WHEN I experienced dry cough and hoarse voice sometime last July and suspected that I had been infected with coronavirus disease (Covid-19), I was in a quandary on whether or not to submit myself to a test. But what I had in mind was that had I contracted the virus, I could not be asymptomatic because I have underlying ailments. I am diabetic and hypertensive, which may complicate with Covid-19. I could have been down and, worse, I could have been hospitalized.
I had no fever and did not experience shortness of breath. I opened a bottle of scotch and I could still feel its taste and smell its aroma. My appetite was still okay. Dako man hinuon ko’g kaon. So, it was not Covid. I consulted three doctors-friends. One suggested that I undergo a swab test. The two others told me there was no need for a swab test. All of them prescribed medicines for my cough and hoarse voice. I decided not to submit to a swab test because what if I become positive? I just filed a 15-day leave of absence from my work and isolated myself. After four days of medication, my dry cough was gone and my voice was back to normal. If it was at all Covid-19, I thank the Lord that I survived without going through the stressful process and the high cost of hospitalization.
The contention of Gov. Gwendolyn Garcia not to test those who have no symptoms is very logical. She cited three cases where she raised doubts on the Covid-19 test, prompting her to issue a warning to city and municipal health officers not to engage in “witch-hunting” of possible positive Covid-19 patients. Meaning, she does not want that health officers will just conduct “indiscriminate” swab testing on any Tom, Dick and Harry, but only on those with symptoms. She even insinuated that maybe health officers are receiving incentives for conducting “indiscriminate” swab testing. She began to question the accuracy of Covid-19 test results.
I agree with the governor that testing should only be performed on patients with symptoms typical of Covid-19 (cough, fever, shortness of breath), those with severe symptoms and those with a combination of the less typical symptoms listed above.
Should asymptomatic cases of Covid-19 still be tested? PCR testing in asymptomatic or mildly symptomatic contacts can be considered in the assessment of individuals who have contact with a Covid-19 case. Screening protocols should be adapted to the local situation. The case definition is being regularly reviewed and updated as new information becomes available.
In the column of Yen Makabenta in the Manila Times last Oct. 18,2020, he quoted the article written by Dr. Michael Yeadon, chief science officer of Pfizer and co-founder of Xiarco Pharma Inc. Dr. Yeadon mentioned the “deadly danger of false positives.” He made three major conclusions; 1) We are closer now to the end of the pandemic than to its middle; 2) Ninety percent of polymerase chain reaction (PCR) tests in the United Kingdom are false positives; and 3) The PCR test is fundamentally flawed and should no longer be used.
I also stumbled on this article written by Bob Curley that was published in Healthline, which asks this question: How accurate are Covid-19 diagnostic and antibody tests? Experts say the current diagnostic tests for Covid-19 are highly accurate, while antibody tests are not as trustworthy. There are two types of common diagnostic tests—one looks for coronavirus’ genetic material while the antigens tests for proteins. Experts say any test must be done properly to be effective.
According to Curley, “there is encouraging and not so encouraging news about Covid-19 testing. The most common test used to diagnose an infection with the virus are almost 100 percent effective if administered correctly. However, the same cannot be said of a test to determine if you already had the disease and have developed antibodies.”
Experts say diagnostic testing is one of the most powerful public health tools for fighting the spread of the virus. Tests identify people who may need treatment. Results also trace who have been in contact with other individuals to help prevent the transmission of the disease further. This can assist epidemiologists in determining how widely the virus has spread. “Testing makes the enemy visible,” said Dr. Emily Volk, assistant professor of pathology at the University of Texas-Health in San Antonio and president-elect of the College of American Pathologists (CAP).
“We should be diagnosing people with PCR tests because they are the most accurate,” said Dr. Christina Wojewoda, a pathologist at the University of Vermont and vice chair of CAP’s microbiology committee.
There are now two types of diagnostic procedures available in the country: 1) The RT-PCR, which detects the virus genetic materials; 2) The antigen test detects specific proteins on the surface of the virus. If performed correctly, RT-PCR swab tests “would be pretty close to 100 percent accurate,” Dr. Volk said. To get the most accurate results, RT-PCR tests should be conducted eight days after suspected exposure or infection, to ensure that enough vital material is present to detect. So, it needs also the right timing.
“Some clinicians know this, but people who are swabbing may not be passing the information along. So, it is also possible to administer the test too late after the body has successfully fought off the disease,” according to Dr. William Schaffiner, professor of medicine in the division of infectious diseases at the Vanderbilt University of Medicine in Tennessee. The test must also be administered properly, which means inserting the swab three inches or so to reach the cavity where the nasal passages meet the pharnyx. “If you’ve had this test and it wasn’t uncomfortable, it wasn’t done correctly,” Schaffner said.
False-positive results, while rare, can occur with PCR tests because the coronavirus generic material may linger in the body long after recovery from an infection. You cannot tell if the person (had an infection) three days or five months ago. Swabs are also used to collect samples for antigen testing. These tests have the advantage of yielding faster results (hours rather than several days). This is what we call here rapid testing, which is being discouraged by no less than our Department of Health officials because of its inaccuracy.