NOTE: This story was first published in The Bohol Chronicle’s Sunday print edition.
Bohol’s first molecular laboratory at the Gov. Celestino Gallares Memorial Hospital is now on its finishing touches towards its targeted launching by middle of July.
GCGMH chief of hospital, Dr.Mutya Kismet Tirol-Macuno, calculated that they would finish installing all the equipment within the remaining days of this month.
The pass box for the molecular lab is expected to arrive from China early this week, while the PCR cabinet is expected to arrive on June 23.
Gov. Art Yap also announced that the provincial government is also procuring at least two containerized PCR lab which is around more than P20 million each.
Aside from the PCR labs, the province also has to purchase reagents and additional test kits, and hire laboratory personnel.
“Moving forward, I do not see any other way. No other way. We have to have the ability to test. We have to have our own capacity to test and it goes with having the ability to contact trace. Contact tracing should come spontaneous when anybody tests positive of Covid. But how many PCR labs can we afford? One PCR lab, at least at minimum, if containerized system, is more than P20 million. And, then, we also need reagents and staff,” according to Yap.
The governor also said that last week, he already released the notice to proceed.
“By the time we can start to operate the PCR laboratory system, we no longer have to bear the long wait for the results from Cebu. Look what is happening now. If one is to go through the real-time reverse transcription polymerase chain reaction (RT-PCR) test now, the swab sample is taken, then submitted to Vicente Sotto Memorial Medical Center in Cebu City where the queue of samples to be processed is long. That is the reason that we should have our own PCR laboratory system,” Yap explained.
The PCR machine that the province earlier received from the national IATF was given to GCGMH.
“After that, naataygihatagnilanga additional ngausaka PCR machine.
And then, mopalit pa angprobinsyangusang containerized system. In the coming days, kinahanglanmopalit pa ta ng additional- -moving forward.
This is also in preparation in case it would become inevitable to reopen Bohol to visitors and businesses would also be allowed to reopen.
“Perokinahanglanmaghinay-hinay ta sapagdawatngmgabisitatungodkaydelikadonaangsitwasyonkaron. Kinahanglannaatay PCR capability. This is the only way moving forward. If you don’t have the ability to test, no ability to contact trace, there is no way naablihannatoang Bohol. If not, we are just putting the entire population of Bohol to risk. So, this is the battle plan against Covid,” according to Yap.
The governor enumerated at least seven points of entry in Bohol with known heavy traffic of arrivals during the pre-Covid period- -the Bohol Panglao International Airport (BPIA) and the seaports in Tagbilaran City, Tubigon, Getafe, Talibon, Ubay, Jagna.
“So, minimum, you have seven. On Loay and Loon, we will try to see. Maybe magtukod ta ng swabbing didto,” Yap added.
TEST KITS
On criticisms that the provincial government does not care about having test kits, the governor clarified that just because Bohol does not have a PCR lab yet does not mean Bohol has no PCR test kits on hand.
In fact, the provincial government has already facilitated PCR tests to 762 Boholanos in the ongoing random mass testing.
Bohol also has available stock of 1,238 PCR Test kits and there are 5,000 more that will arrive in the coming weeks.
This will coincide with the operation of the Provincial PCR Laboratory by July 15, 2020.
On the Anti-Body Rapid Test Kits, the provincial government has already given 2,700 test kits to different LGUs.
These are used for testing the LSIs and OFWs who completed their 14-day quarantine, which is the protocol, before they were cleared and allowed to proceed to their homes when they tested negative of infection.
At present, there are 2,000 rapid test kits available.
“I hope that everyone will understand that Bohol has enough test kits. However, we must also understand that test kits are only effective when properly administered by medical professionals and administered at the right time. Walanagpasabotngatungodkaynaatayigong test kits magpatakalangpud ta ug administer sa test kung kanus-a natoganahan,” Yap explained.
SYMPTOMS-BASED
Yap also reported that in the meeting of the League of Provinces of the Philippines (LPP) with Department of Health (DOH) authorities on June 15, DOH Usec. Maria Rosario Vergeire informed the governors that the prioritization in Covid testing is now symptoms-based.
Vergeire said that the overall goal is to have “a total of 1.5 million tests by the end of July” and so far, the DOH has already conducted a total of 506,000 tests.
“This is about 1.5 percent of our population. At itopoyongpilitpinupuntahansangayon. Sa ngayon, we have a total of 506,000 tests conducted already and hoping naitong subgroups (subgroups E and F) napagdagdagnatin ay maabotnatinang 1.5 million by the end of July,” according to Vergeire.
This is in response to Yap’s inquiry whether or not there is a recommended percentage of the population that DOH wants to test in the coming months and if whether or not there is a target.
Vergeire also made it clear to the governors that the symptoms-based approach is what the DOH applies now in the guidelines on the prioritization of testing.
This means that an individual who manifests no Covid symptom is allowed to proceed in going home to his or her province without the need of testing; and there are no more targets per province as to percentage of testing.
However, testing for subgroups A and B is non-negotiable and they are prioritized.
Based on DOH Department Memorandum 2020-0285, subgroup A refers to patients or healthcare workers with severe/critical symptoms, and relevant history of travel or close contact; while subgroup B refers to patients or healthcare workers with mild symptoms, with relevant history of travel or close contact and who are considered vulnerable. These vulnerable populations include the elderly and those with pre-existing medical conditions that predispose them to severe presentation and complications of COVID-19.
In DOH’s DM 2020-0285, the other subgroups of individuals who “are considered at-risk and are eligible for testing, arranged from greatest to lowest need for testing” are- -Subgroup C: patients or healthcare workers with mild symptoms, and relevant history of travel or close contact; Subgroup D: patients or healthcare workers with no symptoms but with relevant travel history and close contact; Subgroup E: frontliners indirectly involved in healthcare provision in the response against COVID 19; and Subgroup F: other vulnerable patients such as those with comorbidities, those who will undergo high-risk, elective surgical procedures, those living in confined spaces, and others”.
Subgroup E includes “personnel manning temporary treatment and quarantine facilities; personnel manning control points; National/Regional/Local Risk Reduction and Management teams; Barangay Health Emergency Response Teams and barangay officials providing barangay border control; personnel of Bureau of Corrections and Bureau of Jail Management and Penology; personnel serving at COVID-19 swabbing center; and social workers providing amelioration and relief assistance to communities and performing COVOD-19 related tasks”.
Subgroup F includes “pregnant patients who shall be tested during the peripartum period and dialysis patients and immunocompromised patients with HIV, those chemotherapy or radiotherapy”.
CONTACT TRACING APP
Vergeire also told the governors that LGUs may use a contract tracing app, other than the StaySafe app, as long as all information will be channelled to the DOH Covid guide.
She explained though that DILG Sec. Ed Año, who heads the team focusing on the contact tracing mechanisms, will still have to discuss this matter with the LGUs so that its implementation would be smooth if there are LGUs that would use digital contact tracing through apps other than the StaySafe app.
“Yan poangkailangangpag-usapanpagkakungsaka-sakaling may mgaibang LGUs naibangginagamit.
Our head of the contact tracing mechanisms now is DILG. So I think Sec. Año can very well coordinate and sit down with the different LGUs tungkolpodtiosa application naitoparamaayospoangpagpapatupadnatin,” according to Vergeire.
Vergeire said the IATF is endorsing StaySafe application which is now being reviewed by the Department of Information and Communications Technology (DICT), National Privacy Commission, DOH and DILG.
She said based on the evaluation, there was a component of the application that was removed so that its use would be strictly for contact tracing related to Covid.
“Meronhongpinapatanggal don sa application. At data-based pa rin. May pag-uutosnaangStaySafe ay talagang for tracing only nalahatngdatosnamakakalapnito ay papasoksaatingCovid guide,” Vergeire explained.
On Yap’s inquiry about the use of the app of the Red Cross, Vergeire explained that she may not be privy to the IATF guidelines, but what she knows is that what they are very critical about is the channelling of information in the process of contact tracing to the Covid guide.
“So, Kung saka-sakaling may gagamitngibang application, aside from this StaySafe, kailanganlangnatingmapag-usapanseguropaanopomacha-channel yongimpormasyonnagalingdyansa PCR nagigagamitpong, I think, ng Apple. Gamitdyan, dapatpumasoksa Covid guide lahatng information. Yan poangkailangangpag-usapanpagkakungsaka-sakaling may mgaibang LGUs naiba’ngginagamit,” Vergeire explained.