•According to the Organization, testing is the “backbone” of response to this health crisis, which can hugely complement the national physical distancing measures.
•Important to large-scale containment of a disease are multi-sectoral collaboration, resource mobilization, capacity assessment and risk analysis, and establishing of metrics and monitoring evaluation systems of the mitigating measures.
The World Health Organization continues to call for the escalation of testing. Mass testing is a critical step in guiding the isolation and contact tracing efforts.
According to the Organization, testing is the “backbone” of response to this health crisis, which can hugely complement the national physical distancing measures.
The World Health Organization Infection Prevention and Control guidelines emphasize the investments in disease detection, data generation, and community involvement as the indicators of “readiness” for Emergency Management.
According to WHO “readiness” refers to “the capacities and systems that should be in place to enable rapid, effective response in case of a health emergency disaster and to be ready to “aggressively contain outbreak before further spread”.
Thus a country is said to be ready to contain an outbreak if it proactively invests in strong and well-funded national laboratories, operations support and logistics, including contingency plans and funding mechanisms.
Important to large-scale containment of a disease are multi-sectoral collaboration, resource mobilization, capacity assessment and risk analysis, and establishing of metrics and monitoring evaluation systems of the mitigating measures.
To this end, the World Health Organization has partnered with multinational institutions, like the Gates Foundation, Clinton Foundation, and the World Economic Forum (WEF) to ramp up large-scale containment in countries with decrepit public health systems.
Central to actualizing a robust health emergency response is epidemiologic capacity. According to Partners in Health (PIH), an American Organization dedicated to bringing quality healthcare to the most vulnerable around the world, testing is central to “trace and treat” approach.
To achieve this, the Harvard Medical School has suggested that countries continually invest in national laboratories capacity building, train clinical nurses, and involve IPC trained community healthcare workers in response to an infectious outbreak.
The laboratory is an integral part of the continuum of clinical care. About 60%-70% of critical decisions in diagnosis and treatment involve quantifiable laboratory data. Disease management outcomes can be influenced through effective use of this information.
The laboratory supports disease screening for early identification of disease; predictive measures to identify those at risk for a disease; disease identification to diagnose and confirm a disease; treatment which can be initially identified or changed based upon the results of a lab test; and compliance/surveillance to identify whether a treatment is working or if the appropriate level of medication has been prescribed for a patient.
It is only through a test that patients can be correctly identified as infected, the uninfected patients are diagnosed as such, and people that unknowingly had the infection are tested for immunity.
Testing of all citizens, whether or not they have symptoms, is important for making the accurate story of the exact number affected, and what the national mortality rate of the virus actually is. It also helps understand how the disease is evolving – and to what scale it does spread.
It will further enhance evidence-driven decisions about patient treatment, resource allocation, and policies, and it is also vital for post-epidemic economic recovery and future public health outcomes.
To enhance an early push toward large scale testing, it is important to empower our medical research institution which plays a key role in disease diagnosis and research.
KEMRI provides an invaluable epidemiological data, which supports the scientific objectives of regional governments in making timely policy decisions.
It recently innovated a diagnostic solution that, if leveraged, can reportedly test approximately 3000 samples in a day. But it lacks the “financial bandwidth” to build a robust epidemiologic capacity on its own – and many of its researchers are often soft targets for State cartels.
The emergence of HIV into a global health crisis offers many best practices for public health response. Governments invested in drastic upscaling of testing, private sector funding for research institutions, and community involvement.
That level of political commitment and multi-sectoral collaboration are much needed in this era. Because like HIV, this virus is already showing fault lines in our public health – especially, in counties where the health systems are fragile.
Yet, there is still a lot we don't know about it. We, therefore, must work on how to deal with these ambiguities in our daily lives. Testing is key as it is the entry point to a world of possibilities.
To salvage our vulnerable society from the afflictions of this coronavirus – and to protect our village economies from irreparable damage, we must focus not on sacking the researchers, but on empowering them to build epidemiologic capacity for mass and rigorous testing.
The whole premise of response to a pandemic is based on people knowing their status to take more ownership of what they can do.
Author details:
Charles Onyango, Molecular Biologist and Works at GSK Consumer Healthcare, [email protected]