Importance of testing in COVID-19 surveillance

The cry of the World is; when will COVID-19 crisis come to an end? As Scientists are truly doing all their best to find a lasting solution to the pandemic, the virus is fast spreading like wildfire.

It has infected more than 2.9 million people with over 206 thousand deaths globally.

According to World Health Organization and John Hopkins expert in global public health, as at 26/04/2020 16:20 GMT Africa has recorded 31,377 confirmed cases with 1,409 deaths and 9,434 recoveries.

The African continent is challenged with prevailing medical conditions such as malaria, cholera, tuberculosis, malnutrition, HIV/AIDS and prevalence of Cardiovascular and hormonal diseases coupled with limited/poor health infrastructures. The question on the minds of many is Will the Continent be the next epicenter?

The problem is not different from Ghana as cases have increased to over thousand five hundred with eleven deaths. The only solution to Covid-19 lies in rigorous public health surveillance of which laboratory testing is one of its pillars.

Disease Surveillance is the ongoing systematic collection and analysis of data and provision of information which leads to taking action on prevention and control of a disease usually one of an infectious nature example (Covid-19).

What are the global objectives of COVID -19 Surveillance?

To monitor trends in Covid-19 disease at national and global levels, rapidly detect new cases in countries where virus is not yet circulating and to monitor cases in countries where virus has started circulating which involves laboratory investigation and confirmation of cases which is one of the core functions of surveillance and to provide epidemiological (person, place and time) information to guide preparedness and response

Ingredients of public health surveillance includes; a good network of motivated people, a clear case definition (standard set of criteria for classifying whether a person has a particular disease), reporting mechanism, laboratory support, efficient communication system, basic but sound epidemiology, good feedback and rapid response. Before we consider the benefits of testing it is vital we consider the test available for COVID-19 virus.

What tests are available?

The first is Reverse Transcription Polymerase Chain Reaction (RT-PCR) test is a very sensitive test that look for RNA (genetic material) of the virus. This test helps to detect if a person is currently carrying the virus and can detect a little as one virus particle in the swab taking from inside the mouth or nose. This test is recommended by WHO for COVID-19. However, if you are recovered the virus is eliminated and this test cannot determine if you have been infected. This test need laboratory so it takes time for the test to be available.

The second is antibody test: It helps to determine whose immune system has already encountered the virus. This test will help to track the true extent of the outbreak because it will help to know those who have had the virus even though they show no symptoms. After we have cleared the virus these antibodies stay in our bodies to protect us when we encounter same virus again, this test operates on principle of vaccination and vaccine production, thus this test depends on blood samples. According to Chris Whitty; UK Chief Medical Advisor a test that could reliably detect past infection will be transformational.

There are countries that did not conduct enough test at the early onset of the outbreak and it cost them a lot and many countries are making the same mistake. According to the Director Africa Center for Disease Control and Prevention, Dr. John Nkengasong “there is a big gap in the continent on testing”. Some countries like South Africa and Ghana and others on the continent have tested quite a number of people but can that give us a clear holistic picture of the situation on ground? Let consider why testing is essential.

Benefits of testing

Testing leads to early identification of cases. Secondly, testing leads to early isolation to prevent the spread of the infection. Thirdly, it helps to early treat isolated cases. Again, it helps to early search for those who have come in contact with the infected person (contact tracing). More so, it helps to assess if the public health mitigation activities are working. Also, it plays a vital role in determining who have been recovered. For COVID-19 infected person have to receive two negative test in row 24 hours apart (CDC) including other factors to be declared recover.

Furthermore, laboratory testing is one of the pillars for vaccine and drug development. Finally, it assists researchers to characterized the prevalence (existing and new cases), spread and contagiousness of the disease (covid-19).

I recommend that the Government establish more laboratory capacities and strategies to help test for more Covid-19 suspected cases which will give a clear picture of the situation and position the country against any future outbreaks. Also, government need to design an appropriate test system for the entire population.

Citizens must seriously adhere to social distancing, regular hand washing, eating balance diet, drinking enough water and use of face mask when going to public places to remain safe.

To overcome the COVID-19 virus outbreak, we need early identification, rapid isolation, timely establishment of infection prevention and control measures, symptomatic care for those with mild disease and supportive treatment for patients with severe COVID-19 infection.

It is essential to intensify our efforts and sustain it, to fight this highly infectious virus so that our health care and laboratory service will not get strained. After the storm there will be still.

May the Lord bless our home land Ghana and make our nation strong.