Daily News Editorial

COVID-19: Testing the key

Wednesday 01st, April 2020

If the symptoms of COVID-19 infection are similar to that of acute influenza, how do we know we are afflicted by the new, highly infectious disease? And, since the virus spreads rapidly from person to person, we will certainly need to know it fast enough to avoid infecting others.

Just as with all other diseases currently known and treated by the medical sciences, the diagnosis of COVID-19 is done by tests. Body samples are taken and analysed in laboratories and the result will indicate the nature of the infection.

The current challenge is to design testing systems that enable the quickest possible accurate diagnosis. After all, the earlier we know who and how many are COVID-19 positive, the quicker we can act to prevent them from infecting others. And, most importantly, the sooner the treatment of victims, the easier it is to prevent fatalities.

Medical scientists the world over, from the World Health Organisation (WHO) to our own medical scientific community, are unanimous in seeing testing as the core means of fighting the epidemic. In the long term, ultimately, it is hoped that a vaccine will be developed to prevent infection. Till then, it is prompt diagnosis that is the primary measure of preventing a contagion.

But this means test systems that are proactive rather than reactive. That is, rather than wait for symptoms to show sufficiently to suspect COVID-19 and then seek the test, there needs to be constant testing of people in different parts of the country – at public transit points, gathering places – to identify not only the number of infections but also the geographical spread. Such systematic testing will enable anticipation of directions of viral spread and the potential for increases of infections. At the same time, such proactive testing will ensure early diagnosis and thereby save lives.

The more convenient such testing is for the public, the easier it is to ensure the maximum public participation in testing. Simply put, there are broadly four stages in testing for a disease such as COVID-19.

Firstly, there is the stage of noting symptoms and engagement with the testing authorities. Secondly, there is the procedure for providing body fluid samples for analysis. Then, there is the analysis of the samples in a suitably equipped laboratory. The fourth stage would be the medical response to the diagnosis, either by treatment of the patient or by the discharge of the person because she/he is cleared of the disease. Sometimes, the cleared person may be subsequently monitored for a period just in case the infection arises later. Or, the person could be asked to under-go self-quarantine.

South Korea, which has had thousands of COVID-19 positive cases, is being held up as an example of a country that has taken swift and extensive steps to counter the spread of the infection. The success of South Korea is based on the most pragmatic measure of maximising the testing of the population so that those infected are identified as early as possible.

When COVID-19 initially hit Sri Lanka with that single case of a foreigner (who was successfully treated), the medical specialists here were quick to develop a test kit. It was one that could be used in a convenient interaction with potentially affected persons. However, to date the testing procedure currently in use throughout the world needs several hours for sample analysis at specialised laboratories, though at least one company has developed a five-minute test.

Even as it consolidates its early systematic handling of COVID-19, the Government is already moving on to the logical next stage in fighting any lethal and volatile contagion: proactive testing of people across the country. The medical specialist community is already busy developing test procedures designed for convenient public use on a mass scale.

It is not an easy task and certainly an expensive one given that it requires the urgent deployment of design systems, production mechanisms and rigorous ensuring of scientific quality standards.

The medical scientific community, which is broadly unanimous about the need for extensive and systematic testing of the population, is looking to the Government to facilitate the process at the earliest. They point out that the current success in responding to the contagion by slowing down the spread cannot be sustained in the long term unless the spread itself is anticipated comprehensively and stopped.

They point out that some level of mass sample testing at centres across the country will be the final means of containing the epidemic in a viable manner which reduces the greater costs of having to deal with any expansion. Our medical scientists and administrators are already known to be in close consultation with counterparts in South Korea and China as well as the WHO in this regard.

This is the moment for the business community, too, to contribute with design and innovation in cost effective medical engineering on the one hand and investment in mass production on the other.