Walking time bomb
In an Aug. 22 Facebook post, the City Public Information Office has announced that grocery stores have up to Aug. 27 to have their workers tested for Covid-19. The test can either be through the Reverse Transcriptase Polymerase Chain Reaction swab testing or through an antigen rapid testing.
I am not a doctor but I have friends who are and can read available materials on the matter. The Department of Health has issued a clarification that while there are antigen kits approved for commercial use by the Food and Drugs Administration, the DOH does not endorse specific brands or distributors. Even the World Health Organization does not recommend the use of antibody-detecting rapid diagnostic tests for patient care.
The antigen is designed for rapid detection of the virus that causes Covid-19. PCR swab tests can be incredibly accurate, but running the tests and analyzing the results can take time.
Also, the cost of swabbing is a burden. Antigen can provide results in minutes but unlike the swab tests, it cannot detect all active infections. While positive results from antigen tests are highly accurate, there is a higher chance of false negatives. A negative result does not rule out infection and still needs to be confirmed with a PCR test prior to making treatment decisions or to prevent the possible spread of the virus due to a false negative.
The supermarket sector has of course complied. One reportedly arranged for the antigen testing for its 400 employees at Teacher’s Camp triage where there is no laboratory equipped for Covid-19 testing, although swabs were used. There were reportedly no safety protocols (no PPE, biosafety cabinets, no Hepa filters, no exhaust, no autoclaves, no proper hazardous waste disposal), and the results showed that the more than 400 employees tested were all negative. Like the PCOS machine, the results were statistically improbable. Two other big stores along the Quirino Highway (Naguilian Road) and Buhagan Road followed suit and the results again were negative for all. One restaurant followed, proudly posting pictures in FB that their servers and employees were antigen-tested and the results were negative. The pictures posted showed the one who did the swab had no PPE and his face shield became his headgear.
In the grapevine comes the news that 10,000 kits will be available at Melvin Jones for the public soon. With the antigen testing, by Sept. 1 when tourists start coming in, Baguio will soon be Covid-19-free, even with a very high rate of false negative results.
But before sounding out the trumpets in celebration, medical practitioners are up in arms as they say that the rapid antigen test has a 49 percent sensitivity, meaning 51 percent of those tested would have false negative results. With the antigen tests, 100 percent of those being tested in the hundreds are tested negative. There is no showing that the results of the tests are being validated or recorded in a molecular laboratory nor the line lists of patients still being sent to the DOH-Cordillera. A positive result in the antigen test requires confirmatory swabbing in a hospital or molecular laboratory. At the end of the day, it results in double effort and cost.
Another serious question would be, where are the infectious swabs or even kits disposed or discarded? In a legitimate hospital/molecular lab, the disposal of bio hazard wastes requires permits and must be done according to DOH and Environmental Management Bureau rules.
For the owners of the grocery and restaurants, would they be really secure with the results? True, they had savings as the burden of cost of testing was heaped upon them. But is this the end-all – pera pera lang!
Same for the doctors and medical technologists doing the test without authority from DOH or safety protocols. Pera pera din ba? For their customers and the public-at-large, are we really safe with the walking time bombs? After testing using the antigen in their respective stores, the employees who have had negative results will walk around the city and their barangays with a false sense of security and immunity with the thought that they are truly negative of the Covid-19. We would not know who are those infected. The numbers of asymptomatic patients will increase and they will infect the vulnerable group who will later be symptomatic, and these symptomatic patients will go to our respective clinics/hospitals and eventually infect all health care workers.
Dr. Sheila Montemayor Franco, an anesthesiologist, said it all in her Facebook post on Aug. 24. Sigh.
Disclosure: The columnist has business interest in Parkway Molecular & Diagnostic Laboratory and his law firm is the legal retainer thereof.
Happy birthday to our forever little Princess Ysa. The moon and the stars are dancing in joy for you are one of God’s greatest gifts to us. Shine on into adult life, remain simple and humble yet confident and character. We love you to Mars and back! Happy birthday too to tenor Stef Quintin tomorrow, Aug. 31. She officially became an Avila when she married Anton last Jan. 7 proving to all and sundry that she is his lucky charm and forever love! Cheers to both of you, Doth-ers!