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Opinions of Sunday, 22 March 2020

Columnist: Professor Peter Twumasi

Coronavirus testing: My worry

Professor Peter Twumasi Professor Peter Twumasi

Like all other viral infections, testing can be achieved at early stages by molecular testing methodologies including Polymerase Chain Reaction (PCR), Southern Blotting, and other similar blots.

Serological testing methods based on antigen, antibody measurements appearing in many forms including strip tests and ELISA, are good alternatives.

Although both methods are useful in viral disease diagnosis, they all have their shortcomings which when not properly managed could present disastrous outcomes.

The polymerase chain reaction methods targets certain unique sequences or codes in the viral genetic material, DNA or RNA, amplified and products examined to determine whether positive (presence of product) or negative (absence of product) results. PCR generally very specific when correct unique targets of the viral genetic sequence is used.

It is also very sensitive since it is able to amplify exponentially minute amounts of the viral material to a level detectable by the measuring devices. However, this high sensitivity also presents serious challenge. There is high degree of false positives especially when poor primers that tend to have broad similar genetic codes with the virus.

Also, there is a high chance of contamination effect as other viruses with similar sequences could be introduced. Viruses exist in millions on every material including the human body. Thus a method so sensitive could be froth with errors.

Serological tests are based on the persons response to deal with the infection through production of antibodies to counter the virus effect.

This information is however presented later after infection and therefore cannot be a method of choice for testing of newly infected persons. Another problem with this immunological testing method is that people who have succeeded in clearing the viral particles from their bodies will still test positive.

Such a test is however good for disease surveillance purposes with the population, and also to assess resistance of persons to the viral infection.

Currently many laboratories have introduced molecular testing kits to the market that targets certain portions of the new SARS CoV-2 virus which causes COVID-19 disease. These targets include ORF 1ab (open reading frame sequence), nuclocapsid protein (N protein), RdRP (RNA dependent RNA Polymerase gene sequence), viral structural proteins E, S and N genes, and spike proteins.

There's no commercial serological test commercially available for COVID-19. However, many labs have began researching into possible kits to be released for laboratory diagnosis of the disease.

With current SARS CoV-2 testing methodology, a person tested positive does not necessarily indicate the level of severity of the disease in the person. It also does not specifically indicate that a positive result show presence of the new SARS CoV-2 virus as other viruses especial from corona virus family which are not pathogenic could be present too.

It therefore appears to me that the panic in our health system and society arising from people testing positive for the virus may rather result in more deaths than the actual COVID-19 effect on patients. World Health Organization (WHO) has advised that COVID-19 infection is mild to moderate.This can be found on its website with the following message: "Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

The best way to prevent and slow down transmission is be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face.

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).At this time, there are no specific vaccines or treatments for COVID-19.

However, there are many ongoing clinical trials evaluating potential treatments. WHO will continue to provide updated information as soon as clinical findings become available".

We should there ask the following important questions:

Why is the country and the world thrown into the state of panic and confusion as people test positive for the virus?

How reliable are the test results being churned around the world?
Are PCR amplicons targetting only SARS CoV-2 virus and not other corona viruses common in animals and humans?

Are people carrying the new CoV not actually dying from other diseases instead? It appears attention is overly being shifted away from all other diseases and blaming every death on COVID-19 disease?

Although the new Corona viral infection is impacting on the rising global mortality of affected people, we should not overlook the significance of other diseases and conditions in recorded deaths.

In many countries, OPD services in hospitals have been suspended, hospitals have refused to admit new patients of other ailments, people with other diseases such as diabetes, hypertension and cardiovascular diseases are receiving less or no care at all.

The nutrition of the people is getting poorer due to economic difficulties or break in food supply chain.

Lockdowns and isolations will surely affect the general health and the well being of the people if no smart strategies such as home care and government assisted supply of foods to homes where people's movements are restricted, are put in place to minimize the effects.

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