TT to ramp up covid19 testing come Monday

AS EARLY as next Monday, TT should be able to do its own covid19 testing, overseen by the Ministry of Health, no longer limited to the strict criteria imposed by the Caribbean Public Health Agency (CARPHA).

This means the country can now expand the number of tests it does, and on subjects who, for whatever reason, might have had their samples rejected by CARPHA.

Chief Medical Officer Dr Roshan Parasram said at Thursday’s daily covid19 media briefing that TT was expanding testing to primarily focus on people who don’t meet the case definition as described by CARPHA.

“If you want to use the term 'random,' we can: random testing of anyone who presents themselves at a health facility with signs and symptoms of a flu-like illness.

"Our definition will allow them all to be tested so it casts a wider net in terms of who we can test because we don’t have to rely (on) meeting CARPHA’s definition and getting rejected. Any person that wants to be tested, we can test you.”

The process is voluntary, he noted.

“We can’t just draw somebody out of their house. They have to come in. So we are asking people to come in to health centres as usual and we will test you, for not just covid19, but also H1N1 (a strain of influenza) or any viral disease in the country.”

The polymerase chain reaction (PCR) machines needed to run tests have already been set up near the vet labs at the UWI. These machines are currently being validated – samples that are known to be positive or negative as tested by CARPHA are run through the machine to verify accuracy – and once they are given the green light, TT can begin its own testing.

“Once that is ready, then our guidelines as stipulated by CARPHA can be varied somewhat…and we can go outside the guideline to do a lot more community testing if need be, because the (entity) determining rejection of samples based on case definition will now be the Ministry of Health rather than CARPHA. So at that stage we can expand our guidelines completely,” Parasram said.

CARPHA criteria in the early days of the pandemic included people with a recent travel history; contacts of people who travelled; primary, secondary or tertiary contact with a confirmed case; and any suspected case as defined by a healthcare worker.

After the country’s borders were closed on March 22, the criteria were expanded to include people with severe acute respiratory illnesses. And most recently, two weeks ago, the country started “random” testing of at least one sample per day from eight community health centres in Trinidad and one in Tobago.

For the last category, Parasram said, he had to get special approval from CARPHA before community-level testing because it was outside the scope for the rest of the region. So far 63 community samples have been submitted for testing and all have been negative.

Community testing, Parasram explained, is an expansion of the pool of people who would normally be tested. Now, anyone with acute viral illness – anyone displaying symptoms of a cold or flu or cough that does not strictly meet the definition set by CARPHA, can be tested.

“We are going (beyond) CARPHA to do testing, and that is via the initiatives at health centres, on a limited scale, because CARPHA will only accept a limited number of cases in the first instance. But once we get our testing capacity up, we will increase our numbers in the same regard,” Parasram said.

Covid19 in TT is considered "sporadic spread."

“We’ve had travel-related incidents, primary-related cases and a couple local cases in between.

"We need to widen the way we test to basically if there are hidden contacts – people who would not have known they were sick,” Parasram said.

If there are cases that cannot be linked to previous cases, then the categorisation would be "community spread."