In recent weeks the Ministry of Health has come under serious public scrutiny when it comes to Covid-19 testing. Many are of the opinion that the Government should allow for testing to be conducted on every person who has had contact with a positive patient. The revised policy on testing indicates that only those who exhibit symptoms will be tested. Our newsroom asked DR Manzanero to explain how this will reduce the number of positive cases when there may be positive persons without symptoms.
Dr.Marvin Manzanero, Director of Health Services: “We have never actually been doing testing of everybody who is a contact of a positive case. I know CDC has indicated that close contacts should not be swabbed until they’re symptomatic , we had that discussion I don’t think we said that on Monday. We did say that we were going to go once you have community transmission you look for the people who are having chronic conditions, the elderly, pregnant women because you can’t test everybody but in terms of testing close contacts lets say in a household of a given cases you still will continue to do that so we’re not scaling back in that aspect. I don’t think we’re necessarily scaling back in any aspect other than when you do a requirement for two negatives in order for you to be declared as a recovered case so in that aspect we will only be doing one test and if it’s negative you will be considered as a recovered case that’s the only item I can see us scaling back on. As I said the amount of samples that were taken out of Orange Walk is fairly significant. I know people keep saying that we don’t seem to be doing enough tests but you always have to do it by rates that’s one thing that I think we should be aware of when we do comparison in terms of how many people have died as well you have to do it by rates and make your diagnosis based on that. So when you look at our testing rates it is definitely higher than neighboring countries such as Honduras, Guatemala, definitely much higher than Mexico. Countries in the Caribbean region that are having similar numbers in terms of a similar epidemic curve we have higher testing rates than Suriname, Trinidad and Tobago, Guyana and so those are the countries I think you can more or less be able to compare yourself with and our testing rates are definitely higher.”
Belize’s Ministry of Health is not alone when it comes to cutting back on Covid-19 testing. As a matter of fact, the World Health Organization (WHO) is onboard this new policy as they indicated this week in a public conference.
Dr.Maria Van Kerkhove, Technical Lead COVID-19, World Health Emergency Programme: “WHO has issued guidance on testing strategies for how to use testing as part of the control strategy for the COVID-19 pandemic. We’ve outlined guidance for countries that are at different stages of their outbreak whether they have a small number of cases or a large number of cases and it’s up to the countries to adapt that testing strategies to the needs of the country depending on the capacities that the have, depending on the intensity of transmission that they have. What we’ve outlined are strategies to actively find cases and so we have recommendation to test suspect cases and in situation where it is feasible and is possible to expand testing where necessary to really look for the cases so that they could be isolated and that contact tracing can ensue. So there are different types of guidance that WHO has put out on this including the normal laboratory guidance that we have. We have additional considerations for different prioritization of testing depending on your intensity of transmission and we have investigation guidance. So for this specific example of cluster investigations testing may need to be expanded to look for individuals who are on the more mild end of the spectrum or who may indeed be asymptomatic. Again what’s really important is that testing is used as an opportunity to find active cases so that they can be isolated and so that contact tracing can also take place where you identify all of the contacts of a known case and that they can be quarantined and this is really fundamental to breaking chains of transmission.”
The primary purpose of testing is to confirm whether a suspect case has the disease or not and many countries are focused on that as Maria said that allows us then to begin the process of contact tracing to those confirmed cases so it’s really important that testing turn around it’s not necessarily how many tests you do – it is important that the rate of testing is kept high – but it’s also the speed at which those tests are turned around. Getting results back a week or ten days after the test is done really causes a difficulty because then you can’t do effective contact tracing. So the most important part of the testing strategy is to decide who you’re going to test, focusing on those suspect cases and then getting those people tested and getting those results back as quickly as possible and initiating the public health actions either in terms of isolating or quarantining contacts, carrying out cluster investigations and as Maria said in those situations particularly where there has been a cluster of cases broader testing of other people who may have been exposed and who may have been carrying the disease either asymptomatically or presymptomatic then there is a rationale for testing those people because you’ll tend to get a higher return but broad based population based testing at this point in most countries is not really that useful it absorbs a huge amount of resources and you have to have a huge capacity to do testing. So we need to focus on testing the right individuals, we need to focus on maximizing the testing within clusters and we need to focus on the quality of that testing and the speed of the turnaround of that testing and then what happens next. Testing is one thing, testing is one part of the process it’s what happens when you test how quick the result comes, how quick the investigation happens and how quickly you can intervene to shut down chains of transmission. Sometimes we get to focused in on the act of testing itself. It’s a vital part of a very important chain of activities that helps us to suppress this virus.”
To date, Belize has carried out seven thousand two hundred and eighty nine tests across the country. In terms of recent infections, the Belize Sugar Industries (BSI) has reported that two of their employees have tested positive for Covid-19. The company sent out a release saying that they have acted decisively and quickly in collaboration with the Ministry of Health (MoH) to conduct their risk assessment and contact tracing for all other employees possibly exposed to these individuals. Additionally, BSI says they have responded according to our strict protocols to ensure our employees’ health and safety. All employees identified as having close contact with these individuals have been informed and placed on self-isolation.