Good Practice Pointer: Testing for the COVID-19 virus

Author(s): Eluzai Hakim, FRCP Edin, FRCP

Associate Editor

South Sudan Medical Journal

Testing for the virus is important, and when this is being carried out, explain to those tested why it is important. It is known that many infected people show no symptoms or signs of COVID-19, but they may be very contagious. Testing allows these asymptomatic people to be identified so they can be quarantined.  Some Non-Governmental Organisations have pledged sums of money to support resource poor countries to manage COVID-19. I suggest that a portion of this money be devoted to carrying out testing for the  coronavirus in those with symptoms, healthcare workers, the police, prison officers and prisoners, the army, airport personnel, civil servants, school teachers, bus and taxi drivers and those who come into contact frequently with members of the public.

Testing and isolating asymptomatic people eliminated the virus in a village

Sergio Romagnani, an Italian academic at the University of Florence[1]  carried out blanket testing in an isolated village of 3,000 people and found that 50-75% of people were asymptomatic for COVID-19, but these represented a “a formidable source” of contagion. After quarantining those who tested positive the number of people sick from COVID-19 fell from 88 to 7 in less than ten days.

  Hence, testing people is vitally important. According to Allyson Pollock2, Professor of Public Health “Case finding, contact tracing and testing, and strict quarantining are classic tools in public health to control infectious diseases” According to the WHO, these methods have been painstakingly adopted in China. In Singapore and Vietnam meticulous contact tracing, clinical observation and testing were vital in containing the disease [2].

South Sudan Household Survey (UNICEF 2006) stated that the average number of people per household was five. The potential difficulties of quarantining within this social set up could be challenging as most people live in the same room or “tukul”, made of grass thatch and mud and wattle. The South Sudan COVID-19 Task Force needs to come up with an innovative plan of quarantining the older person (>60 years) and those who test positive for the virus. The middle way is to test as many people as possible and isolate those who are positive in designated tents or low cost housing which can be erected rapidly using local building materials.

References

1. Day M. Testing and isolating asymptomatic people, “eliminated virus” in village. BMJ. 2020 Mar 23;368:m1165. doi: 10.1136/bmj.m1165.

2. Pollock AM, Roderick P, Cheng KK, Pankhania B. Controlling the spread of COVID-19. BMJ 2020;369:m1284