MANILA, Philippines — Several medical societies in the country do not support efforts of companies to have their employees undergo rapid antibody testing as a requirement for them to be allowed to return to work, saying this would not only create a “false sense of security” but also further strain businesses’ and the health-care system’s resources.
Citing available evidence, the Philippine Society of Microbiology and Infectious Diseases (PSMID) on Tuesday said “there’s no added value” in requiring antibody testing for workers who neither have symptoms nor have direct contact or exposure to someone suspected or confirmed to have COVID-19.
Dr. Issa Alejandria, the PSMID president, explained that one of the reasons medical groups do not recommend the mass use of both the IgM (immunoglobulin) and IgG (immunoglobulin G) antibody tests available in the market is that “two-thirds” of its results are false positives, as the kits do not look for SARS-CoV-2, the virus that causes COVID-19, but rather the antibodies a person has developed from a current or past infection.
Poor performance
“The available rapid antibody test kits will just tell us whether you have or do not have the antibody. It does not tell you whether that antibody is high enough to be protective or to neutralize the virus,” Alejandria said.
“The test will perform poorly among asymptomatics. The virus belongs to the same family of coronavirus as the common cold. Your results may be a false positive since you have antibodies against the common cold,” she added.
Given the high incidence of false-positive results, the PSMID and the other medical societies—the Philippine Medical Association, Philippine College of Physicians, Philippine College of Occupational Medicine (PCOM), Philippine Society of General and Internal Medicine, Philippine Academy of Family Physicians, and the Philippine Society of Public Health Physicians (PSPHP)—are concerned that workers would be unduly forced into isolation and companies and the health system would unnecessarily be wasting much-needed resources.
As it is, the Department of Health (DOH) is already pressed into filling the 15,000 slots for health workers under its emergency hiring program.
Latest data also show only about 44,000 beds in local government-run quarantines nationwide, and barely 1,500 beds in quarantines managed by the national government.
Alejandria said people who would test positive using the IgG kits may have a “false sense of security” that they are immune to COVID-19. IgG is the antibody that stays in one’s body long after infection.
Expensive
“But we do not know [yet] the duration of immunity, the duration of infection and whether you can be reinfected again if you get exposed to someone coughing and has the virus,” she said.
As of May 15, the Food and Drug Administration (FDA) has accredited for public use 47 rapid antibody test kits. Each kit can cost from P900 to P4,500, which means that a company with 500 workers would easily spend anywhere from P450,000 to P2.3 million in a single mass testing of its workers.
Companies who would opt to have all their employees undergo rapid testing would have to shoulder the cost themselves. This is because under the universal health-care law, the Philippine Health Insurance Corp. cannot pour in funds on a technology that has not been approved by the Health Technology Assessment Council.
Dr. Phil Pangilinan, the PCOM president, said that because businesses have yet to recover from the “economic devastation” brought about by COVID-19, they should understand that rapid antibody test kits are not a cost-effective measure.
“The rapid antibody test kits have its advantages, disadvantages and limitations. These tests do not detect the virus. Thus, it is not recommended as a screening tool for early infection, let alone used to screen workers prior to returning to work,” Pangilinan said.
Rather than use the rapid antibody test kits, the medical societies recommended applying the 14-day test to determine if workers are fit to return to work. This test requires workers to be symptom-free for two weeks.
On top of this is the observance of physical distancing, the wearing of protective masks, hand-washing, cough etiquette and daily symptoms screening by a safety officer in the workplace.
“Implementing these minimum health standards and monitoring the proper implementation of these health standards remain to be the most cost-effective measure in preventing the spread of the disease,” Alejandria said.
Dr. Aileen Espina, a PSPHP representative, noted that if businesses would still insist on using the rapid test kits, “they should lay out a plan on how these tests can be best used to ensure the safety and welfare of the workplace.”
Build testing labs instead
Civil society group Action for Economic Reforms urged local officials, as well as companies, to instead use funds they may have allotted for rapid test kits to put up PCR (polymerase chain reaction) laboratories in their localities to help increase the country’s testing capacity.
It said workers should also be able to easily go on sick leave to reduce the likelihood of the virus from spreading.
Earlier, Health Undersecretary Maria Rosario Vergeire appealed to companies restarting their businesses to review their policies, particularly on the grant of sick leaves. She pointed out that workers should be allowed to use this benefit “without fear of any negative consequences.” INQ