To test or not to test
Official data from the Department of Health (DOH) reveal a hidden folly of the administration’s coronavirus testing policy: Out of 842 deaths officially recorded as caused by COVID-19, a staggering 457 of them were declared as positive posthumously — sometimes more than a week after they flatlined.
That’s over 50 percent of the total deaths. In more than half of all deaths, it takes the DOH nine days after death to make a public announcement that a patient indeed died of COVID-19.
Elsewhere in the periodic DOH data drops, the independent monitor covid19stats.ph has also pointed out discrepancies between national tallies of regional and provincial reports of tested individuals found positive for coronavirus, and the tallies announced in the daily DOH briefings.
As of May 20, the DOH announced 13,221 COVID-19 cases in the Philippines. But its own data drop which includes reports from regional and provincial health authorities reveal a much higher figure of 16,822.
The slow pace and the discrepancies are not the end of the problem with the “expanded targeted testing.”
In a Facebook post, Dr. Gene Nisperos reminded the public about the problems of the administration’s testing policy.
Nisperos, president of the University of the Philippines All-Academic Employees Union and a faculty member of the UP College of Medicine, put it this way:
“Before March 16, all PUIs were being tested regardless of severity of symptoms. After March 16, because of limited kits, the DOH changed its protocol such that only PUIs with severe symptoms were tested. Those with mild symptoms were sent home for observation.
“A few days later, the nation found out that asymptomatic politicians were tested EVEN AHEAD of symptomatic patients. Not only did the DOH violate its own protocol; these VIPs were given preferential treatment over those who actually needed the tests. The DOH’s ‘targeted testing’ was not only narrow and limited but was also elitist.
“More recently, the DOH again changed its protocol, from the PUM-PUI classification to the suspect-probable-confirmed COVID-19 classification. Despite the alleged increasing number of test kits and testing capacity, the target for testing became even narrower, as PUMs or asymptomatic people were effectively excluded.
“This approach was debunked by LGU experience, as in the case of Valenzuela, where five out of 40 asymptomatic people (or PUMs) tested were actually positive for COVID-19. That is 12.5% of PUMs, a major source of disease spread, as they exhibit no symptoms and may freely mingle with us unnoticed.
“Clearly, government is using testing ONLY to CONFIRM COVID-19 cases, not prevent its spread.”
According to Nisperos, “in medical school, students are taught that once a clinical diagnosis is reached, through proper history-taking and physical examination, diagnostic tests are mainly confirmatory. The DOH is basically applying this to the COVID-19 pandemic, which is wrong and problematic. By focusing only on those with overt symptoms already, testing is largely confirmatory of whether the case is indeed COVID-19 or not. THERE IS NO PREVENTIVE OR PUBLIC HEALTH ROLE OF TESTING IN THIS.”
“Hence, government’s aversion to ‘mass testing’; it will be unraveled that from the outset, there have been no real plans to address the public health emergency through public health interventions that will prevent the spread of COVID19,” he adds.
Nisperos thus provides scientific, medical, and public health basis for citizens’ outrage that the administration wasted the opportunity provided by the quarantine to “test, isolate, and trace” coronavirus carriers.
“Without any real mass testing, all measures such as creating quarantine centers and having dedicated ICU beds and ventilators become token. Without any real mass testing, it is so easy to draw flawed conclusions from insufficient data. Without any real mass testing, policy will be dictated, not by health considerations but by vested political interests,” said Nisperos.
The multidisciplinary Scientists Unite Against COVID-19 has also explained that mass testing does not mean universal testing, as a pushback to the fake news from some quarters that seek to falsely define mass testing.
“If we can test, we can detect cases, isolate the carriers, and trace their contacts,” said the group.
The demand for mass testing has been pretty clear from the very start: Test all suspected cases, test all healthcare frontliners, test all close contacts of confirmed or probable cases, and surveillance for high-risk communities or vulnerable populations. No VIP testing.
The scientists are ready with recommendations on how to build testing capacity in order to operationalize mass testing: Facilitate the immediate hiring, training, and deployment of additional personnel to supplement the current workforce and enable labs to extend operating hours; simplify and streamline the accreditation process for new testing laboratories by capacitating labs to overcome technical challenges; and coordinate the procurement of lab supplies and reagents from international suppliers and distribute them according to the needs of the testing labs.
As the scientists put it best and on this one many would totally agree:
“Mass testing is not going to be easy — but that should be no excuse for the government not to do it.”
The world’s longest lockdown should not be in vain. Quarantines can only limit the spread of the virus. Mass testing is important so we could detect and treat our people who have fallen ill, and consequently address the concerns of a public demanding scientific solutions, not military solutions, to a pandemic.