Expanded testing on COVID-19 begins: What to expect

Kristine Sabillo, ABS-CBN News

Posted at Apr 14 2020 05:18 PM | Updated as of Apr 14 2020 08:59 PM

Researchers work in a laboratory at the Philippine Genome Center on March 12, 2020. The center is part of the development of a local test kit for COVID-19 led by the UP-National Institutes of Health in efforts to improve early detection of the virus, expedite the mass production of the kit, and ensure its availability to the public at lower costs. Mark Demayo, ABS-CBN News

MANILA (UPDATE) — The "expanded testing" for the coronavirus disease 2019 (COVID-19) in the Philippines was expected to have started Tuesday, a Health official said, amid appeals for mass testing in the country.

"Inaasahan po ang tuluyang pag-increase ng ating testing capacity at implementasyon ng expanded testing coverage ngayong araw, April 14," Department of Health Undersecretary Maria Rosario Vergeire said in a press conferece.

(The continuing increase of our testing capacity and implementation of expanded testing coverage is expected today, April 14.)

Vergeire issued guidelines for the expanded testing, as she warned the public against flocking to testing centers. 

PRIORITY CASES

Vergeire emphasized that patients and health workers who are in severe or critical condition will be first on the list for COVID-19 testing.

“Isusunod naman po natin ang ating mga kababayan na may mild na symptoms, maging ang mga taong higit sa 60 years old, may ibang karamdaman, at may maselang pagbubuntis or high-risk pregnancy,” she said, referring to what the DOH calls the vulnerable population.

(We will next test those who have mild symptoms and are 60 years old and above, have other illnesses and are undergoing high-risk pregnancy.)

Vergeire said other patients and health workers with mild symptoms will be prioritized next, even if they are not part of the vulnerable population.

“Sa huli, ang ating mate-test ay ang mga pasyente, healthcare workers, at iba pang frontliners na wala naman pong sintomas ngunit may exposure sa COVID-19,” she said.

(Last on the list for testing are patients, healthcare workers and other frontliners who do not have symptoms but have exposure to COVID-19.)

This is slightly different from the previous DOH protocol that does not recommend testing of asymptomatic cases.

Vergeire defined exposure to COVID-19 as face-to-face contact for at least 15 minutes with a confirmed case within a 1-meter distance, direct physical contact with a confirmed case, and caring for a probable or confirmed case without using personal protective equipment.

“Kapag mild lamang ang inyong mga sintomas, o wala kayong sintomas, wala po kayong exposure, o kaya wala kayong history of travel sa mga lugar na may community transmission o laganap ang COVID-19, hindi po recommended na sumailalim kayo sa testing,” the health official said.

(If your symptoms are mild or you do not have symptoms, you do not have exposure or do not have history of travel to places with community transmission or widespread COVID-19 cases, then you are not recommended to undergo testing.)

Vergeire explained that they set such protocols in place to prevent people from crowding hospitals and exposing themselves to infected patients.

She also reminded those who qualify for prioritization to first consult with a doctor over the phone before going to a hospital. Those who think they qualify for testing can call their telemedicine hotline at (02) 8424-1724 for the Telimed Management Inc and Medgate, or (02) 7798-8000 for Globe and TM users.

Below are the things that can be expected with the expanded testing, based on previous DOH statements:

1. 3,000 TESTS DAILY

The government has said it plans to run 3,000 tests by April 14, and then 8,000 to 10,000 tests by the end of the month.

In order to do this, the DOH said on Monday it was expediting the accreditation of laboratories. Accreditation involves 5 stages: assessment, validation or on-site assessment by experts, personnel training, proficiency testing or validation by the Research Institute for Tropical Medicine, and full-scale implementation.

As of Monday, Health Undersecretary Maria Rosario Vergeire said the 15 certified laboratories are expected to increase as 28 more are supposed to finish their assessment by the end of the month.

“We will also be prioritizing laboratories in Stage 1 and Stage 2 in Visayas and Mindanao,” she said. 

Currently, most of the accredited laboratories are in Metro Manila, resulting in delayed testing or backlogs in the rest of the country.

2. MASS TESTING BUT RISK-BASED

Vergeire has also earlier clarified that the expanded testing will still be “risk-based," which meant that those from the vulnerable population will be prioritized, as mentioned above.

3. VOLUNTEERS, MORE SHIFTS

Vergeire said that starting April 14, 300 volunteer medical technologists, molecular biologists, lab technicians and researchers will be deployed to help man laboratories.

There will also be more shifts in laboratories to allow for continuous testing.

More equipment will also be brought to laboratories. Some will be borrowed from academic institutions.

4. MORE TEST KITS

While the Philippines started out with less than 5,000 test kits when the pandemic began, it has at its disposal close to 100,000 test kits already, as of Monday, April 13, based on the DOH COVID-19 tracker.

It is unclear if this already includes the test kits developed by the University of the Philippines National Institutes of Health, which are supposed to help increase testing capacity. An initial 26,000 was purchased by the government and more than 90,000 will be sold commercially for private laboratories or donors to buy.

The government has also given the go signal for the commercial use of rapid test kits, which may not be as accurate as PCR test kits. The latter is considered “gold standard” for COVID-19 testing.

Based on the Interim Guidelines on Expanded Testing or DOH Memorandum 2020-0151, rapid antibody test kits may already be used, but a confirmatory test using a PCR test kit is required.

According to the COVID-19 tracker, as of Monday, a total of 43,500 tests have already been conducted in the country, involving 38,103 individuals. Of those tested, 5,596 yielded positive results; 32,462 are negative; 28 are equivocal; and 17 were classified as invalid. The tracker's chart noted that the total positive tests may be higher than the total confirmed cases reported because some test results are still undergoing case validation and processing.

5. NEW TECHNOLOGY

Vergeire had also mentioned that the Philippines is waiting for the delivery of 3,000 Cepheid GeneXpert cartridges, which have already been approved in the US for COVID-19 testing.

It is compatible with existing GeneXpert machines that have been used for tuberculosis testing.

Testing using this technology is supposed to be much faster than the existing PCR testing, allowing more samples to be processed.

As of Tuesday, the Philippines has logged 5,223 confirmed COVID-19 cases, including 335 fatalities and 295 recoveries.