Ministry of Health: Only gold-standard testing for covid19

The Ministry of Health’s preferred method of testing for covid19 has been the gold standard test, said Dr Naresh Nandram, principal medical officer of health and epidemiology on Thursday during the Ministry of Health’s daily covid19 briefing.

Not all tests are the same, Nandram said. The molecular-based methodology, known as the gold-standard test, is preferred over the rapid serological test for its accuracy and reliability. This is also the preferred method of the World Health Organization (WHO), which is why the Ministry of Health has been using it.

Molecular-based tests are accurate from the first day that a patient presents with symptoms, said Nandram. Serological tests are not useful until 14 days after a patient first presents with symptoms and are less accurate.

“From the Ministry of Health’s point of view, the earlier we can diagnose a patient, the better we can manage that patient clinically (and) the better that patient will fare in the long term.”

He said molecular-based tests use a nasopharyngeal swab and are done in specialised labs by highly trained staff and usually take a few hours to obtain results. Serological tests are blood tests and, although the patient can obtain results in several minutes, they are only about 50 per cent accurate.

“That’s the same as flipping a coin to determine if someone has (covid19),” he said.

As a result, the Ministry of Health and the WHO do not recommend serological testing for use in hospital settings.

TT has also made huge strides in local testing capabilities, said Nandram. He said at the beginning of the epidemic, only the Caribbean Public Health Agency (CARPHA) could facilitate testing. However, through “collaborative efforts,” testing expanded to the UWI virology lab, under the direction of the Ministry of Health.

“This was a game-changer,” said Nandram, adding the move allowed the Ministry of Health to set its own testing criteria, allowing officials to expand community testing and handle a larger number of samples, increasing the government’s capacity to respond.

Nandram said the expansion of local testing is being done in phases. “These phases are not dependent on each other…we are approaching all simultaneously.”

He said molecular-based testing will soon be done at labs set up in the North Central Regional Health Authority, the Medical Research Foundation and the South West Regional Health Authority. He said they already have equipment on site.

The next phase is the decentralisation of covid19 testing to major hospitals throughout the country, including Scarborough General Hospital, Port of Spain General, San Fernando General, Sangre Grande Hospital and the Eric Williams Medical Sciences Complex.

He said the machines at these hospitals are different because while they use the same molecular technology, the turnaround time is short. Within an hour of receiving a sample, labs should have results. He said this would be especially beneficial to healthcare workers on the ground.

Nandram also said community testing is “one of the tools used for evidence based decision-making and one of the earlier indications that something might be brewing within our population.”

He said to date 821 community tests were done, and have all come back negative.