The College of Community Physicians of Sri Lanka (CCPSL) said today evidence from South Korea and Singapore implies that flattening of the epidemic curve is achievable with aggressive testing strategy and urged the Government to adopt the World Health Organization (WHO)’s “Test Test Test” strategy.
The CCPSL that put forward 12 proposals for strategic planning to address the current situation of COVID-19 epidemic in the said the health authorities must revise the testing criteria expanding to cover more suspected cases and contacts with clear prioritization strategy by a technical team
“ WHO advocates if countries detect, test, treat, isolate, trace, and mobilize their people in the response, those with a handful of COVID-19 cases can prevent those cases becoming clusters, and those clusters becoming community transmission. One of the main objectives of COVID-19 testing is to find and isolate asymptomatic carriers, before they spread the infection unwittingly ,” CCPSL said in a news release today (9 April)
In the Sri Lankan context, the CCPSL said the increased detection of cases and carriers reduces the need for more stringent government measures, like curfew and movement restrictions. “ During the initial response, Sri Lanka adopted fairly strict criteria on who should be tested for COVID-19. As the epidemic evolves, this slow rollout of testing and limited testing capacity may blunt the response to the epidemic,” the CCPSL said.
The Organization observed that reasons for not carrying out more testing would be due to multiple logistical problems with Reverse Transcription Polymerase Chain Reaction (RT PCR) testing done only at seven centers currently. “These are the Medical Research Institute (MRI), Kandy Teaching Hospital (TH), Anuradhapura TH, Karapitiya TH, Ragama TH, Infectious Disease Hospital and Sri Jayewardenepura University), while there are many laboratories all over the country which have GeneXpert machines, which could perform the testing, provided the FDA approved kits are available for this purpose,” CCPSL said.
The Community of Physicians also suggested that Sri Lanka employ volunteering medical laboratory technicians (MLTs) in other government laboratories and scientists with real time PCR experience at laboratories with unutilized GeneXpert machines, establish a larger central laboratory (at MRI) with some of the unutilized GeneXpert machines and employ volunteering MLT/Scientists, adopt pooling of samples for PCR, which can exponentially increase the testing capacity and explore the rationale and feasibility of rapid Ag or Ab based serological testing.
CCPSL added that in keeping with the high testing rates expected following the recently revised screening criteria, a prioritizing mechanism should be worked out for the target groups being tested. “Further, other options should be considered to prevent hospitals getting overloaded with test positives. Self-isolation/separate centers should be considered for asymptomatic or mild cases,” CCPSL said.