Table 2. COVID-19 testing access and strategy, six European countries, 2021.

Testing access and strategy
Country	Overall Testing Access category	Where testing done	Target populations for testing	Testing logistics and payment	Paid testing	Home testing	Non-symptomatic screening outside of target groups	Other
Belgium	Some restrictions	RT-PCR: laboratories, and testing centres Antigenic: laboratories, GP’s office.	Those with symptoms, high risk contacts, returning travellers, those targeted in cluster investigation.	A QR code, reserved for target populations, is necessary for a free test. This can be provided by a GP, contact tracer, or in some cases by the testing centre directly.	Anyone without a QR code may pay between 47 and 80 euros for an RT-PCR test.	Individuals may buy at-home antigenic tests in pharmacies.	Some school testing and testing of healthcare workers is organised particularly in the case of cluster investigations. No specific strategy is in place to routinely test non-symptomatic individuals that are not included in targeted testing groups.	The testing system is set up around RT-PCR tests. No need for RT-PCR confirmation of positive antigenic tests performed in laboratories or GP offices. Individuals with positive at-home antigenic tests should perform a confirmation RT-PCR test.
England	Few restrictions	RT-PCR: any healthcare setting, at home, in the community, in managed quarantine facilities Antigenic/LFD: anywhere including at home, schools, business or in monitored settings	RT-PCR: Those with symptoms, contacts, travellers from certain countries, ad hoc testing, confirmation of positive LFD if necessary LFD: anyone	RT-PCR tests are free for anyone in target groups and can be performed at listed sites or conducted at home by ordering testing kits to be delivered and returned by mail. LFD tests are always free and can be performed in listed sites, obtained in pharmacies, or ordered online and delivered by mail.	RT-PCR tests for travel related purposes may be purchased at market rates (around 70 euros).	LFD may be conducted at home. RT-PCR samples may be taken at home.	LFD are designed for regular testing of non-symptomatic individuals. National recommendations include using an LFD when engaging in activities that may increase exposure to COVID-19 (social events, etc.). Schools, business, and other structures also have regular non-symptomatic testing using LFD.	Systematic confirmation RT-PCR test is necessary after a positive LFD.
France	Few restrictions	RT-PCR: laboratories, hospitals Antigenic: pharmacies, GP’s offices	Those with symptoms, contacts, travellers, ad hoc testing campaigns (e.g. variant investigation) or high risk communal areas (airports, retirement homes). No difference between RT-PCR and antigenic tests.	Anyone can receive a free antigenic or RT-PCR test at testing sites. Appointments at laboratories are often necessary for RT-PCR tests.	All testing is free of charge.	Individuals may buy at-home antigenic tests in pharmacies.	Some screening campaigns in high-risk communal areas (airports, retirement homes, schools) exist as well as among healthcare workers. Individuals may test themselves at any time for any reason for free.	A confirmation RT-PCR test is recommended after a positive antigenic test or a negative antigenic test for symptomatic individuals as well as those with a positive at-home antigenic test.
Italy	Some restrictions	RT-PCR: drive-in testing centres, laboratories, hospitals Antigenic: drive-in testing centres, laboratories, hospitals, pharmacies	Those with symptoms, contacts, those testing to end isolation. No official difference between RT-PCR and antigenic tests although differences may exist in practice.	A prescription or another specific authorisation is needed for a free test. These are provided to those in target groups. A prescription can be obtained in person or by phone. Most testing is done in drive-in testing centres.	Anyone can be tested if they pay. Test prices vary by region. RT-PCR may cost around 70 euros. Antigenic tests may cost around 8 to 15 euros	Some home visits by contact tracers are organised to test individuals. Individuals may also buy at-home antigenic tests in pharmacies.	Screening of specific groups exists and depends on regions, (e.g. healthcare workers, schools) In mid-May around 22% of cases nationally were identified through screening activities.	Regional differences between testing type and strategy exist. Individuals with a positive at-home antigenic test should perform a confirmation RT-PCR or antigenic test in an authorised facility.
Romania	Some restrictions	RT-PCR: laboratories, hospitals Antigenic: pharmacies, GP’s office	Those with symptoms, those testing to end isolation, symptomatic individuals with a negative antigenic test. Those included in medical risk groups (e.g. oncology, dialysis) if accessing the health system.	Testing is free for those who fall into the target groups.	For those who do not qualify for a free test, RT-PCR may be conducted for 50 euros and antigenic tests for 25 euros	Individuals may buy at-home antigenic tests in pharmacies.	Screening on hospital admission is conducted as well as routine screening of health and social workers and residents in long-term care units.	Individuals with positive at-home antigenic tests should perform a confirmation RT-PCR test.
Sweden	Some restrictions	RT-PCR: drive-in testing centres, hospitals, testing centres, home delivery of tests Antigenic: hospitals, primary healthcare facilities including elderly care	RT-PCR: Symptomatic individuals, contacts, travellers, ad hoc studies, those with scheduled surgery, those confirming a positive antigenic test Antigenic: specific situations when a quick result is needed including outbreaks or other special situations	Free tests are available for those within the target groups and available through testing centres or home-delivery of self-sampling kits. Antigenic tests used within the healthcare system are also free for target groups.	Anyone outside of targets groups can pay for RT-PCR or antigenic testing (30–100 euros).	In some regions, most sampling for RT-PCR tests takes place at home through a delivery system. Individuals may also buy at-home antigenic tests in pharmacies.	Outside of contact testing and special studies, no specific efforts are made for non-symptomatic testing in the community. National point prevalence studies using PCR have been done periodically throughout the pandemic to estimate prevalence nationally. Some regional screening is done to identify cases among healthcare workers.	RT-PCR tests are generally not recommended within 6 months of having had a positive RT-PCR result in the community. A positive antigenic test or at-home antigenic test should be confirmed with an RT-PCR test.

GP: general practitioner; LFD: lateral flow device.