COVID test confusion as figures draw criticism

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In mid-March WHO’s director-general Dr Tedros Adhanom Ghebreyesus had this advice, “We have a simple message for all countries: test, test, test.”

The idea of proper testing for COVID-19 in T&T has come under intense scrutiny over the past few days as the government continues to face mounting criticism and scepticism over the number of actual tests that are being performed on a daily basis.

The question of the quantity and quality of tests performed by CARPHA was brought into full view of the public after allegations were made by Crime Watch host Ian Alleyne on Tuesday night at the Caura Hospital- who claimed that he had tested negative twice and was given his discharge papers.

But a letter issued from the Attorney General’s office yesterday signed by attorney T Ramkissoon stated that Alleyne had tested positive for COVID-19 on March 24, and April 8, 2020. Four days later the CMO indicated that Alleyne tested negative for the COVID-19 virus on April 12, but two days later on April 14 he tested positive for the COVID-19 virus.

CMO Dr Roshan Parasram, when questioned at yesterday’s Ministry of Health COVID-19 press conference, would only say that the issue will be investigated. But the CMO failed to go any further in explaining why these tests could have turned up faulty; either giving false positives or false negatives.

The issue of testing has become a matter for “grave concern” according to a virologist speaking to Guardian Media on the condition of strict anonymity since the country recorded its first official COVID-19 case one month and four days ago.

“Realistically, we do not have the resources to test one million people in a 7-0 day period. So realistically, if we wanted to get the data, we need to make an informed decision, on how many can we test to give statistically relevant data. We are skirting around the issue,” the virologist added.

The domino effect across the world and the severe health and economic impact later led to tighter regulations by the T&T government as they attempted to stifle the spread of the virus.

Ideally, if the situation had improved on April 15 the stay at home sanctions would have been lifted.

But on April 6 Prime Minister Dr Keith Rowley announced to the nation the stay at home measures would be extended to April 30.

Test figures have drawn criticism from the public and other sectors who have clamoured that more tests are needed.

Minister of Health Terrence Deyalsingh gave that assurance a week ago when he hoped to get the private labs onboard to facilitate increased testing across the country. On Good Friday Minister Deyalsingh again reiterated the ministry’s promise to ramp up the number of tests with the introduction of ‘surveillance testing.’ This essentially would be for persons who did not present with symptoms and had not been located through contact tracing.

Based on the data provided over the last 40 days by the Ministry of Health, Guardian Media was able to calculate that of the 1,282 tests submitted to CARPHA an average of 32.05 tests were being conducted on a daily basis thus far. Was this enough?

Did these sample tests include persons who were retested? Did they include samples that were rejected?

If this turned out to be the case then it would essentially mean that the average number of people tested is far less than anticipated.

Between March 6 and March 19 – one day before the Trinidad nationals were brought back to the country from the Costa Favolosa cruise off Guadeloupe the average number of persons tested by the Health Ministry daily, even before the country confirmed its first case on March 12- was a meagre 8.8 persons based on the figures calculated.

On March 19 the figures stood at 155 COVID-19 tests and that figure jumped to 250 tests on March 20th after the returning 68 nationals were part of those tested along with other citizens. On March 21, 34 additional tests were conducted bringing the figure to 284. One day later on March 22- that figure was 306 tests with just 16 more persons tested.

On March 23 the Ministry of Health then announced that they were expanding the testing criteria and the following day they announced the arrival of 4,000 test kits into the country.

Prior to this, they had indicated only those with a travel history or who had come into contact with persons who had travelled would have been tested. With the widening test criteria, those who met the case profile could now be tested.

By March 25, the number of tests performed was 370 and this jumped to 415 and then 467 on March 26 and 27th respectively.

For the remaining days of March 28-31 – a mere 83 cases were done, which just worked out to just over 20 tests per day.

Between April 1-4 there were 250 tests done at an average of about 62.5 people tested – as of April 1 there were 586 tests conducted to date and by April 4 there were 736 tests.

On April 5 the number of people tested rose to 825 which meant 89 persons were tested in a 24-hour period.

The sharp rise in numbers here could have meant that many persons from the cruise and otherwise who had initially tested positive would have been subjected to another round of tests.

On April 8, the Ministry of Health said the country had conducted 974 COVID-19 tests and by the following day that rose to 1045 tests- some 71 additional tests conducted in 24 hours. Again possibly due to several persons again being retested with other new persons.

From April 10-14 there were 21,24,26 and 22 tests done respectively on a daily basis bringing the total number of tests for the last 39 days to 1,282 tests with random testing expected to have started on Tuesday last.