One of the key fac­tors in tack­ling the spread of COVID-19 across the globe is test­ing. In South Ko­rea, for ex­am­ple, mass test­ing has been used to try and quick­ly iden­ti­fy and iso­late those with the dis­ease. Test­ing is al­so vi­tal to cal­cu­late ac­cu­rate in­fec­tion and sur­vival rates – da­ta that is crit­i­cal for get­ting pub­lic safe­ty mea­sures right. So what tests are be­ing used by health of­fi­cials and what de­vel­op­ments are there to come?

There are two main ways to test for in­fec­tion with SARS-CoV2 (the coro­n­avirus that caus­es COVID-19 dis­ease). The first is a very sen­si­tive test that looks for the ge­net­ic ma­te­r­i­al of the virus us­ing a tech­nique called Poly­merase Chain Re­ac­tion (PCR). This can de­tect as lit­tle as one virus par­ti­cle in swabs tak­en from in­side the mouth or nose. This test is the cur­rent ac­cred­it­ed test­ing method by the Min­istry of Health of T&T as it is quite ac­cu­rate re­gard­ing its speci­fici­ty and sen­si­tiv­i­ty. A sec­ond type of test mea­sures the an­ti­body re­spons­es to virus­es in blood serum known as the rapid test. There are many virus com­po­nents that our bod­ies make many dif­fer­ent an­ti­bod­ies against. Some an­ti­bod­ies are very use­ful, and kill the virus or stop in­fec­tion, and some are less use­ful, bind­ing to com­mon parts of the virus but with­out help­ing our de­fens­es. Be­cause the im­mune re­sponse to COVID-19 may take some time to be launched, and to pro­duce these an­ti­bod­ies that the rapid test tests for, there will be a time pe­ri­od af­ter con­tract­ing the virus that you will test as false neg­a­tive. So that cur­rent­ly, the speci­fici­ty and sen­si­tiv­i­ty of this test may not be ap­pro­pri­ate in a T&T pop­u­la­tion. Af­ter some time has elapsed dur­ing the spread of the virus, this test may prove more use­ful.

Not every­one needs to be test­ed for COVID-19. Here is some in­for­ma­tion that might help in mak­ing de­ci­sions about seek­ing care or test­ing.

Most peo­ple have mild ill­ness and are able to re­cov­er at home

There is no treat­ment specif­i­cal­ly ap­proved for this virus.

Test­ing re­sults may be help­ful to in­form de­ci­sion-mak­ing about who you come in con­tact with.

The Cen­ter for Dis­ease Con­trol and Pre­ven­tion (CDC) has guid­ance for who should be test­ed, but de­ci­sions about test­ing are at the dis­cre­tion of state and lo­cal health de­part­ments and/or in­di­vid­ual clin­i­cians. Clin­i­cians should work with their state and lo­cal health de­part­ments to co­or­di­nate test­ing through pub­lic health lab­o­ra­to­ries like in T&T, or work with clin­i­cal or com­mer­cial lab­o­ra­to­ries.

If you de­vel­op emer­gency warn­ing signs for COVID-19 get med­ical at­ten­tion im­me­di­ate­ly. Emer­gency warn­ing signs in­clude*:

Trou­ble breath­ing

Per­sis­tent pain or pres­sure in the chest

New con­fu­sion or in­abil­i­ty to arouse

Bluish lips or face

*This list is not all in­clu­sive. Please con­sult your med­ical provider for any oth­er symp­toms that are se­vere or con­cern­ing.

Please in­form your doc­tor if you have any of the fol­low­ing:

A his­to­ry of re­cent trav­el to a lo­cal, re­gion­al or in­ter­na­tion­al re­gion where COVID-19 spread is con­firmed and you present with fever and cough.

You have symp­toms of a fever and a cough and no his­to­ry of trav­el, but de­vel­op dif­fi­cul­ty breath­ing or short­ness of breath.

You fall in­to a high-risk group for COVID-19 in­fec­tion com­pli­ca­tions and de­vel­op symp­toms of a fever and cough. High-risk groups in­clude the very old, the very young, preg­nant women, those with co­mor­bidi­ties like; Di­a­betes, heart dis­ease, chron­ic lung dis­ease, liv­er dis­ease, kid­ney dis­ease and the im­muno­com­pro­mised.

Re­mem­ber if you need to vis­it your health­care provider in these cir­cum­stances, you should call ahead so they are pre­pared and they will be able to pro­vide you with the nec­es­sary in­for­ma­tion to pre­vent the spread of your in­fec­tion.

Once your doc­tor has tak­en the de­ci­sion to test you for COVID-19, do not be alarmed as the test is noth­ing to be afraid of. A cot­ton swab will be in­sert­ed in­to your nose or throat on­ly deep enough to reach the mem­branes where virus­es grow. This might be a bit un­com­fort­able, but there is no dan­ger or risk to be­ing test­ed. The test is safe­ly pack­aged and cat­a­logued. It is then sent to a li­censed and ac­cred­it­ed clin­i­cal di­ag­nos­tic lab­o­ra­to­ry for pro­cess­ing. In T&T these in­sti­tu­tions use the PCR to de­ter­mine if vi­ral ge­net­ic ma­te­r­i­al is present. If it is present, it means you have been in­fect­ed and will show up as pos­i­tive. In about 48 hours your doc­tor will reach out to you with the re­sults. And ad­vise you on what are the next steps to get you the care you need.

Dr.Visham Bhimull

MBBS (UWI)

Diplo­ma of Fam­i­ly Med­i­cine (UWI)