Rapid antigen tests not to spot cases with no symptoms

As of Thursday, October 29, 2020

By RASHAD ROLLE

Tribune Senior Reporter

rrolle@tribunemedia.net

HEALTH officials say the rapid antigen tests, which are key to the country’s plan to reopen with relaxed requirements, are not useful in detecting the disease in asymptomatic carriers of the virus.

Their comments came as the Bahamas Association of Medical Technologists released a statement yesterday saying the rapid tests should not be sold to businesses and organisations that lack the “necessary capabilities” because of the infection risk.

“Testing should only be done by healthcare professionals who are trained specifically for this purpose,” the BAMT said.

“Increased testing cannot mean a disregard of the guidelines and standards that have been set to keep us all safe. COVID-19 is a highly infectious virus that is still spreading rapidly amongst us… the use of rapid tests must be done with the utmost care and not taken for granted because of its apparent simplicity. This is not a pregnancy test and the risk of infection is extremely high. These kits should not be sold to businesses and organisations without the necessary capabilities.”

Dr Merceline Dahl-Regis, health consultant in the Office of the Prime Minister, said during a press conference yesterday that up to 40 percent of COVID-19 carriers are asymptomatic.

When asked if the antigen tests can identify the virus in such people, Dr Jessica Edwards, a medical microbiologist at Princess Margaret Hospital, said the test is not recommended for this purpose.

“The Ministry of Health is actively looking at the performance of the rapid antigen diagnostic test for use in our population,” she said.

“We do feel that once the test has been approved and is satisfactory for use, we should be able to use it effectively in symptomatic patients, particularly symptomatic persons being those that are having signs and symptoms that suggest a COVID-19 infection.

“We also think that this test may be useful in the population where contacts have been exposed to cases confirmed to be positive or COVID-19.

“The Ministry of Health at this time does not recommend using those tests for the asymptomatic populations or wider screening and so it would not be a useful option at this time.”

Dr Indira Martin, head of the Bahamas National Reference Laboratory, added: “There is a lack of data in that particular population and the recommendation thus far from the WHO has been for use in symptomatic individuals.”

The Bahamas will reopen its borders with relaxed requirements on Sunday in a process that has some differences from the July 1 reopening, after which an explosion of cases and deaths were recorded.

Visitors and returning residents will be required to produce a negative COVID-19 test from an accredited lab that is no older than seven days. When they arrive in the country, they will be administered a rapid antigen test.

Those who test negative will be administered the same test five days later.

Visitors and returning residents/citizens will no longer be required to quarantine for 14 days after arrival in the country, beginning on November 1.

ThisIsOurs 3 years, 5 months ago

im lost. if an individual is symptomatic what's the mystery? We can tell the person with the hacking cough and high fever to go home and quarantine. Seems it would be more useful if we could find the asymptomatic in the population. But I do agree that handing over tests to "regular" people could be very dangerous. unless we in the apocalypse where the accountant has to perform appendectomies

whogothere 3 years, 5 months ago

There are a number of different virus that produce the same symptoms... Asymptomatic are not really spreaders it’s rare. Mild symptoms that person think are like a cold or flu is where people are not vigilant. But remember COVID is just that - a cold for the most of persons who experience it. There is little risk unless you re older or sick (as with flu) common sense protocols would have seen us through this without cratering our economy....

joeblow 3 years, 5 months ago

We need to do two thing simultaneously (if that is possible for a Bahamian in government):

1) rapid antibody testing- we need to know who has had the infection and get this group back to work. Every person in the tourism industry should be tested to determine who has already been infected. If a person has been infected, they should be able to go back to work!! The risk of reinfection is extremely low.

2) Antigen testing can determine those who have viral particles in the body. It cannot tell if it is a new infection or a recovered person with virus particles still in the body while they have no symptoms.

If these idiots ordered 1.5 million of each test and started mass testing, this country could know exactly what to do within one week!

whogothere 3 years, 5 months ago

Have to say I agree with with a population of 393k it should be a no brainer. Of course we have a number of illegal persons that would cooperate with testing and we probably don’t have the manpower to role it out. But with community leadership and partnerships this is exactly what should have happened - Iceland has the population as us and this is exactly what they did months ago...sigh a least it’s warmer here...

newcitizen 3 years, 5 months ago

Talk about fake news. Antigen tests are less accurate than a PCR, but they detect symptomatic and asymptomatic with the same accuracy. Some people who are asymptomatic slip through, but most are caught. Is it better to catch 9 out of 10 people with active infections or spend 10 times the amount on a test that takes 10 times as long. Rapid antigen tests taken often is the best approach we have to this virus and getting back to any semblance of a working economy.

whogothere 3 years, 5 months ago

Somewhat true - pcr tests are much more specific but are actual in a sense less accurate then antigen tests mostly because they are over sensitive and they overdetect the virus Ie you could have had it weeks ago but viral remnants still show up on a pcr test. This produces a lot positives that are not infectious, similar because the test takes a long there is greater chance of transmission is someone is truly positive. In other wards it’s great for generating panic but more or less useless in combatting viral spread. But Antigens test Are not effective at picking Pre symptomatic Or asymptomatic persons which is why the gov is required a second test on entry and why frequency of testing is important.

ColumbusPillow 3 years, 5 months ago

Please survey those who have been PCR tested to reveal what is the expected wait time for a report, after a swab test In Canada it can be longer than 6 days versus 15 minutes for an antigen test!.

trueBahamian 3 years, 5 months ago

🤦‍♂️ I don't get the stupidity of this government. Why would you recommend a test that doesn't give results for ALL persons infected. If asymptomatic infections represent 40% of your infections, you need a test to identify these people.

We're sitting here watching the government chug along with a medical and economic disaster strategy. This is a time for a vote of no confidence in the PM, the firing of the Minister of Tourism and the Minister of Health. The mistakes made and the continued strategy shows recklessness and a total detachment from logic.

whogothere 3 years, 5 months ago

The asymptomatic are really only about 2% of transmission, but can represent up to 70% of those person infected. This why covid cases are inconsequential. Most people are not transmission risk accept in particular circumstances. The Japanese who have not excessively locked down focus on control these circumstances or super spreading events.

trueBahamian 3 years, 5 months ago

Thanks for th at info. 2% is still not zero, but from a risk based approach they would represent a lower risk population. This would make sense as to why the testing done in some countries that I heard of focused on persons exhibiting symptoms.

I'm not a proponent of.lockdowns and curfews. I want a solution like everyone else. I think it's a matter of increased testing and contract tracing. If you identify those persons infected and th use who were exposed to someone infected and you quarantine them, you can control the spread. Lockdowns are simply an exercise of.kicking the can down the road. It.clearly isn't achieving any real results. A short term dip followed by explosion of cases when you reduce restrictions.

The_Oracle 3 years, 5 months ago

Sorry, the Bahamas Association of Medical Technologists position sounds like self protection/self interest. Tests that can be administered by anyone, population wide, is a good move. Expand your data base if results can be collected/correlated, and that part is important. If the rapid test requires a blood sample/finger prick, it is no different than a blood sugar test. If it requires a saliva sample, what is the danger?

DWW 3 years, 5 months ago

anyone else losing faith in the Bahamas medical establishment? if they continue with this rhetoric they will do more harm than good. STOP putting up road blocks and start putting forward solutions. The entire medical establishment is like "hey don't do that" but they don't offer any alternative. people need to eat, to work, to play, to live. and continuing this silly dialogue of "Stop don't do anything" is just creating more problems than it solves. if you drop the jar on the floor you do stop, but then you put on shoes grab the broom and start cleaning it up. This medical profession is paralyzed and unable to find the shoes or the broom.

Does it really take a 4 year degree and a 3 year apprenticeship to stick a stick up someone's nose? If you aren't helping you are hurting.

trueBahamian 3 years, 5 months ago

It's a skillful stick up the nose. Lol. Let's be nice with our medical personnel. These days it's hard to differentiate real issues or someone working an angle. We have politicians failing and trying to spin. We have medical experts failing and trying to spin. It's too many games on this pandemic.

What we do know is that economies are severely impacted by shutdowns. Medical experts are still grappling with this virus. We're in the middlr.of the madness. We probably won't see daylight until mid 2021.

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