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, or if your family doctor is not available, the family doctor hotline 1220. 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 calling your family doctor.
The testing call centre set up by Medicum and SYNLAB will contact you within one day of receiving a referral letter from your family doctor for mobile coronavirus testing. Generally, you can expect to get tested on the same day or the next day at a mobile sampling site, with a waiting list of up to 2 days for home testing.
According to the agreement between the state, the Health Board and the Estonian Society of Family Doctors, sampling sites have been established. You can find them HERE.
The nasopharynx sample can only be given by the person who received the electronic referral letter on the basis of their identification document.
You must arrive in a personal car to the sampling site to ensure 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. As potential carriers of the virus are not allowed to travel by public transport or taxi. You may 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 your house, give a sample and return home immediately afterwards.
Drive the car to the agreed place on time!
Please turn off the car engine while giving the sample.
In addition to mobile sites, there are also home sampling units available across Estonia thanks to Fertilitas, Alre, Elder, SYNLAB, Kuressaare and Kärdla Hospitals. If you do not have the opportunity to travel by car, please state this at the time of booking and you will be given the opportunity to receive a mobile unit at home in the coming days.
On the day of the testing, the mobile unit will contact you and inform you when they will arrive to take the sample. Please be sure to stay home that day!
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 sample taken from the nasopharynx will be arranged at home, and a specific time is agreed for this. At present, there are 10 home units available all over Estonia.
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 that day!
Taking a test at home is many times more expensive!
After each home visit, the sampler replaces all his or her protective equipment, which is in limited supply in Estonia. Therefore, home testing is only possible to a limited extent. Therefore, 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 result must be issued in Estonia within 48 hours.
In case of a positive result, you will be contacted by the testing call centre, regardless of whether you have given a referral-based sample, a paid sample or a sample at the border. Those who gave a referral-based sample can see their results on digilugu.ee 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.
In case of a negative result, a corresponding short message will be sent to those who crossed the border (both Estonian citizens and foreign nationals).
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.
During the emergency situation in effect in Estonia, the Government has decided to make an exception and reimburse the first three days of illness retroactively for sick leaves taken from 13 March until the end of the state of emergency. The benefit rate depends on the reason for the absence from work and is calculated on the basis of the employee’s average income for the previous year.
Once the changes necessary for payment have been accepted, the Estonian Health Insurance Fund will make an additional payment for those whose sick leave certificate has already been closed and who are in good health by that time. This may take some time due to the additional workload. If you are still running out of sick leave at that time, you will receive the total amount of extra days’ benefit. It is likely that these payments will start in May, the Health Insurance Fund explains. More information can be found HERE.
The planned change does not affect the certificate for care leave, as they are already financed by the Health Insurance Fund from the first day of illness and to the extent of 80% of the carer’s average salary last year.
- Work from home. Don’t go to the office (communicate through your phone, Skype, Teams, Zoom, etc.).
- Shop wisely. Plan your shopping ahead, go to the store alone and stock up on food for a prolonged period.
- Avoid public spaces. Exercise alone, away from others.
- Be social only by means of digital solutions.
- Strictly follow the rules of hygiene. Wash your hands!
- Require your family, loved ones and friends to follow the same rules — we need to make a collective effort to combat the virus.
See the recommendations of the Health Board for a person suspected of having COVID-19 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 golden standard for coronavirus testing.
The PCR method has been regularly used by doctors for many years to detect other viral infections of the respiratory tract (e.g., influenza).
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.