Urgent need for mass testing
Our nation’s “war plan” against the COVID-19 disease is in a state of disarray. There are discordant voices and signs of needless turf war among our public officials. This is happening at a very crucial time when we desperately need a clear and unified plan, because the numbers of our sick and dead are fast increasing. The conflict among our officials is on the issue of whether or not our country should go on “mass testing” to identify those who are infected in our communities. Department of Health (DOH) Secretary Francisco Duque III disfavors “mass testing,” arguing that we lack funds and that we have few hospitals equipped to do the tests.
But a phalanx of senior officials favors mass testing: Secretary Carlito Galvez Jr. who’s the chief implementer of the national action policy against COVID-19, Finance Secretary Carlos Dominguez III, Socioeconomic Planning Secretary Ernesto Pernia, and several senators including Vicente Sotto III, Panfilo Lacson, Juan Edgardo Angara, Richard Gordon, and Sherwin Gatchalian. Angara complained that the DOH should not monopolize the testing; in his exasperation over Duque, he tweeted Foreign Affairs Secretary Teodoro Locsin Jr.: “Please tell your colleague to get his head out of his ass.”
The mass testing being called for does not involve all 110 million Filipinos, but only those who are either exhibiting symptoms or has a history of travel to an area with COVID-19 incidents. These people are in the tens of thousands, per the data of cities and municipalities.
Dr. Minguita Padilla has gone on interviews and created videos that provide clear information. There are two kinds of test available today: the PCR (polymerase chain reaction)-based test which detects the presence of the COVID-19 virus in the body, and the rapid test kit which detects antibodies that develop after the virus enters the body. The PCR-based test is touted as the gold standard, but it requires expensive equipment and advanced laboratories that very few hospitals have. It will take many weeks before the DOH can equip more hospitals to do such tests. The rapid test kit has a small margin of error if it finds a person negative of the antibodies. But when it finds a person positive, the result is highly reliable. Its advantage is that it’s much easier and cheaper to administer, similar to a mere pregnancy test.
Most of our officials who are pushing for mass testing want our country to avail of the rapid test, because time is crucial. But the DOH has been denigrating the rapid test in its public advisories, pushing instead for PCR tests.
The Food and Drug Administration (FDA) approved the use of rapid test kits on March 30. But the next day, Duque issued DOH
Circular No. 0160 saying that the rapid test cannot be used for mass testing. Two days later, April 2, Galvez announced that the government will start mass testing on April 14. Since we don’t have enough PCRs yet to do mass testing, Galvez has no choice but to use rapid test kits, in defiance of the DOH circular. What strange play is Duque up to?
There are two battlegrounds in this war. The frontlines of defense are the communities, and the last lines of defense are the hospitals. It is understandable that the DOH advocates the PCR test for hospitals, because each confined patient needs precise diagnosis for exact medication. But city and municipal health workers are monitoring residents in communities blindly, because they don’t have access to any test kit. They should be provided with rapid test kits for them to accomplish the “detect-isolate-treat” strategy of the government. We will flatten the curve by doing fast and mass testing in the communities, not by doing few and slow tests in the hospitals.
Even if we say that the rapid test can only correctly identify 88 out of 100 persons who are positive for the antibodies, that’s 88 infected people disabled from being “spreaders.” And even if the PCR test gives more precise results (although it can also yield wrong results), its precision advantage is canceled out by its slowness and scarcity. While long lines of people are waiting to be PCR-tested, the undetected positive ones continue to spread the virus.
President Duterte should crack the whip and order a mass testing through the rapid test method now.
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