COVID-19 test first before vaccinating?

Over the weekend, Beijing and Hongkong reportedly implemented another round of mass testing due to the suspected outbreak of a more contagious variant of the 2019 coronavirus disease (COVID-19). The renewed mass testing in China’s capital city of Beijing and in Hongkong came following an outbreak of new local cluster of cases believed to be linked to a more infectious virus variant. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)—the strain that gave rise to COVID-19 pandemic—originated from the Wuhan province of China.

The World Health Organization (WHO) so far identified three mutations of the Wuhan-COVID into countries of origin. The first one that broke and we now have a confirmed case here is called the United Kingdom (UK) variant. The second variant spread out in South Africa and the third variant broke out in Sabah, Malaysia last month. Over the weekend, Japan reported about a new variant detected from a COVID-infected Japanese girl who has no history of travel abroad or contacts with any travellers.

This brings to mind a concern raised by mass testing advocates during my Kapihan sa Manila Bay virtual news forum last Wednesday when we had designated “testing czar” presidential adviser on flagship projects and programs Vivencio “Vince” Dizon as featured guest. Dizon also happens to be the designated chief coordinator of the Philippine government’s “T-3” that stood for “Test, Trace, Treat” strategy. Joining Dizon as reactors in our Kapihan sa Manila Bay were Dr. Emilio Q. Villanueva III and Tom Navasero. Dr.Villanueva—no relation with the writer—is an associate professor of pathology at the University of the Philippines-Philippine General Hospital and head of several clinical and molecular laboratories in the country. Navasero, on the other hand, is the founder and chief executive officer of LABx Corp., a biotech company which actively develops and designs COVID-19 solutions.

During our Zoom Webinar, the mass testing issue was raised to Dizon in the light of the new COVID variants while the Philippine government prepares to roll out soon its own vaccination program. This is because Dizon serves concurrently as deputy chief implementer of the National Task Force (NTF) on the National Action Plan Against the COVID-19 pandemic. He also sits at the Inter-Agency Task Force for the Management of Emerging and Infectious Diseases (IATF-MEID)—the policy-making body that recommends to President Rodrigo Duterte on quarantine rules and other government responses to control the COVID-19 pandemic.

Under the government’s anti-COVID vaccination program, it targets up to 70 million Filipinos, or two-thirds of the population to achieve the WHO-prescribed “herd immunity.” Government authorities earlier announced the initial batches of vaccine doses starting next month.

At the outset, Dizon echoed the confidence of WHO experts that the anti-COVID vaccines so far developed on third phase of clinical trials showed same efficacy to fight the COVID-19 variants. “To us, our strategy does not change even with the new variants from UK, South Africa and Malaysia,” Dizon declared. But since the Philippines now has one confirmed case of the UK variant from a Filipino traveller who returned from a Dubai trip, he disclosed, an added requirement is to send for gnome sequencing those samples found COVID-19 positive for those travellers from the 30 or so countries placed under tight watch for the UK variant.

So far, Dizon cited, the testing capacity of the government has tremendously improved from the two government laboratories at the start of the pandemic in March last year. But now, Dizon noted over 200 molecular laboratories of hospitals both from government and private sector and those operated by local government units (LGUs) as well as medical services companies are conducting tests.

They all account for the average of 30,000 to 40,000 COVID tests per day reported to the Department of Health (DOH), Dizon cited. He clarified though this average is based only on the WHO-imposed use of real-time reverse transcription polymerase chain reaction, or RT-PCR, as the “gold standard” for COVID-19 swab tests of the nose and throat. According to Dizon, this does not include the number of testing done through antigen. And soon, Dizon added, there would be “saliva-testing” that the Department of Health (DOH) and the Food and Drug Administration (FDA) finally approved to be done by the Philippine Red Cross.

Unlike the RT-PCR where results come out after 24-hours or so minimum waiting time, the antigen results come out within 15 minutes after machine reading to detect COVID. Applying only nose swab, it gave rise to anecdotal criticisms that antigen is prone to produce false positive, or false negative result of COVID-19 infection.

As “testing czar,” Dizon declared: “Both the RT-PCR and antigen can detect COVID-19 infection.”

Navasero blamed poor quality antigen products as giving the antigen testing method the bad reputation it does not deserve, even when it is RT-PCR based too. Navasero vouched for accurate, faster and more affordable antigen distributed here in our country by his company LABx. In fact, he cited, Sofia 2, FINA and AgILA are being used by certain LGUs in the Philippines. All three are based on Fluorescent Immunoassay technology that reads the results using lasers to detect and measure a subject’s viral load.

Taking off from what Dizon invoked as the government’s “whole of nation” approach to fight COVID-19 pandemic, Navasero suggested to include mass testing in the roll out of the vaccination program using antigen for added precaution. But under the government’s current guidelines, getting COVID test first before vaccinating is not required.

As of latest gnome testing, DOH revealed 16 other Filipinos got infected with this highly transmissible UK variant. Science and experts’ opinion on the matter must guide our vaccination program considering these anti-COVID vaccines are all still under clinical trials. The ball is on the court of Dizon as “testing czar” to push it forward or not.