Tribute to heroes
On Dec. 1, 2023, the Bayanihan Covid-19 Laboratory Network Recognition Ceremony was held in Makati City. There, we from the Philippine Childrens Medical Center (PCMC) had a reunion of sorts with fellow Covid-19 testing-laboratory staffs from all over the Philippines, whom we only saw during Zoom meetings in over two and a half years.
It was a fitting tribute to the unsung heroes of the fight against the pandemic, for we pathologists and medical technologists rarely get to see the patients, only their nasopharyngeal and oropharyngeal swabs in test tubes. More often, the focus was on doctors and nurses treating patients in the ICU. But the fight starts with identifying the enemy through testing.
Early on, only the Research Institute of Tropical Medicine (RITM) had the capacity to test SARS-COV-2 via RT-PCR, and the backlog was tremendous. Patients often died without a diagnosis. The DOH scrambled to have more laboratories accredited to do RT-PCR testing. The Philippine Society of Pathologists (PSP) and the Philippine Association of Medical Technologists (PAMET) mobilized their members to create a workforce to man the molecular labs. There were trainings via Zoom on biosafety and biosecurity as well as on molecular testing for medical technologists. Pathologists also had training in molecular pathology for supervision of the labs and for signing out and validating the results.
The DOH created the CDRS (Covid Document Repository System) software for timely submission of accurate and complete results, which also required training of the clerks manning the Covid labs’ reporting arm. All in all, there were 310 Covid-19 testing centers accredited by DOH by January 2022, an impressive feat by any measure.
There was no time to celebrate then. We all buckled down to work day and night, which was unheard of for pathologists, as we usually don’t have night time duties. But we never hesitated, losing sleep night after night to validate the Covid runs churned out by our medical technologists, who also had to contend with wearing PPE, making it hot, uncomfortable, and cumbersome while performing their duties. Many opted to stay in the hospitals rather than go home and risk infecting their family members, another hardship borne out of dedication to their craft.
As the numbers of the infected rose, the more we had to test: their close contacts as well as the hospital personnel treating Covid patients. Then there were the non-medical frontliners — the military, police, economic workforce, and the delivery riders who delivered medicine, food orders, and other essential supplies.
The initial wave of infections was rapidly replaced by the more virulent Delta variant, and more testing had to be done. After a short lull, the Omicron mutant strain and its rapidly developing variants caused another huge wave of infections, again overwhelming testing labs’ capacities. Even the medical technologists and clerks fell victim to the virus, causing some labs to temporarily cease operations, thereby putting a strain on the other surrounding labs. Only in the second half of 2022 were we given some breathing space as the mass vaccinations took effect and raised immunity to herd levels. Nowadays, Covid testing has greatly slackened, and the urgency and stress is no longer felt acutely.
On our part, testing wasn’t our only concern. We in the PSP had proposed the pooled-testing technique to greatly increase capacity to test. With the funding provided by Gonegosyo partners, we conducted the research to prove its utility. The PCMC Covid-19 testing laboratory was the lead facility for the research, in conjunction with the RITM and the Perpetual Help Medical Center as our partners to perform the technique.
We ventured into the then newly reopened supermarkets to recruit volunteers for testing, who were then swabbed onsite, and the samples quickly transported to the labs for testing. Having personally done it and come face to face with an infected person during the interviews, I could say now that it was perhaps foolhardy of me to have done that at my age. But at that point in time, there was no time to think of self. All I could think was we had to finish the research and apply it quickly.
Once validated, we had it published in the Philippine Journal of Pathology and proposed it to the IATF as a tool for testing in localized lockdowns. The Covid Lab Experts Panel (CLEP) approved it as a valid technique, and so in about six months, we proceeded to train over 150 labs in pooled testing, via Zoom of course.
All in all, it was an exciting, fearful but exhilarating time. Would I do it again when the next pandemic rolls around? Yes! Except that I pray not to experience another pandemic in my lifetime. But for now, my fellow lab partners, take a bow!
It was a fitting tribute to the unsung heroes of the fight against the pandemic, for pathologists and medical technologists rarely get to see the patients, only their nasopharyngeal and oropharyngeal swabs in test tubes.