PMA: No to rapid test as requirement for returning to work

The Philippine Medical Association (PMA) on Friday reiterated its position that rapid antibody tests (RATs) should not be used as a requirement for workers to return to work, especially for those who are asymptomatic.

RATs could be used a week after symptoms of the severe respiratory disease COVID-19, said the PMA statement signed by its president Jose Santiago Jr. and secretary general Ricardo Batac.

“We do not recommend rapid antibody test for mass testing and as criteria for return to work,” the statement said.

“Absence of clinical symptoms for 14 days can be used for the time being as a criteria for return to work,” it said.

In May, PMA and six other medical societies opposed the use of RATs as a requirement for workers to be allowed to return to work, stressing that this would only create a “false sense of security” and further strain the resources of businesses and the health-care system.

In an earlier statement this week, PMA said the use of antibody rapid test kits to detect SARS-CoV-2, the virus that causes COVID-19, should be done under certain conditions, such as using only kits that have “the acceptable range of sensitivity and specificity.”

PMA issued a statement on June 2 expounding this position after Santiago said in an online press conference a day earlier that he would recommend the kits to PMA members.

“The use of rapid antibody test kits should be placed in the right context. This was the opening statement of Mr. [Joey] Concepcion,” the June 2 statement said, referring to the presidential adviser for entrepreneurship.

Both Concepcion and Santiago held a press conference on June 1 where they announced that they would further collaborate despite some tension between the business leader and doctors in May.

The use of the RAT kits was an initiative of private companies that wanted to test their workers. The PMA said it just set conditions on “its proper use.”

The initiative it referred to was Project ARK, short for Antibody Rapid test Kits.

4 conditions

Under the Concepcion-led project, companies voluntarily buy antibody rapid test kits for their employees. More than 1.2 million of these kits had been ordered so far by over 300 companies, according to an earlier statement from Concepcion, who also heads food and beverage company RFM Corp.

“First, the rapid antibody test kits must belong to FDA’s [Food and Drug Administration] validated list of kits with the acceptable range of sensitivity and specificity, preferably Elisa,” PMA said.

“Second, the test must be used in conjunction with RT-PCR,” it said, referring to reverse transcription polymerase chain reaction test, which the Department of Health considered as the “gold standard” for testing for SARS-CoV-2.

‘Research setting’

“Third, tests must be done with the supervision of a physician well-versed in interpreting results and clinical correlation. Fourth, it must be used in [a] timely manner in relation to the symptoms,” PMA said.

Citing a statement by the Philippine College of Physicians (PCP) and Philippine Society for Microbiology and Infectious Diseases (PSMID) back in April, PMA said “the use of a validated rapid antibody test is recommended to give an accurate figure on the prevalence of COVID-19, along with the herd immunity, utilizing this information for possible protection and return to work.”

The PCP and PSMID statement, however, said antibody test kits “should only be used in a research setting.”

“We hope that policymakers will take heed of warnings from medical experts that the use of these tests in any other setting are not only questionable of value, but also potentially harmful to individuals, to the general public, and most of all, to our health-care workers in the front lines,” the two groups said.

PMA issued its June 2 statement after its president was reported saying that he would recommend antibody rapid test kits to PMA members.

He said this in response to a question during the June 1 press conference on whether PMA still had any concerns on antibody rapid test kits.

He was asked repeatedly and explicitly to clarify if he would recommend the kits to PMA members.

“Antibody rapid testing kits per se [have their] usefulness. Of course, it should be done in a timely manner so you could really maximize the use of it and not to waste the testing kits,” Santiago said at the press conference.

“And of course, I would like to say not all antibody test [kits] are created equal,” he said, noting that some brands were more reliable and accurate than others.

Reliability

Santiago said then that he also agreed with a comment from pathologist Bu Castro who said that “there could be a low reliability, but not low enough to be rejected.”

“If you have a 60-percent efficacy [in a vaccine, for example], and not 100 percent, would you still use it? For me, I will, because you can save 600,000 of the population for every 1 million,” Castro had said.

“If there is a 50-percent reliability in rapid testing kit, I would also use that. Why? I can prevent the 50 percent that it can detect [from infecting] other people,” Castro added.

PMA was one of the medical groups that issued a joint statement last month saying that various rapid antibody tests “have high false positive rates and may bestow a false sense of security when results are negative, resulting in unintended harm.”

Santiago himself signed an open letter on May 21, inviting Concepcion to a guided tour in COVID-19 referral hospitals so he would see what doctors and front-liners really do.

This was in response to a comment Concepcion made after medical groups, including PMA, warned against the use of antibody rapid test kits being pushed by Concepcion.

Concepcion had said that doctors do nothing but complain. He later apologized for that statement. —JOVIC YEE AND ROY STEPHEN C. CANIVEL