NOTE: This story was first published in The Bohol Chronicle’s Sunday print edition.
In the pervading reality that the healthcare system remains inadequate to handle a full-blown outbreak of coronavirus disease (COVID-19), the organization of physicians in Bohol emphasizes the use of Reverse Transcription Polymerase Chain Reaction (RT-PCR) as the test of choice for COVID diagnosis.
In the position paper from Bohol Medical Society (BMS) sent to Governor Arthur Yap, June 9, and signed by its President Jefferson Ong, MD, the health care professionals also strongly discouraged the use of the other test: Rapid Antibody Diagnostic Test (RADT) due to its misleading results.
Moreover, the same group comprised of a core that sits in the Bohol Inter Agency Task Force on the Management of Emerging Infectious Disease (BIATF) Medical Team Cluster also recommends for Bohol to maintain a General Community Quarantine status, at least, until a definite treatment or a safe and effective vaccine is readily available.
On the use of RT-PCR, which is a very complex laboratory process that includes the use of actual swabs from patients taken from the nose or throat.
These samples, can already be rife with disease causing virus, is brought to the Special Pathogens Laboratory (SPL) which should be a Biosafety Level 2+ (BSL2+) facility.
A BSL2+ facility is a laboratory that is tasked to handle valuable biological materials that require administrative oversight, control, accountability, and specific protective andmonitoring measures in laboratories to protect their economic and historical (archival) value,and for the population from their potential to cause harm, a physician familiar with infectious disease control shared.
VBM may include pathogens or disease-causing virus and bacteria, toxins, as well as non-pathogenic organisms, vaccine strains, foods, genetically modifiedorganisms (GMOs), cell components, genetic elements, and possible extraterrestrial samples, he enumerated.
This laboratory, when its studies can go to the levels of the molecular components of these pathogens, adopts a bio-security level that almost equals the standard security measures for handling deadly nuclear elements, according to the source in infectious disease management.
The security is so strict that any breaches in the protocols can mean the pathogens could infect people in the laboratory and bring the disease outside, without them knowing.
Everyone in the laboratory must have a thorough knowledge on biosecurity and biosafety, as well as the facility must have fail safe and redundant safety systems as certified and accredited by World Health Organization and the Research Institute for Tropical Medicine on the very least, medical sources familiar with infectious disease control added.
It may be recalled that the Department of Health is now currently evaluating the Dr. CelestinoGallares Memorial Hospital laboratory for its feasibility for a BSL2 laboratory.
On the other hand, Gov. Yap announced during the Radio Pilipinas Network Briefing Friday June 19 that the Provincial Government would be putting up a mobile containerized RT-PCR laboratory which should be operational by July 15.
Over this and the country’s dire need for a BSL2 laboratory for the RT PCR tests, BMS urged the government through Gov. Yap, that equipping, training and accreditation of RT PCR laboratories be placed on top of the government priority.
When the government can easily put up the necessary infrastructure for the laboratory, it would be an entirely different thing if one talks about who operates and runs or manages the clinical supervision of the facility that needs highly trained professionals, in the time when the fight against the virus has critically depleted the country’s health frontliners.
This, they said if we would want to ease the community quarantine measures to a level where economic functionality for sectors would be feasible.
Regarding the use of the RADT in screening for COVID-19, BMS stresses on the points raised by the Philippine Society of Microbiology and Infectious Disease (PSMID) refuting the usefulness of the RADT.
Moreover, the MBS position as well as the PSMID’s is consistent with the letter issued by the Philippine Medical Association, which states their position not to recommend the use of the RADT for mass testing as a prerequisite for return to work orders.
PMA argues that a negative result from the RADT can cause one to have a false sense of security while a false positive result can cause undue alarm and consequent waste of resources.
In the meantime, in the absence of a readily accessible RT PCR testing with timely results, BMS stands by the protocols issued by the Bohol COVID-19 Medical Technical Team strictly requiring a mandatory 14-days of facility quarantine upon arrival of an individual in Bohol.
In fact, when an executive order by the governor also allows home quarantine, BMS highly recommends facility quarantine to ensure compliance, and in some cases, home quarantine with very strict guidelines as drafted by the COVID-19 Medical Team, may be allowed. (rahchiu/PIA-7/Bohol)