Concerns are again being raised about insufficient testing after the Ministry of Health cut down on the swabbing of asymptomatic primary contacts of COVID-19 positive patients.
The new criteria for swabbing started last week after members of the health team were given specific instructions not to swab primary contacts if they were not displaying any symptoms of the virus.
A Ministry of Health source, who requested anonymity, said many members of the county surveillance units were incensed by this development, saying a reduction of swabbing and testing may reduce statistics but will also not show the enormity of community clusters.
“If a COVID positive patient lives in the same house with his family and was using the same kitchen and the same bathroom or bedroom, there is a great likelihood that his family will also be positive. But based on the new criteria, if the family is not showing symptoms, they are not swabbed. They are expected to remain in quarantine at home but without being tested, there is no indication for those primary contacts to be deemed positive even though they may very well be positive,” the source said.
Saying many COVID-positive patients were unable to self-isolate at home because of space constraints, the official said the ministry has not been making adequate provisions to accommodate these patients in facilities.
“Additionally, 24,000 test done only represents 1.71 per cent of the population, which is not enough testing and 2,000 of these are repeated tests,” the source said.
Saying the decrease in tests will bring down the high numbers, the source said this is why the figures have been reduced drastically in recent days, compared to two weeks ago when over 100 people were testing positive in a day.
But speaking at the Ministry of Health’s press conference on Tuesday, Chief Medical Officer Dr Roshan Parasram said changes had been made to the way swabbing was being done.
“As it relates to our policy on swabbing, we swab anyone who is a primary contact generally. However, there are certain groups we did slight amendments. Persons who have developed symptoms post-dating the original person that would have tested positive, seeing as we would have gone to home isolation. Those persons that were pre-dating the person that was positive in terms of symptomology—we are swabbing them right away,” Parasram said.
He added, “The asymptomatic cases we would swab thereafter if need be but they would be monitored for the full duration of 21 days. The primary contacts outside of a household, whether they are symptomatic or not, we will continue to swab those as per usual.”
Responding to comments from Director of the Department of Communicable Diseases and Health Analysis at the Pan American Health Organisation (PAHO) Regional Office Marcos Espinal, who said that T&T was not doing enough testing to know the extent of the pandemic, Parasram said the ministry has always followed PAHO and Ministry of Health’s guidelines.
“From the beginning, we have been testing based on a case definition. We have been testing symptomatic people from day one,” Parasram said.
“We test people who come to our facilities. We don’t go to people’s home to do testing unless you’re a primary contact or a case at home in your family, so we have abided by PAHO guidelines and WHO guidelines in terms of their clinical case definition for testing from day one.”
He added, “There has been a considerable increase in testing over the last month and this has been so because we have seen a lot more viral illness presenting at our facilities.”
Up to yesterday, 23,934 samples were sent for testing at CARPHA with 2,922 tests being repeated. The testing rate in T&T is currently at five per cent. Espinal said Mauritius in East Africa, which has a population comparable to T&T, has done over 200,000 tests in comparison to T&T’s almost 24,000.