The refusal by the Caribbean Public Health Agency’s (CARPHA) lab to test for COVID-19, four samples coming out of St Vincent and the Grenadines (SVG) speaks to the need for local testing capabilities.
As at March 31, 2020, samples for 44 persons had been sent for testing, most at CARPHA’s laboratory in Trinidad and Tobago (T&T). There have so far been two positive results.
In the most recent batch, four samples were rejected by CARPHA because they did not satisfy the testing criteria for COVID-19.
CARPHA has advised chief medical officers, laboratory directors and national epidemiologists that samples must meet the criteria for a suspect or probable case of COVID-19. A circular from CARPHA dated March 12, 2020 advised that a Suspect case is:
a) a patient with severe acute respiratory illness (fever, and at least one sign/symptom of respiratory disease (e.g. cough, shortness of breath), AND with no other cause that would explain the symptoms AND a history of travel to or residence in a country/area or territory reporting local transmission of COVID-19 during the last 14 days prior to symptom onset OR
b) a patient with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to the onset of symptoms OR
c). a patient with severe acute respiratory infection AND requiring hospitalization AND with no other cause that would explain the symptoms.
A probable case is defined as a suspect case for whom testing for COVID-19 is inconclusive, while a confirmed case is a person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.
Prime Minister Dr Ralph Gonsalves said on Thursday that the four samples had been sent to CARPHA out of an abundance of caution.
“CARPHA say listen, unless you have the symptoms, we are not testing.
“Because when we send the data sheets down with the samples, what I’ve been advised is that you have to list what symptoms they had,” Gonsalves explained.
Last week, Minister of Health Luke Browne said that testing for COVID-19 in SVG should begin on or about April 6, 2020.
He said that the necessary equipment and supplies have already been ordered and should be in country by today, once there are no delays with delivery.
A testing site has already been identified away from the laboratory at the Milton Cato Memorial Hospital (MCMH) because of space requirements, and training for laboratory personnel has also been arranged.
The capital cost associated with developing testing capacity for COVID-19 is approximately $300,000, the minister said.
Apart from sending local test samples to CARPHA, the Best dos-Santos Public Health Laboratory in Barbados also does testing for the Ministry of Health.