After the timeout

The most promising news reported yesterday was about the development of the real rapid test for coronavirus disease 2019: simple, cheap, accurate, and with instant results.

Not surprisingly, the test was developed in Israel. Jews account for some 20 percent of all the Nobel Prize recipients on the planet. This one might earn another Nobel, for the doctors at the Center for Geographic Medicine and Tropical Diseases at Sheba Medical Center, outside the Israeli capital Tel Aviv, who have tested the new method on hundreds of patients.

According to reports from several foreign media organizations, the rapid test involves making patients rinse their mouth with a saline solution, which is spat into a vial. The specimen is then tested in a device small enough to be held in one hand. Using artificial intelligence or AI, the device scans the specimen for a reaction consistent with SARS-coronavirus-2 that causes COVID-19.

In “less than a second,” according to one report, the result is out, with 95 percent accuracy that can still get better.

Equally promising is the affordability of the test: less than $0.25, or about P12 at yesterday’s official rate. I’m sure there are many Filipinos who will be ready to invest in the portable AI device even for their own household. Produced for the Sheba research center by Israeli company Newsight Imaging, the device is expected to cost less than $200, or about P9,700 at current rates.

The person who gave me a P2,000 Israeli-made SARS-CoV-2 killer face mask by Sonovia is now scrambling to order the AI device on Amazon.

It’s not yet available, folks. In these days of seeming hopelessness, however, we clutch at every piece of promising news.

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In the meantime, people are assessing the impact of the two-week “timeout” granted by the government to harried medical professionals, with Metro Manila and four provinces reverted to the stricter modified enhanced community quarantine or MECQ (to the despair of jeepney drivers and owners of many businesses).

The face shield is the most visible change implemented during the timeout.

As of last Monday, the price of standard face shields in Divisoria, Manila had doubled from just a month ago. Not even my status as suki or regular customer would make the stall owner relent and give the old price of P25, even for a bulk order.

The wholesale distributor had also raised the price, the stall owner said, so now it’s P48, so sorry, take it or leave it. Maybe if I ordered a minimum of 1,000 pieces, I might have been given a little discount, but nothing like P25 each.

Prices of disposable face masks, at least, remained unchanged, at P100 per box of 50 pieces.

Professor Guido David of the University of the Philippine’ OCTA Research team, who faced “The Chiefs” on Monday night on OneNews / TV5, noted reports that under certain environments, particles emerging from the mouth and nose can remain airborne for a few hours.

Viruses in those particles can then easily enter the gaps between the face and the face shield, which is now mandatory over face masks in public transportation and workplaces.

David notes that the face shield requirement presumes that pathogens, including SARS-CoV-2, shoot out of the mouth and nose, as in coughing and sneezing.

But emerging studies on the behavior of SARS-CoV-2 indicate that the particles can remain suspended in the air and swirl around certain environments, such as an enclosed room with no open windows, for several hours.

David, who together with the other OCTA researchers has achieved celebrity status as a reliable data cruncher in this pandemic, does acknowledge that the face shield can be an added layer of protection.

This is true especially if someone coughs or sneezes in front of you. And especially if the person wears a mask below the nose, as I have seen many people do. Street dwellers don’t even bother wearing masks.

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A less visible development during the two-week return to MECQ is the house-to-house contact tracing that has been launched by the Department of Health, backed by police and barangay personnel, to find mild and asymptomatic COVID cases and, if needed, to make them transfer to quarantine facilities outside their homes.

Our contact-tracing effort has yet to go high-tech, as others such as the Taiwanese have done using smartcards and phone apps. Instead, we’re told that thousands of additional contact tracers are being hired.

As for isolation, local governments are working with the Department of Public Works and Highways and other agencies to convert public schools and other existing structures outside hospitals into quarantine facilities.

COVID testing, although much improved, remains a problem. During the two-week timeout, medical groups brought home the warning about the risks of relying on rapid antibody tests to screen workers for COVID.

The Philippine General Hospital, drawing from its experience as one of a handful of COVID referral facilities, warned in a paper disseminated to the medical community that the antibody tests, given the acronym RATs by health professionals, has an accuracy of only 20 percent.

Some quarters have voiced concern that complacency or a false sense of security borne of negative results using RATs might have contributed to the past weeks’ surge in COVID, as public transport and more businesses resumed operations and people returned to work under general community quarantine.

With the two-week timeout, preparations were made for the rollout of pooled testing, this time using the more reliable but also much more expensive test for SARS-CoV-2 itself, the real-time reverse transcription-polymerase chain reaction swab test.

The pooled swab rRT-PCR test might yet be the answer to the weakness of our COVID testing capability. There’s no spinning it: the capability remains woefully inadequate.

Which is why I’m hanging on to yesterday’s piece of good news from Israel. Ultra rapid saliva test, and cheaper than a face shield, here it comes! We hope.