By Argie C. Aguja
Senior Features Writer, The Philippine STAR

Not all test kits to detect COVID19 are alike and each has its own advantages and disadvantages

As the worldwide number of infections reach more than five million cases, 1,899,675 recoveries and 328,172 deaths (as of May 21), the World Health Organization (WHO) continues to call for urgent action to test all suspected cases, noting that the ‘backbone’ of an effective coronavirus response is the ability to conduct large scale testing.

“We have a simple message got all countries: test, test, test,” said WHO director general Dr. Tedros Adhanom Ghebreyesus during a virtual press conference where he emphasized the crucial need to escalate testing, isolation and contact tracing efforts.

On January 10, the full genetic sequence of the SARS-COV-2 virus has been uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) platform. In just a few short weeks, pharmaceuticals and research labs were able to develop diagnostic kits that can detect the coronavirus. But not all tests are alike, since each kit possesses different advantages and disadvantages.

In the Philippines, health professionals are using two different testing methods to screen suspected and probable COVID-19 cases: reverse transcriptase polymerase chain reaction (RT-PCR) tests also known as ‘swab tests’ and the rapid test kits (RTK). Here are some characteristics that sets each test apart.

RT-PCR: Slow and accurate

Majority of the tests being conducted today are based on the RT-PCR test method, considered as the ‘gold standard’ in testing. Specific and sensitive, the test accurately detects the presence of genetic material from the virus.

The RT-PCR test begins with a licensed healthcare worker or lab scientist extracting a specimen from a patient (with or without symptoms) through a throat or nasal swab. Samples are then transported in ice and delivered to testing labs for processing where the RNA virus is converted to DNA using reverse transcriptase enzymes. The presence of viral DNA can then be detected and interpreted by data either as positive or negative.

While accurate, RT-PCR tests are more labor intensive and processing samples in specialized laboratories can take anywhere from 24-48 hours (not counting the time it takes to deliver samples to the labs), making it more expensive.

Rapid test kits: fast but not fool-proof

Meanwhile, rapid test kits can produce near-instant results at the cost of accuracy. Instead of detecting the genetic materials from the virus, rapid tests rely on identifying the immune response of an individual.

A licensed healthcare worker will extract blood from a patient and the rapid test kits interpret the results in as little as 15 minutes. The test reads for two kinds of antibodies: the immunoglobulin M (IgM) or the early immune response, and the immunoglobulin G (IgG) or the delayed immune response. Because it relies on antibody detection rather than the presence of the virus, it is best used on symptomatic patients during the 5th to 21st day of showing symptoms.

Although speedy, the accuracy of rapid tests relies on the sensitivity of the kit itself. Thus, there’s a higher chance for errors — false positives and false negatives may be common. Another cause for concern is that antibodies only develop several weeks after the infection, so antibody-based tests like this might miss asymptomatic cases or those in the earliest stages of the disease. A confirmatory RT-PCR test is therefore administered for those turning positive results after a rapid test.

By Michaela Tangan
Features Writer, The Philippine STAR

For somebody with anxiety and depression, the coronavirus disease 2019 (COVID-19) pandemic feels like being stuck in a circus, carnival, and Metro Manila during a Friday rush hour, combined. The word ‘overwhelming’ can’t measure up to the feelings whirling inside.

On some days, thoughts of uncertainty will greet you upon waking up in the morning. There’s “Will I still have a job tomorrow?” and “Can I still afford food and pay bills in the coming months?” Feelings of helplessness, irritability, and confusion, including the struggle with focus, inspiration and productivity, are right on your tail in the afternoon.

If you’re lucky, you’ll just roll from side to side for minutes before falling asleep. But for most nights, you’ll be followed by fears about COVID-19. Boulders of thoughts like, “Did I catch the virus at work?” or “What will happen to my family if I get infected by the virus?” will lead to panic.

It’s okay, you are not alone

The World Health Organization (WHO) shared reports from different countries, showing the pandemic’s increased impact on mental health.

In Ethiopia, there was a three-fold increase in the prevalence of symptoms of depression. China, the origin of the COVID-19 outbreak, reported high rates of depression, anxiety, and insomnia. Healthcare workers in Canada have also reported a need for psychological support.

Italy and Spain have said that children in their country have difficulties concentrating, irritability, restlessness, and nervousness. Meanwhile, in the UK, 32% of young people with a history of mental health needs agreed that the pandemic had worsened their mental health problems.

While there are currently no such figures available for the Philippines, public and private groups have launched initiatives to help Filipinos struggling with mental health. Social groups encourage people to talk to mental health professionals and support groups via phone and online consultations, psychotherapy, and workshops. Meanwhile, social workers or the Barangay Health Emergency Response Team (BHERT) give ample support for those suffering from COVID-19 and their families.

There are also continuous mental health information, education and communication campaigns on social media.

Moving forward together

To face mental health issues, the WHO suggests the continued support for community actions that strengthen social cohesion and reduce loneliness, particularly for the most vulnerable.

“Such support is required from the government, local authorities, private sector and the general public, with initiatives such as the provision of food parcels, regular phone check-ins with people living alone, and organization of online activities for intellectual and cognitive stimulation,” WHO said.

WHO also sees the current situation as an opportunity to build a mental health system that is fit for the future.

“The scaling-up and reorganization of mental health services that are now needed on a global scale is an opportunity to build a mental health system that is fit for the future. This means developing and funding national plans that shift care away from institutions to community services, ensuring coverage for mental health conditions in health insurance packages and building the human resource capacity to deliver quality mental health and social care in the community,” WHO – Department of Mental Health and Substance Use director Dévora Kestel said.