Editorial | Aggressively test for COVID-19
Up to last Friday, when there were 30 confirmed cases of COVID-19 in Jamaica, the health authorities had tested 250 persons for the new coronavirus. That’s the equivalent of 0.008 per cent of the island’s estimated population of 2.9 million.
Before doing those tests, the Government, it reported, received 3,000 test kits from the World Health Organization (WHO), which, if all had been used, would have meant that 0.1 per cent of the population had been tested. Put in ridiculous form, if all Jamaicans were to be tested using only those kits, the best each individual could expect is a small fraction of a test.
At last Friday’s briefing, the authorities disclosed, too, that they ordered 10,000 test kits for the National Public Health Laboratory (NPHL), which, in a fortnight or so, will have the capacity to test for COVID-19. It will join the Nation Influenza Centre at the microbiology laboratory at The University Hospital of the West Indies. It isn’t clear if the kits for the NPHL include, or are separate from, the 6,000 test kits the Government said it will receive from the Pan American Health Organization (PAHO) “in the coming weeks”.
In any event, according to the chief medical officer, Jacquiline Bisasor-McKenzie, the health and wellness ministry doesn’t anticipate a shortage of test kits “in the medium term”. That, though, is based on how you look at things, and what you want to achieve.
First, even as we wait to be assuaged about the constitutional correctness of the route to some of its policies, this newspaper generally supports the administration’s strategies, thus far, for containing the spread of the virus and cushioning its economic fallout. We applaud the alacrity with which it has acted.
Test, though, which epidemiologists globally say is crucial to determining the real spread of the virus, and charting the most effective strategies against it, is a question mark.
If the 10,000 test kits being acquired for the NPHL, plus the 3,000 received earlier from the WHO, were used to test for COVID-19, that would bring the total to 13,000 kits, allowing for the testing of 0.448 per cent of the population, or 448 out of every 100,000 persons. With 19,000 kits, assuming the 6,000 to be received from PAHO are separate from those ordered for the NPHL, the ratio would increase to a little over half of one per cent (0.65 per cent) of the population, or 655 tests per 100,000.
It is, however, not necessarily as straightforward as this. There is, sometimes, the need for retesting to confirm an initial diagnosis. So, there is not necessarily a one-to-one ratio between the use of a kit and determining whether an individual has, or is free of, COVID-19.
There is, too, the stealth with which this new coronavirus can spread. Many people who have it may be asymptomatic, and, therefore, can pass it on without anyone being aware that they are carriers. The disease’s long incubation period, and people’s seeming capacity to pass on the virus, even when they don’t seem to be sick, is another complicating factor. The virus is likely to be far more prevalent in a community than is immediately apparent.
MOVE TO BLOOD TESTS
The experts, therefore, say that the best way to get a handle on the disease is to robustly test for it. While being mindful of the cost implications of enhanced testing, as well as the global competition for test kits, it is necessary, we believe, for Jamaica to ratchet up its programme, beyond existing protocols, including, perhaps, random voluntary checks for the diseases, or signs thereof.
In this regard, Iceland is an example. Up to a week ago, the north Atlantic European country – 1,086 COVID-19 cases up to Monday – had tested more than 5,000 persons, or 1.5 per cent of its population. This translates to around 1,500 per 100,000, a rate significantly higher than South Korea, which has been noted for its aggressive testing. The Icelanders have a good grasp of the spread of the virus, which they can factor into deeper scientific analyses, including the potential for persons to develop immunities to the disease.
Further, beyond the nasal and throat swabs to detect the presence of the virus, Jamaica should also move to serological, or blood tests, to look for the residual antibodies in people who may have had the disease and recovered, without showing symptoms, or whose symptoms might not have been associated with COVID-19.
This would not only help to give a fuller sense of the prevalence of the virus in the society, but provide researchers with scientific information – presuming that such work is being done in Jamaica – that might help in the development of plasma treatment for the disease, from the blood of seroconverted persons. Already in Holland, blood banks are searching for such antibodies in blood donated by seemingly healthy individuals.