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Sri Lanka to ramp up COVID-19 tests using 20-minute rapid antigen test kit; GMOA concerned over delay

GMOA Editor Dr Haritha Alutghe

ECONOMYNEXT – Sri Lanka will use an antigen test kit for expedited COVID-19 detection that will deliver results in 20 minutes, prior to using the costlier PCR test for further testing, the Ministry of Health (MoH) said.

At present, health officials are heavily dependent on PCR tests to identify patients which makes random tests too expensive and time consuming. A PCR test costs about LKR 6,000 at private hospitals and due to a backlog, results take at least 24 hours to come while a minimum of three tests are required to confirm a case of COVID-19.

“We can use this test kit to identify patients within 10-15 minutes and we can use it in the field to carry out random tests,” MoH Laboratory Services Deputy Director General Dr Saman Rathnayaka told the privately owned Derana TV today.

“It can especially be used to do mass tests at once in the field within a few minutes’ time and we can use it to identify patients and remove them from that environment,” he added.

According to news reports, the MoH  has imported 200,000 antigen kits from South Korea and plans to import another 800,000 kits over the coming week. A kit costs arounds LKR 1,200.

“These kits will be used to test employees in companies in the export processing zone and companies under the Board of Investment (BoI) where there are more than 800,000 peopleworking,” Rathanayake said.

According to British scientific journal Nature, the antigen rapid test kits are the size of a credit card which costs globally around USD 5 and displays results within 15-30 minutes and does not require a lab or a machine to process.

It detects specific proteins – known as antigens — on the surface of the virus and can identify people who are at the peak of infection, when virus levels in the body are likely to be high.

However, the accuracy levels are lower than the polymerase chain reaction (PCR) test which detects even single minuscule amounts of the SARS-CoV-2 virus that causes COVID-19, Nature reported.

The journal further reports that antigen tests need a sample to contain thousands — probably tens of thousands — of virus particles per microlitre to produce a positive result. This means if a person has low amounts of the novel coronavirus in their body, the test might give a false-negative result. The detection rate is much higher in this kit for infections in early stages, according to Naturel, but accuracy rates tend to drop after a week or so of infection.

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GMOA raises concerns over delay

Meanwhile, the Government Medical Officers’ Association (GMOA) warned today of more COVID-19 deaths in Sri Lanka in the coming weeks.

GMOA Editor Dr Haritha Aluthge told reporters this morning that with the number of cases reported in the community that were under quarantine and given the current death rates, Sri Lanka will see more deaths in the coming weeks. There are also more patients in the community than before, he added.

“COVID-19 has spread throughout the island to all 25 districts. At a time like this we should work not on increasing these red zones but on decreasing them. To do that, taking and implementing right decisions is a must,” Aluthge said.

“This is a very dangerous situation. For nine months, we only had 13 deaths. Now within two weeks, we have seen 16 deaths. The change in virus type can be the cause of this. If we look at the deaths in the past two weeks, we can see that a majority is within the Colombo municipal council area. We must find the reason for that,” he said.

Aluthge called on MoH officials to pay close attention to the recent spike in COVID-19 death toll and to investigate the deaths in the Colombo municipal area in particular.

“The antigen test was introduced as an alternative to the PCR test. Currently, a validation process is under way to determine whether the test is suitable for our country. We believe this process has taken a needlessly long time,” he said.

The GMOA spokesman further said that in emergency cases, such validation processes can be completed in 48 hours and called on the government to expedite it.

Referring to media reports that antigen test kits have already been imported, Alutghe said: “We are concerned as to how this happened if the validation process is still ongoing. What will we do to these test kits if it is determined that the test is not compatible with our country? Who approved this?”

However, Alutghe said, the GMOA wishes to see the antigen kits be used for mass-testing in Sri Lanka.

He also expressed concern about cases being identified in the Welikada prison, urging the authorities to bring the situation under control urgently lest the country is faced with a precarious situation.

“We will get to a point where we’re no longer able to increase the number of PCR tests we do. We must find alternatives if we get to that point. The rapid antigen test is such an alternative. PCR is a must but using this rapid antigen test, we can do random tests more quickly, as an alternative,” said Aluthge. (Colombo/Nov05/2020)

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