Laboratory testing key to addressing Covid-19

Human activities across the globe have significantly scaled down due to Coronavirus(Covid-19) pandemic. Nations have instituted lockdowns disrupting daily routines of many. From December 2019, the virus that causes Covid-19 disease, SARS-COV-2, has quickly spread from Wuhan in China, to many countries across the world prompting the World Health Organisation (WHO) to declare it a Pandemic on March 11, 2020.

As the virus continues to spread, the WHO is monitoring the situation and keeping records of confirmed Covid-19 cases worldwide. The WHO says there is only one way to confirm a Covid-19 case at the moment – through laboratory testing.As of July 26, 2020, there were about 2.92 million confirmed cases worldwide with almost 204,000 deaths. These numbers will definitely continue to go up as new infections occur and as more laboratory tests are done.

Malawi officially registered its first three confirmedcases on Thursday, April 2, 2020. The tests had been done at the National Health Reference Laboratory (NHRL) in Lilongwe a day earlier. As of Sunday, April 26, 2020, the country had 34 confirmed cases  andthree deaths.

At the moment, Malawi has three laboratories doing Covid-19 Reverse Transcription Polymerase Chain Reaction (RT-PCR) testing, namely, National Health Reference Laboratory (NHRL) in Lilongwe, College of Medicine and Wellcome Trust Laboratory in Blantyre. A fourth laboratory at Mzuzu Central Hospital is reportedly almost ready for Covid-19 testing.

We seem to be in sync, at least in terms of diagnostics thoughts, with other countries as recent talks on Covid-19 have centered on increasing the laboratory testing capability and capacity.It is not surprising that diagnostic companies are working on fast, novel and easily accessible ways of testing for Covid-19, but what is worth the struggle about scaling up testing? How crucial is laboratory testing in managing Covid-19 and minimizing further spread of Coronavirus?

Malawi’s initial utilization of Covid-19 laboratory testing has shaped the country’s approach to the pandemic. It was after confirming our first cases when, as a country, we began to respond to the pandemic differently from the time we had not registered cases – at least officially. It was after the laboratory confirmation of the existence of cases in Malawi that the President of the Republic of Malawi, H.E. Professor Arthur Peter Mutharika, on April 4, 2020, announced new measures to be implemented in response to the findings.

We can list a litany of interventive changes whichhave been implementedsince our laboratories confirmed the first cases. One thing is clear: the very fact that we registered laboratory-confirmed cases changed institutional and national response to the pandemic. Even if we were to confirm a single case, our approach to tackling coronavirus disease would have not been the same as the time we had not registered any case.

The WHO has been calling upon scaling up of Covid-19 testing and that where such testing is not available, samples should be sent to laboratories in regions or countries that are able to do so, a clear indication that laboratory testing is crucial.

The fact that many infected people are able to carry and transmit the virus without showing symptomsmakes laboratory confirmation unforgeable.Considering the dynamics of the disease, dependency on symptomatic diagnosiswould be hugely misleading.

Covid-19laboratory testing hasgiven us direction on what to pay attention to as we continue to address the pandemic. With confirmed cases, our Covid-19 response teams willbe able to initiate contact tracing, if possible, to find people who might have possibly been exposed to the virus and potentially exposing others to it if they were infected themselves. This is important in breaking the chain of infection.

On the other hand, the pandemic has probably tested our diagnostic abilitiesin response to demanding outbreaks that require high-output, state of the art diagnostic power – the very reason we must strive to invest in and utilize modern diagnostic techniques and tools.

Advancement in diagnostic prowess not only equips us with scientific evidence to the existence of bugs such as this novel Coronavirus, but also kills myths and fake news circulating in society on the same particularly where symptoms are not definitive and symptomatic diagnosis is inconclusive.

We commend the efforts that the government and donors are putting up to scale up our testing capabilities for Covid-19. As a Laboratory Scientist, I am hopeful that when the pandemic is over, we shall put effort into adopting modern diagnostic tools for routine use in our health facilities.

• The author, writing in his personal capacity, is a Medical Laboratory Scientist working at College of Medicine Private Clinic in Blantyre.

 

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