Medical groups insist: Call vs use of RATs for workers based on ‘best evidence, experiences’

MANILA, Philippines — Despite being berated by businessman and presidential adviser Joey Concepcion, medical groups on Friday stood by their advice that rapid antibody tests (RATs) should not be used as a basis for asymptomatic persons to be allowed to return to work.

In a joint statement, the seven medical societies, whom Concepcion claimed to be all talk but are “doing nothing,” stressed that their recommendation Tuesday against the use of RATs to allow workers to go back to work was based on “best evidence and experiences currently available to us.”

The groups added that while they understand and laud the business sector’s efforts to ensure the safety and well-being of their workers, they, too, have an obligation “to keep the health and well-being of our patients” as well as “to assist governments and enterprises to make wise, evidence-informed decisions.”

“Available data shows that various RATs have high false-positive rates and may bestow a false sense of security when results are negative resulting in unintended harm,” the medical societies said.

The seven medical groups are the Philippine Medical Association, Philippine Society of Microbiology and Infectious Diseases (PSMID), Philippine College of Physicians, Philippine College of Occupational Medicine, Philippine Society of General and Internal Medicine, Philippine Academy of Family Physicians and Philippine Society of Public Health Physicians.

Instead of using RATs, the doctors reiterated their recommendation that the “best buy” for companies is to practice the “14-day test” in allowing their employees to go back to work.

This means that a person should not show any symptoms related to the coronavirus disease 2019 (COVID-19) two weeks from the time they were exposed to a suspect or confirmed case.

“This clinical test is more accurate than the RAT, can be feasibly done by occupational health physicians or nurses on asymptomatic individuals, and incurs no additional costs for laboratory procedures,” the group said.

Earlier, PSMID president Dr. Issa Alejandria explained that they do not recommend the mass use of both the IgM (immunoglobulin) and IgG (immunoglobulin G) antibody tests available in the market since “two-thirds” of its results are false positives. This is because these kits do not look for the SARS-CoV-2 virus, which causes COVID-19, but rather the antibodies a person has developed from a current or past infection.

“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.

As of May 19, the Food and Drug Administration has accredited for public use 52 rapid antibody test kits. Each kit can cost from P900 to P4,500, which means 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 healthcare law, the Philippine Healthcare Insurance Corp. cannot pour in funds on a technology that has not been approved by the Health Technology Assessment Council.

Health Undersecretary Maria Rosario Vergeire advised the business sector to instead use their funds for RATs to restructure their workplaces to ensure that it complies with the standards needed under the new normal.

These include engineering controls such as placing physical barriers, creating infrastructure to facilitate work from home arrangements, provision of masks as well as supplies for handwashing and sanitation.

Vergeire added that based on the World Health Organization’s findings, “asymptomatic transmission has not made a dent…meaning if there are [cases] they are only a small percentage.”

She clarified that those who have tested positive for the new coronavirus but are yet symptomatic may be in the pre-symptomatic stage, or could get sick in the next few days.