The world hastens toward making medical breakthroughs like vaccines to quell the COVID-19 pandemic that caused around seven million confirmed cases and 400,000 deaths as of press time. However, the reliability of every potential intervention, testing method, and treatment must be established based on proper and relevant evidence before these can be implemented in society.
Public awareness has to be raised on the country’s progress in the fight against COVID-19. To accomplish this, the National Academy of Science and Technology (NAST) held its first session of the webinar series COVID-19: Where We Are and Where We Want to Be last May 27.
Testing for rigorousness
Testing and treatment are among the public health interventions in deterring further spread of infectious diseases like COVID-19. In establishing the reliability of different methods, Academician Antonio Miguel Dans from the Health Sciences Division of NAST highlighted Science as the basis for making the right decisions about these intervention options and programs. “Science is there to guide [the policymakers]. Therefore, we should support Science and believe in Science,” he reiterated.
There are three tests for detecting COVID-19 traces: the reverse transcription-polymerase chain reaction (RT-PCR) test that detects for the presence of viral genetic material; the serology test that detects the blood levels of antibodies produced in response to the infection; and the 14-day test that involves asking the patient’s health status—like having observed flu-like symptoms—within the past 14 days. Each test is validated by comparing the number of correctly detected infectious and non-infectious patients.
Dans compared the antibody test and the 14-day test in terms of their reliability, given a specific number of people to be tested. Based on existing literature, the antibody test on average correctly detects 71 percent of positive patients and 83 percent of negative patients, while the 14-day test is more reliable, correctly identifying 87 percent of positive patients and 99 percent of negative patients.
An arguably larger point of concern for validating a testing method pertains to the proportion of false positive and false negative cases. False negative cases can worsen the spread of the disease within the vicinity as the infected individuals might go about their daily lives thinking they are not sick; meanwhile, a healthy worker who falsely tests positive might lose their source of income, especially those that observe a “no work, no pay” scheme.
Further, contact tracing is already overburdened as it stands; when someone tests positive, individuals who came into close contact with the patient over the previous week have to be found and must also undergo self-quarantine—but if the case was actually a false positive result, then a lot of time and resources would have been wasted in tracing and isolating these close contacts.
Despite the 14-day test being reliable as Dans illustrated, its effectiveness in checking for COVID-19-positive patients requires a significant level of trust. “Ang worry dito, aamin ba yung mga tao na mayroon silang nararamdaman? Eh, kung depende doon yung sweldo nila, baka i-deny nila,” he pointed out.
(The worry here lies in whether people would admit to feeling sick or experiencing symptoms. If their livelihood would be affected, they might deny it instead.)
For workers to recognize the importance of “telling the truth about their health”, the interventions have to be framed “not as [a form of] punishment” but as means “to protect their family, community, and co-workers”, Dans highlighted. To allay livelihood concerns, he further proposed providing them free healthcare services, additional sick leaves, and financial assistance.
Further, Dans recommended looking into clinical trials to verify claims regarding the effectiveness of a treatment. “[Clinical trials] compare groups of patients who are given the treatment being tested and groups of patients who are not given that treatment, such that we may begin to see that it is perhaps not so effective,” he explained.
One such clinical trial is Solidarity, launched by the World Health Organization (WHO) and its partners to seek out an effective treatment against COVID-19. The Philippines is a participant in the ongoing trials, with the University of the Philippines-National Institutes of Health serving as the national representative.
Where the Philippines stands
Several research endeavors around the world are contributing in the fight against COVID-19. Health Sciences Division Head Academician Jaime Montoya highlighted some of the ongoing local studies, each aligned with at least one of eight Research and Development areas given focus by the Philippine Council for Health Research and Development.
Some local projects are aimed toward reducing the risk of healthcare workers from contracting the disease by minimizing exposure. The RxBox Telemetry System in the University of the Philippines Manila Philippine General Hospital enables monitoring of patients from a distance via dashboards; a related project involves the Telepresence Terminals that act as teleconferencing devices, allowing long-distance communication between medical personnel and COVID-19 patients.
There are also software applications used among local government units, such as the Feasibility Analysis of Syndromic Surveillance using Spatio-Temporal Epidemiological Modeler (FASSSTER), a web-based platform that monitors daily cases and forecasts healthcare capacity of hospitals based on the case data. One of its features is called TanodCOVID, an SMS-based system that allows citizens to inform local health authorities if they have at least one of 11 reportable COVID-19-related symptoms like cough, fever, and breathing difficulties.
Meanwhile, the Research Institute for Tropical Medicine has been focusing on pattern recognition and tracing the cumulative spread of COVID-19 in the Philippines. One of their projects involves understanding seroprevalence or surveying the extent of disease occurrence in a population based on blood serum samples, as it would be “very helpful in giving us an idea of the true burden of the [COVID-19] infection in the Philippines.” It is complemented by understanding the transmission dynamics of the virus via contact tracing among the asymptomatic and symptomatic individuals through antibody response detection.
With all the data and publications being generated by these endeavors, it has also been necessary to keep up with the deluge of information. As such, the scientists also commended the efforts of the Philippine Society for Microbiology and Infectious Diseases database team, who have been conducting rapid reviews of the literature, analyzing the results, and contextualizing the implications as new data and changing trends emerge.
While professionals and institutions around the world are working to mitigate the spread of COVID-19, ordinary citizens must also play their part. “As individuals, we have the power to prevent the spread of the virus by getting educated, staying at home, maintaining [physical] distance, and taking care of ourselves,” Montoya reminded.