KEVON FELMINE

kevon.felmine@guardian.co.tt

Even as the Min­istry of Health ap­proves the use of home test­ing kits for COVID-19, the Pan Amer­i­ca Health Or­gan­i­sa­tion (PA­HO) does not rec­om­mend this as part of the fight against the pan­dem­ic. 

One rea­son PA­HO Di­rec­tor of Health Emer­gen­cies Dr Ciro Ugarte gave was that pub­lic health au­thor­i­ties must have prop­er sur­veil­lance of every pos­i­tive case con­firmed by a test. Ugarte spoke at PA­HO's week­ly press brief­ing on COVID-19 in the Amer­i­c­as yes­ter­day.

“De­pend­ing on the sur­veil­lance strat­e­gy im­ple­ment­ed in each coun­try, re­port­ing every case is re­quired to fol­low close­ly fol­low the dy­nam­ic of the epi­dem­ic. That may not be easy if a self-test­ing strat­e­gy is im­ple­ment­ed, par­tic­u­lar­ly be­cause it is as­so­ci­at­ed with a con­di­tion that the per­sons who have test­ed pos­i­tive are stig­ma­tized and prob­a­bly suf­fer more than the dis­ease it­self,” Ugarte said.

There is no oblig­a­tion for peo­ple to re­port their pos­i­tive re­sults to the Min­istry of Health from the rapid anti­gen kits. How­ev­er, Chief Med­ical Of­fi­cer Dr Roshan Paras­ram ad­vised that peo­ple sub­mit to a Poly­merase Chain Re­ac­tion (PCR) test fol­low­ing a pos­i­tive anti­gen test re­sult.

The home kits are rapid anti­gen tests that al­low users to know whether the virus is present in their bod­ies with­in a short time.

How­ev­er, Paras­ram said these tests are not of­ten ac­cu­rate and can give false neg­a­tives and pos­i­tives.

Ugarte said SARS/COV2 di­ag­nos­tic test kits were a crit­i­cal com­po­nent of the pre­ven­tion and con­trol strat­e­gy of the pan­dem­ic. Ugarte said tests should be re­li­able, af­ford­able, ac­ces­si­ble and pro­vide re­sults rapid­ly to en­sure ap­pro­pri­ate clin­i­cal care and sup­port for pa­tients. There­fore, it can in­form au­thor­i­ties what ac­tions to take in pre­vent­ing com­mu­ni­ty trans­mis­sion.

“PA­HO does not rec­om­mend self-test kits as there is not strong ev­i­dence so far in­di­cat­ing a re­al im­pact on the trans­mis­sion of the virus, and the cost-ef­fec­tive­ness should be eval­u­at­ed con­stant­ly. We are not aware of a new pol­i­cy for in­di­vid­u­als to re­port their own test kits.”

PA­HO en­cour­ages coun­tries to de­cen­tral­ize test­ing and use new strate­gies based on na­tion­al con­di­tions. Ugarte said self-care and in­di­vid­ual re­spon­si­bil­i­ty re­mains crit­i­cal to slow trans­mis­sion and con­trol the pan­dem­ic. At the same time, good lab­o­ra­to­ry prac­tices that pro­duce ac­cu­rate COVID-19 re­sults are key to en­sur­ing lab­o­ra­to­ry test­ing ben­e­fits the pub­lic health re­sponse.

PA­HO ac­knowl­edges the high de­mand for test­ing in many coun­tries with high in­fec­tion rates in the re­gions. In many coun­tries, this de­mand re­sults in peo­ple wait­ing more than 48 hours to know their sta­tus­es. There­fore, Ugarte ad­vised that au­thor­i­ties need to iden­ti­fy pos­i­tive cas­es where there is com­mu­ni­ty trans­mis­sion in the con­text that the avail­abil­i­ty of self-test kits will not be for every­one, in­clud­ing non-symp­to­matic peo­ple. 

In the past week, new in­fec­tions in the Amer­i­c­as de­creased by 31 per cent com­pared to the pre­vi­ous weeks, but deaths in­creased by 13 per cent, with high­er growths in parts of Cen­tral and South Amer­i­ca.

The re­gion record­ed over 4.8 mil­lion new cas­es and 33,000-plus re­lat­ed deaths in the past week. The Caribbean saw a slow­down of new in­fec­tions, but deaths con­tin­ued to climb. New cas­es in­creased by 88 per cent in Do­mini­ca and con­tin­ued to rise in St Vin­cent and the Grenadines.

In North Amer­i­ca, new in­fec­tions and deaths de­creased while hos­pi­tal­iza­tion and In­ten­sive Care Unit ad­mis­sions de­creased in the Unit­ed States of Amer­i­ca and Cana­da. Deaths in­creased by al­most 30 per cent in Cen­tral Amer­i­ca, but cas­es are be­gin­ning to slow, with new in­fec­tions in El Sal­vador drop­ping by 70 per cent. Be­lize and Pana­ma saw new in­fec­tions drop by over one-third.

In­fec­tions are al­so slow­ing in parts of South Amer­i­ca, but deaths con­tin­ue to rise across the re­gion rang­ing from 9.4 per cent in Bo­livia to 42 in Venezuela. 

PA­HO Di­rec­tor Dr Caris­sa Eti­enne said the da­ta showed that coun­tries with high­er vac­ci­na­tion cov­er­age saw low­er ICU ad­mis­sions and deaths. “This em­pha­sizes the im­por­tance of ex­pand­ing ac­cess to vac­cines, in­clud­ing boost­ers where avail­able to save lives. When cas­es surge ex­po­nen­tial­ly as they have in the past few weeks, the bur­den falls most­ly on the peo­ple that ar­mour our health sys­tems. For them, there is noth­ing mild about the Omi­cron wave,” Eti­enne said.