Minister of Health the Hon. Dr. Duane Sands explained that the Ministry of Health’s Surveillance Team will continually pursue contact tracing of persons who were exposed to the COVID-19 cases. “We have identified 892 contacts through our contact tracing system,” Dr. Sands noted during a COVID-19 Update Press Conference at the Ministry of Health, Thursday, April 16, 2020. “It has been proven that a country’s ability to appropriately monitor, evaluate, and implement policies and clinically support its citizenry are keys to containing an outbreak of COVID-19.” He stated that one of the lynchpins of evaluation of COVID-19 is laboratory testing.
The Health Minister said the World Health Organization and other leading health institutions support enhanced testing capabilities. “Consequently, the Ministry of Health is planning our testing expansion for COVID 19 in at-risk populations such as contacts of active cases, nursing homes, the prison and with health care workers. “Expanded testing is critical for us to have an increased understanding of the pandemic in The Bahamas so we can plan and prepare to protect these vulnerable populations.” He explained that to determine COVID-19 positive cases and to gauge community spread, it is important to have a sustained testing mechanism. Dr. Sands then elaborated on the testing process for COVID-19.
He said there are currently two different types of tests:
1. The genetic/molecular test, or real time polymerase chain reaction (RT-PCR) test. This test requires –
a. evidence of an infectious agent;
b. the genetic material or RNA of the virus; and
c. swab samples from the nose and throat of a suspected case.
2. The serological test or blood test. This test requires:
a. evidence of the body’s reaction to the virus;
b. the presence of antibodies, IgM and IgG; and
c. a sample of blood from a suspected case.
“Currently, The Bahamas has instituted RT-PCR as the gold standard in-country, and it is performed at the accredited National Reference Lab.” Dr. Sands added that the Health Ministry is exploring the introduction of rapid testing. He said the first step in the process requires in-country validation of the rapid serological testing. “It is confirmed that although rapid test kits give faster results at a cheaper price, they are often inaccurate. “Since all of the many types of these tests have not yet been internationally validated, the Ministry of Health is only exploring this method currently and not using it as a confirmatory method at this time.” Dr. Sands stated that once the validation process is completed, and if the tests are found to correlate with the country’s gold standard method, wider screening for COVID-19 at the community level will commence. There are 10,000 rapid test kits in-country.
“Currently, the Ministry of Health has some 7,000 RT-PCR test kits to start expanded testing using this method. “These RT-PCR test kits are sterile and designed to detect if a patient is currently infected with COVID-19. The test is highly sensitive and specific.” He added that persons tested using this method and identified to be positive are determined to be truly confirmed positive cases of COVID-19. “This test does not give false negatives. That is why it is known as gold standard of testing for COVID-19. RT-PCR testing is carefully carried out at the National Reference Laboratory here in New Providence.”
Dr. Sands said the National Reference Laboratory is internationally accredited by the College of American Pathologists, and is the only laboratory in The Bahamas certified by the Pan American Health Organization/World Health Organization to perform COVID-19 testing. “This means that all other tests for the diagnosis of COVID-19 outside the purview of the Ministry of Health must first be approved for use in The Bahamas.” He added, “I wish to assure the Bahamian people that the National Reference Laboratory receives a continuous supply of test kits from the Pan American Health Organization.”