Mass testing on April 14; but who to test is unclear

If the Department of Health (DOH) will have its way, the persons to be included in the “mass testing” for the new coronavirus disease (COVID-19) starting on April 14 would only be those who are vulnerable because of their advanced age or existing ailments and those who had been exposed directly to the contagion and are showing symptoms.

The mass testing was announced on Thursday night by presidential peace adviser Carlito Galvez Jr., the chief implementor of the government measures against COVID-19, the acute respiratory disease caused by the SARS-CoV-2 virus, which has triggered a pandemic.

Caught off-guard

It appears that the DOH was caught off-guard by the announcement as Health Undersecretary Maria Rosario Vergeire was unable to provide details of how the mass testing would be conducted.

“We would talk about it in the IATF-EID (Inter-Agency Task Force for Emerging Infectious Diseases) meeting the right direction and real content of the mass testing pronouncement of Secretary Galvez,” Vergeire said at the daily Laging Handa government briefing on Friday.

Vergeire pointed out, however, that mass testing did not mean everyone would be tested for SARS-CoV-2.

Priority

Priority would also be given to health care workers, who are most exposed to the virus.

But if existing DOH guidelines were to be followed, come April 14 those who will be tested will be elderly people with preexisting ailments, the severe to critical cases, front-line health workers and persons under investigation (PUIs), or those who have symptoms and had recently traveled or had been exposed to persons found positive for the virus.

Excluded would be persons under monitoring (PUMs), who are like PUIs but without the symptoms.

Cumulative figures

The current number of PUIs and PUMs remains unclear as Vergeire said the 6,002 PUIs and 6,021 PUMs recorded were cumulative figures.

Galvez on Thursday said PUIs and PUMs would be tested.

It was unclear whose decision will prevail.

Nearly two weeks ago, Vergeire said that mass testing would be considered only if the “experts would recommend it.”

It also appears that the DOH would use the PCR-based (polymerase chain reaction) testing method for the mass tests.

Currently, the DOH only considers the results of PCR tests in determining if a patient is positive for the virus.

While it has allowed the use of rapid antibody test kits, positive results using this device still need a confirmatory test using the PCR-based test kits, which can give results in 24 hours.

Possibly 3K tests a day

Under the March 31 DOH Department Circular No. 2020-0160, Health Secretary Francisco Duque III has also prohibited the use of the rapid test kits for mass testing due to the “high risk of misinterpretation.”

The PCR-based tests measure the viral load of a patient while the rapid tests measure the antibodies. A patient’s rapid test result may be negative if he is tested too early into the infection when he had not yet developed antibodies against the virus.

A positive result may not mean he has the SARS-CoV-2 as his antibodies may be for a different virus or ailment.

Dr. Beverly Ho, Duque’s special assistant, expressed confidence that the government would have the capacity to conduct mass testing by April 14. It could do a total of 3,000 tests a day by then.

UP-made test kit approved

The main laboratory conducting the tests, the Research Institute for Tropical Medicine, is now processing around 1,000 tests daily and that is expected to increase to 2,000 in the coming days, Ho said.

The other seven accredited subnational laboratories can process another 500 tests daily and 40 more laboratories are awaiting accreditation.

The Food and Drug Administration (FDA) on Friday night approved the commercial use of the test kit developed by the University of the Philippines-National Institutes of Health (UP-NIH), bringing to 21 the number of accredited PCR-based test kits.

UP said that it has already begun mass producing the kits.

A Chinese-developed rapid test kit was also approved by the FDA. There are now nine accredited rapid test kits.

Deaths hit 136

By the end of April, Ho said that they expect their testing capacity to increase by “at least 8,000 tests per day.”

The DOH on Friday reported 29 more patients have died of COVID-19, pushing the death toll to 136. It said 385 more were confirmed to be infected bringing the country’s total to 3,018.

Ho said the sudden spike in the number of fatalities was due to the “late reporting of deaths.”

A 7-year-old girl from Ilocos was among 11 who were reported on Thursday to have died, the DOH said. The girl, identified as Patient 2415, is the country’s youngest to have succumbed to COVID-19 so far.

The 10 other casualties were on average 60 years old. Except for one patient who was a resident of Davao City, all were from Metro Manila.

“It is clear to us that the number of cases now has yet to go down,” Ho said.

The government has also been preparing various venues to serve as quarantine facilities or temporary hospitals, including the Philippine Arena in Bulacan which will be turned into a “megaquarantine facility” for COVID-19 cases, PUIs and PUMs, according to Vince Dizon, president of the Bases Conversion and Development Authority.

New quarantine sites

Other sites to be used as quarantine areas include Amoranto Stadium, Quezon Institute, Veterans Memorial Medical Center, Quezon Memorial Circle in Quezon City; PhilSports Complex in Pasig City; Rizal Memorial Complex in Manila; Philippine International Convention Center and World Trade Center in Pasay City; Duty Free Philippines in Parañaque City; Food Terminal Inc. in Taguig City; Filinvest Tent in Muntinlupa City.

Dizon said three other venues in Clark City will also be converted into COVID-19 facilities—the Asean Convention Center and New Clark City Athletes’ Village as quarantine centers, and two buildings of the New Clark City Government Center, which will be converted into a COVID-19 hospital.

The quarantine facilities in Metro Manila will accommodate residents from nearby cities. —WITH REPORTS FROM JULIE M. AURELIO AND MELVIN GASCON