories do not issue Ct values. This decision is based on a consensual agreement between the Estonian Society of Laboratory Medicine, Estonian Society for Infectious Diseases and Estonian Health Board.
The Ct value used in the test is determined by the test manufacturer and is based on research results.
In the SYNLAB Eesti lab in Tallinn, SARS-CoV-2 is determined with the RT-PCR method, using the ThermoFisher TaqPath COVID-19 CE-IVD RT-PCR reagents. These reagents are designed to detect three SARS-CoV-2 genes, N, S and ORF1ab. According to the rules set forth by the manufacturer, sample material is considered positive if the presence of at least two of these genes is confirmed. In addition to Ct values, the results are also evaluated based on the RFU value (relative fluorescence unit) and rise of the amplification curve.
More detailed information by the manufacturer can be found here.
In addition, SYNLAB Eesti has successfully performed comparative tests with a WHO reference laboratory and participates regularly (several times a year) in international comparative tests.
The methodology has been verified in the lab and is accredited by the Estonian Accreditation Centre. The laboratory has a permission issued by Estonian Health Board for provision of health care services in the field of laboratory medicine.
A patient’s infectiousness depends on a number of factors: the amount of virus particles in the respiratory tract, the amount of virus particles spread (normal breathing versus singing/sneezing), precautions taken (masks, keeping distance), etc. Laboratory tests analyse the presence of the virus in the respiratory tract. As explained above, PCR does not directly determine the level of infectiousness. The level of infectiousness has been indirectly evaluated by correlating the Ct values with cultivating the virus in the cell culture.
The claim that a large number of PCR positive patients have only residual positive results and thus are no longer infectious may only be valid in certain limited patient groups (e.g., in case of surveillance testing of random people). The majority (ca 90%) of tests sent to the laboratory for diagnostics have extremely high viral loads, indicating infectiousness. Only in fewer than 5% of cases a low infectiousness level can be assumed (based on research data from Jaafar et al. 2020 and SYNLAB Eesti sample statistics).
The possibility that a person is PCR positive but with a certain degree of probability he or she is not infectious cannot be an argument in refusing to wear personal protective equipment or disregarding other rules.
As with any other test, the test result, including the Ct result, should be evaluated in the clinical context (presence of symptoms, time from the onset of symptoms and, if necessary, results of additional analyses, e.g., antibodies), and should not be used to automatically determine the patient’s level of infectiousness. The final interpretation falls upon the treating physician, who takes all this into account and decides whether the patient should be isolated or may already have recovered from the infection.
It is important to note that Ct values are not different in symptomatic and asymptomatic patients. With asymptomatic patients, it is difficult to determine precisely the beginning of the infectious period.