Mass testing for patients suspected of having coronavirus disease 2019 (COVID-19) will begin Tuesday, health officials said, with priority being given to the seriously ill and essential front-line personnel.
“We want to clarify that not everybody will be tested, this is not indiscriminate testing… so we’ll prioritize the severe cases, the vulnerable population, the elderly, the sick, those with co-morbidites and the pregnant. Health care workers, especially if they have symptoms, are included,” said Health Undersecretary Maria Rosario Vergeire during a briefing Monday.
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On April 4, the Health department said there would be expanded testing to get a fuller assessment of the public health situation as the number of confirmed COVID-19 cases in the country was expected to increase.
There are 10 laboratories now accredited and capable of testing patients nationwide.
These include the Medical City in Pasig City; St. Luke’s Medical Center in Quezon City; Bicol Public Health Laboratory in Legazpi City, Albay, Vicente Sotto Memorial Medical Center in Cebu City; Baguio General Hospital and Medical Center in Benguet; San Lazaro Hospital in Manila City; Southern Philippines Medical Center in Davao City; Lung Center of the Philippines in Quezon City; University of the Philippines’ National Institutes of Health in Manila; and Western Visayas Medical Center in Iloilo City.
Before their accreditation, only the Research Institute for Tropical Medicine served as the confirmatory testing laboratory for COVID-19.
Vergeire said testing would be ramped up progressively.
“When we reach the time that our government..,. can produce 8,000 test kits per day, we’ll include those with exposure, those with travel history and symptoms,” Vergeire said.
Vergeire urged the public to continue the practice of physical and social distancing and frequent washing of hands which have been proven effective in curbing the transmission of COVID-19 in other countries.
She said it would take from six months to a year and a half before any “deployable” vaccine is developed.
Senator Panfilo Lacson, who has criticized the slow pace of testing, welcomed the move toward mass testing.
“There is no saying that Secretary Carlito Galvez Jr. is not doing a good job as chief implementer of the government’s national response against COVID-19, by playing catch-up for the inadequacies of some people,” Lacson said.
But Lacson said he could not understand why the Department of Health keeps issuing circulars that circumvent a provision of the Bayanihan Act that provides some leeway for the use of donated test kits that have already been in use in other countries.
One DOH requirement, for example, is an application by the manufacturer or distributor.
“Since these are donations and therefore not for business purposes, how in the world will these donors look for local distributors, or look for the manufacturer to file for an application?” Lacson said.
He said the new law states that all donated health products need only a certification from the regulatory agency of the donor country that allows the use of those products.
With the continuing increase in the number of confirmed cases and deaths due to the novel coronavirus, Lacson said, the DOH must make adjustments.
At the same time, Lacson said he hoped contact tracing would become more efficient with new rules about the mandatory disclosure of COVID-19 infected persons.
The Manila city government, meanwhile, said it is now capable of conducting more than 1,600 COVID-19 swab tests a week as it begins its localized targeted mass testing.
Manila Mayor Francisco “Isko’’ Domagoso said localized targeted mass testing would begin at the Manila Health Department and the city’s six district hospitals.
Domagoso has designated Manila City Health Officer Dr. Arnold Pangan to lead the localized targeted mass testing.
The following health facilities operated by the city government are now capable of conducting about 232 COVID-19 swab tests per day, or 1,624 per week: MHD/Delpan Quarantine Facility—50 tests per day; Ospital ng Maynila—20 tests per day; Sta. Ana Hospital/MIDCC — 30 tests per day; Gat Andres Bonifacio Memorial Medical Center 50 tests per day; Ospital ng Tondo—17 tests per day; Justice Jose Abad Santos General Hospital—15 tests per day; and Ospital ng Sampaloc—50 tests per day.
All swab tests will be processed either by the Department of Health’s Research Institute for Tropical Medicine (DOH-RITM) or the University of the Philippines Philippine General Hospital (UP-PGH).
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Dr. Gap Legaspi, UP-PGH director, has committed to the Manila city government that they can release the results in two to three days.
As of Monday, about 934 swab tests have already been conducted by the Manila city government.
Hospitals operated by the Manila city government are now authorized to send COVID-19 patients to the Ninoy Aquino Stadium, which was recently turned into a quarantine facility by the national government.
Health advocates, civil society organizations, youth groups, and medical societies, meanwhile, supported the call of experts not to use the rapid antibody tests for clinical or public health purposes.
“We echo the call of numerous experts —rapid antibody tests should not be used outside a research setting at this time. In this time of crisis, we believe that tests and treatments should be carefully assessed before routine use, so as not to aggravate the dangers of the disease and the difficulties already faced by our health care system,” said members of the Stop COVID-19 Coalition.
According to the World Health Organization, the lack of evidence on the accuracy of the rapid antibody tests means that they must only be used in research settings, until there is enough proof supporting their use for specific indications.
The Philippine College of Physicians (PCP) and the Philippine Society of Microbiology and Infectious Diseases (PSMID) also discouraged the use of the rapid antibody tests for clinical care, citing the high rate of false positives and false negatives, particularly when used during the first 14 days of illness.
The Stop COVID-19 Coalition appealed to the government not to use the rapid antibody tests at this time, given the very high error rates.
“As much as 72 percent of positive tests will be false positives. Non-COVID-19 cases will be classified as COVID-19 cases and this will lead to errors in management. Numerous non-COVID patients will be sent to COVID centers, exposing them to patients with COVID-19, and occupying scarce beds during this great time of need,” said Dr. Antonio Dans of the Asia-Pacific Center for Evidence-Based Healthcare, one of the organizations that signed the statement.
Aside from false positives, the rapid antibody test could also report false negatives, which could further worsen the spread of the virus.
“Seventeen percent of negative tests will be false negatives. COVID-19 cases will be classified as non-COVID-19 cases and this will lead to a false sense of reassurance. Numerous COVID-19 patients may be sent to PUI centers, inadvertently exposing other patients as well as health care providers,” added Dr. Eddie Dorotan, convener of the Galing Pook Foundation.
To date, there have been 4,648 confirmed cases of COVID-19 in the country. Of the 4,648, 297 have died while 197 have made a full recovery.
The Stop COVID-19 Coalition statement has been sent to the members of the IATF. With PNA
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