Dr Joy St John

NECESSARY ACTION: Dr Joy St John

Executive director of the Caribbean Public Health Agency (CARPHA) Dr Joy St John believes that every person in the Caribbean has a 50 per cent chance of contracting COVID-19.

Speaking yesterday during a virtual press conference on the coronavirus pandemic, St John was asked to comment on the use of nationwide shutdowns and in some Caribbean countries, a curfew, in the war against COVID-19.

She said such action was necessary based on spread patterns in early-affected countries.

She said each person now stood a 50 per cent chance of getting infected and the illness has so far presented in two ways.

Around 80 per cent of people who contracted COVID-19 would be able to withstand it with mild symptoms.

But 20 per cent—especially seniors and the chronically ill—would have to be hospitalised and some patients would die, she said.

And as concerns rise over the global availability of testing kits for COVID-19, another CARPHA official said the agency was equipped with at least three weeks’ worth of a reagent component in the two-part testing system and has in place a pre-order and is actively seeking a supply.

CARPHA Assistant Director of Surveillance, Disease Prevention and Control Dr Lisa Indar said yesterday the agency has projected that it has a three-week supply of the reagent needed for PCR (polymerase chain reaction) testing of the virus, which comprises an extraction and then amplification process.

The PCR test is the only method shown to so far have a 100 per cent determination rate in both areas, as compared to the serology test being offered by some institutions and which is not recognised by the World Health Organisation (WHO).

St John reiterated that the agency remains the only authorised facility to accurately test for COVID-19.

In a question and answer session with reporters, Indar said CARPHA’s modelling was done on the assumption that one per cent of the Caribbean population would be impacted by the pandemic and it was preparing to be able to conduct 20,000 tests.

Indar acknowledged that there currently existed a blip in the trade supply chain and that testing components were in demand but said the three-week supply at CARPHA provided a “buffer”, while the agency actively sought a supply.

She said the wait time could be more than three weeks but the agency has been given an assurance that “we are likely to receive it”.

Indar said the agency took a proactive role in January and pre-ordered supplies and testing media, which would normally have come to it by now if not for a global shortage.

St John reiterated that CARPHA does not issue test results to patients or individuals but to designated public health agencies and called on people and physicians to “refrain from calling CARPHA” for results.

This was not a matter of violating a patient’s rights but of ensuring that results do not end up anywhere they ought not to, as this would be a violation of ethics on CARPHA’s behalf.

Costs to testing

St John said all samples that meet the WHO guidelines used by CARPHA are tested and those which do not are rejected, with 929 regional tests and 553 from Trinidad and Tobago having been done from February 10 to March 31.

The WHO guidelines used by CARPHA are available on the agency’s website and note that samples will not be tested after ten days, as this results in a decline of the viral load needed to determine whether a sample is positive.

Samples are only accepted from designated public health departments of the 18 member countries and a sample will be rejected if it is not properly packaged.

Tests are conducted at a cost of US$250 each and CARPHA has carried out US$228,000 worth of testing done to date.

In response to a query as to whether CARPHA had misplaced samples or mixed up results, Indar said that she could say with certainty this has not happened and all samples going to the agency, whether tested or rejected, have been accounted for.

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