CEBU

DOH 7: Rapid antibody test more cost-effective than RT-PCR test

CEBU. Residents of Barangay Apas, Cebu City took rapid antibody tests on the third day of the massive testing for the coronavirus disease (Covid-19) on Friday, May 8, 2020. (Photo by Amper Campaña)

THE Department of Health Central Visayas (DOH 7) says the use of rapid antibody testing to help detect Covid-19 in the workplace is more “cost-effective” than the reverse transcriptase polymerase chain reaction (RT-PCR) testing.

The DOH 7 made the reaction following statements from medical organizations that reiterated their opposition to the use of rapid diagnostic test (RDT) in checking for Covid-19 infections in the workplace as this does not accurately detect if a person is infected with the disease.

In a statement, DOH 7 spokesperson Mary Jean Loreche said they respect the opinions of their colleagues from the medical societies on their opposition to the use of rapid antibody tests in the workplace.

Loreche said: “The Centers for Disease Control and Prevention (CDC) has outlined its recommendations on the type of testing modality to be used. The rapid antibody tests are useful when they are utilized for epidemiological studies, monitoring and surveillance.”

On Tuesday, Aug. 4, 2020, the Philippine Society of General Internal Medicine (PSGIM), during an online forum, reiterated its opposition to the use of RDT in the workplace as it does not accurately detect a current Covid-19 infection.

In an interview with ABS-CBN, Antonio Dans, M.D., spokesperson of the Healthcare Professions Alliance Against Covid-19, said the test only checks if a person has already an antibody against the disease and not the actual SARS-CoV-2 virus.

He said they believe that the widespread use of rapid test kits by local governments and offices as a requirement before workers can return to their jobs could have led to the rise in coronavirus infections.

Dans said: “The rapid antibody test is not accurate. The World Health Organization has warned us against it. If there are 10 people infected with Covid-19, it cannot detect 50 percent of those cases.”

Likewise, Aileen Espina of the Philippine Society of Public Health Physicians, in a national interview, said using a test for an unintended purpose can create a “false level of security.”

The DOH 7, however, said the RDT is never intended for diagnosing Sars-Cov-2.

The DOH 7 said just like any diagnostic modalities like RT-PCR, which they agree to be the gold standard for testing, the RDT has its limitations including timing of sample collection, the sample itself and the methodology in the processing of the test.

It said when all the variables are placed in the proper guidance then the test result itself can serve as a guide on the next action plan.

The antibody test measures the immune response to an exposure to an offending substance which is the coronavirus, it said.

“In our present state where the prevalence is already very high, to proceed to PCR as a means of testing for workplace requirements may defeat its purpose as the intention for the testing is not to diagnose but rather to monitor and surveil the status of the employees,” reads a portion of the DOH 7’s statement.

“Moreover, it is more cost-effective to do rapid antibody testing as a conduit to PCR testing rather than subjecting all employees to PCR testing,” it added.

The DOH 7 said that for return-to-work test requirement, the DOH in its DMO no. 2020-0220 said there are recommendations and guidelines for the test options.

Based on the memorandum, employers who opt to conduct testing of asymptomatic returning employees may do so in a representative sample of those who have returned to work physically and have a high risk of contracting Covid-19 due to the nature of the work like those of frontliners.

Testing using RT-PCR among representative samples for baseline can be conducted to look for any evidence of asymptomatic transmitters.

If tested positive, the returning employee or worker is a Covid-19 case and will be isolated and referred accordingly for proper management. If found negative, the employee can continue working with usual precautions. If initially tested negative but developed symptoms, the employee must be tested accordingly based on DOH Memorandum 2020-0180.

Alternatively, testing using Food and Drug Authority-approved RDT test among representative samples can also be conducted up to every 14 days.

Employees who test negative for both IgM and IgG antibodies or those who test IgG-positive regardless of IgM antibody results, may continue to work.

Employees who test IgM-positive but IgG-negative on the first test shall be isolated for two weeks and will undergo repeat testing on the 14th day of isolation. (WBS)


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