Expanded testing, finally

A belated but much necessary step in fighting the deadly virus that has killed 397 in the country as of yesterday finally kicked off on April 14. “Progressive mass testing” for COVID-19 will help identify the infected, isolate and treat them, and trace those that had contact with them to prevent further infections.

As of April 17, only 49,613 individuals have been tested—or not even 1 percent of the Philippines’ 106 million population. Under progressive mass testing, the government is no longer testing persons under monitoring (PUMs) and is prioritizing those who have severe flu-like symptoms, the elderly, pregnant women, the immunocompromised, and medical workers who show respiratory symptoms.

It has set up 132 specimen booths across the country, with 34 in Metro Manila, where most of the confirmed cases have been concentrated. The aim is to test from 4,400 to 9,800 per day by April 20, and 13,000 to 20,000 daily by April 27, before the Luzon-wide enhanced community quarantine (ECQ) ends on April 30.

As countries like Vietnam, Taiwan, and South Korea have demonstrated, mass testing is key to getting a handle on the spread of the virus and containing it, thus flattening the curve of infections.

In the Philippines’ case, however, Dr. Gene Nisperos of the University of the Philippines College of Medicine has warned against false narratives of flattening the curve “when we do not even have reliable numbers due to the lack of testing.”

While other countries were quick to address the brewing health crisis by closing international borders and conducting targeted tests as early as January, the Philippine government took more than a month since the country’s first COVID-19 case was confirmed on Jan. 30 before the ECQ was imposed on March 17. And within that near-full month of the ECQ, Nisperos noted, it remained unclear where mass testing was in the grand scheme of things; without these tests, the government was practically fighting the pandemic blind, not knowing which part of the population was infected and where to focus its limited medical resources.

Incredibly, on March 20, the DOH even said there was no need for mass testing yet. In contrast, that same month, Vietnam had already developed its own cost-efficient test kits, implemented targeted testing, identified clusters and closed down hamlets, and swiftly isolated the infected—decisive measures that helped the country keep its COVID-19 fatalities to zero.

The massive gaps in the national government’s response has forced local governments to organize their own testing centers.

The Makati City government is collaborating with the Philippine Red Cross to conduct mass testing of those with COVID-19 symptoms and even asymptomatic frontliners. “You have to remember, the priority of the DOH are those who have symptoms of the virus. So we will be conducting our own testing. We will test our frontliners. We need to make sure that they are not sick,” said Makati Mayor Abby Binay.

Valenzuela City, meanwhile, has been testing its residents since last week in partnership with The Medical City. What it found was alarming: Five of 40 PUMs in the city tested positive for the virus, and two in another batch of 30, leading Mayor Rex Gatchalian to appeal to the DOH to review its guidelines. “By not testing PUMs, are we not in danger of releasing potential carriers into the community that may lead to contagion?” he asked.

Marikina City’s experience is perhaps the most telling example of DOH’s bureaucratic, hidebound ways in the face of a pandemic. The city set up a testing center as early as March, but had to relocate to another location to meet DOH’s biosafety guidelines.

The laboratory was finally approved by DOH only last Thursday — a weeks-long delay that so exasperated Marikina Mayor Marcelino Teodoro that he declared he would open the facility with or without a license, given the gravity of the situation: “Namamatay ang mga tao, hindi nila nate-test. Walang kapasidad, kulang na kulang ang testing center sa bansa, malinaw ‘yan… Malaking kasalanan sa tao, tingin ko, kung wala kang gagawin.”

That’s a fair assessment. As the government’s expanded testing kicks into high gear, leading to the projected rise in the number of people identified as positive and requiring quarantine or treatment, it would need to move much more urgently than it has demonstrated so far.

In terms of technical capacity alone, the DOH needs to increase the number of institutions that can operate 24/7 and process the tests. At present, there are only 16 laboratories handling the tests, while about 50 more are still facing an accreditation bottleneck at the department. Hospital capacity is, of course, another problem altogether. Because the country’s leaders reacted slowly, now the Philippines has to play catch up, big-time.