Several countries in the Caribbean have the capacity to test for the dreaded COVID-19, Pan American Health Organization’s Director Dr. Carissa F. Etienne revealed. These include Suriname, Guyana, Trinidad and Tobago, Barbados, Jamaica, Dominica, Belize, Martinique, Haiti, the Bahamas, French Guiana, Aruba, St. Marteen, Curacao, Cayman Islands, and Bermuda.
The exclusion of St. Vincent and the Grenadines from this list has sparked much debate in recent times although Health authorities here disclosed, from the outset, the local capacity to test for COVID-19. At a February 3 Ministry of Health, Wellness and the Environment media briefing, Elliot ‘Black Ice’ Samuel, Chief Laboratory Technologist at the Milton Cato Memorial Hospital, said, “nCoV has been deemed to be a level 3 pathogen and this has a lot to do with the ability to contain the virus at a facility level…. In our part of the world, there are only 2 labs with the capacity to work on nCoV currently – CDC Atlanta and CDC in Canada. Our National Influenza Center for the region – which is the Caribbean Epidemiology Center – is currently building capacity to be able to detect this virus; they have a level 3 laboratory at CARPHA.
“St. Vincent and the Grenadines, as well as a number of countries across the region, currently don’t have the capacity to detect the virus. So our efforts are going to be focused on collecting adequate specimens, ensuring the integrity of the virus is maintained through collection also preventing our health care workers from becoming contaminated and passing these samples on to our National Influenza Center which is the Caribbean Epidemiology Center in Trinidad and Tobago.”
In an early Tuesday morning, ANN exclusive interview Samuel offered further clarity regarding local testing capacity. He said, “at that time [February 3], what was not fully understood was the transmission route of the virus. It was believed that the virus may be airborne hence it was thought to be a level 3 pathogen. Now we know that the virus is not airborne. It’s transmitted from aerosolized droplets. The biosafety level classification is now at Level 2. We do have BSL 2 capacity and so do many countries. So we have seen a few countries develop their own capacity to test.”
The Health official explained further, “we can manipulate samples because we have a BSL 2 containment levels lab. But we are not testing because we don’t have a PCR platform to perform tests. So we will still collect and ship samples to CARPHA.”
According to Wikipedia, Polymerase Chain Reaction is a laboratory technique used in molecular biology to rapidly make millions of copies of a specific DNA sample. This then allows scientists to take a very small DNA sample and amplify it to a large enough amount to study in detail.
Dr. Etienne described Washington based PAHO’s role in the Caribbean’s response to the virus spread as being chiefly “to detect, to contain and to manage cases.” Cognizant too that while there is “some capacity” in the region more work must be done to improve that capacity.
Lab Chief Samuel is confident in his team’s ability to capture samples as necessary. When asked about the per day sample collection capacity he said, “I don’t see a barrier to sample collection. Once the person fits the case definition as a probable case the sample would be collected and sent.”
Pressed further to enumerate the current capacity in the unwanted event of the COVID-19 community spread phrase he said, “don’t be expecting a huge situation to manage from the start. It usually starts with an index case or cases and in our case, it will be imported as we don’t have the agent here. Once you detect and contain this case and manage it well, the transmission can be broken. To think that we will be testing a large number of persons is jumping to the fourth stage of an outbreak where there is community spread of the agent. So let’s take it in strides: detect, isolate, manage.”
Asked whether his team considered the rate at which the situation, with its deadly implication for some percentages of infected cases, can “get to stage 4” Samuel replied, “ from what we are seeing from the other affected countries outside of China, and you can corroborate this by what is in the news, the number of cases is not rising rapidly from the index cases – with a few exceptions.”
It is unclear exactly what the precise technological defect is with the required PCR platform. Equally unclear is the necessary time it would take to acquire and operationalize the technology.