OSES-INTEC values attractive rapid tests for detection of COVID-19 and economic reactivation of DR
The epidemiologist Eladio Pérez, coordinator of the OSES, understands as key measures to reactivate the economy, use serological tests to monitor the work environment and identify HIV-positive employees
SANTO DOMINGO. - The serological test (rapid test) for the detection of COVID-19 is a very attractive technique, because its efficiency does not require that the infection be active, so it is useful not only as a diagnostic method, but also to carry out epidemiological screening studies.
The claim was made by the epidemiologist Eladio Pérez, coordinator of the Social Security Observatory of the Instituto Tecnológico de Santo Domingo (OSES-INTEC), who also understands that these tests can differentiate between different types of antibodies that are produced at different stages of the disease.
“M immunoglobulins (IgM) are generated initially and represent a primary response process to an acute infection, but their durability is short; immunoglobulins G (IgG) indicate a secondary response to infection, it begins to be produced during the acute phase, several days after IgM, but it confers protection for longer periods, it is called memory immunoglobulin. Therefore, it can be used as a massive diagnostic tool, especially important in SARS-CoV-2, where a very high number of asymptomatic patients is estimated, "explains the doctor.
In his document "Considerations on the COVID-19 pandemic in the Dominican Republic", the epidemiologist highlighted that among the advantages of rapid tests are the speed of results (between 5-15 minutes), samples with no or low viral load, mass production at low cost, they also do not need transportation to a laboratory, complex instrumentation or specialized personnel to know the result.
However, Pérez pondered that its disadvantages lie in the limited sensitivity (82-96%, reproducibility problems (from batch to batch) and dichotomous qualitative response. In addition, he said that the immune system requires time to activate and generate the antibodies ( between 2-5 days) and that there is an inherent variability in the immune response of each individual.
"After explaining this, it is evident that rapid tests are very useful, especially to know the seroprevalence state of a population. Furthermore, if used correctly, they can be a very capable tool for screening and epidemiological control, ”said Pérez.
Rapid tests and labor market
The OSES coordinator understood that serological tests could be used as a tool for reintegration into the workplace, since people seropositive with IgG have immunity to the virus, which means that they could return to work. Meanwhile, people with positive IgM have an active infection and therefore they would go on to strict surveillance.
“They could be used in schools and other institutions in the form of repetitive sampling on people who frequently interact. If an individual obtains a positive result, strict vigilance would be established with colleagues, "said the doctor.
For the epidemiologist, COVID-19 could become an occupational risk disease, since many people, depending on their work activity, could be exposed to this virus. “The possible long-term consequences of having the disease are not yet known, and in a reality like this, it would have a direct impact on the field of social security. If a person becomes disabled or with limited abilities, they must have some type of social protection in the area of pensions and health coverage ”.
Therefore, using serological tests to monitor the work environment and identify seropositive employees, according to the doctor, and adding to the identification of employees with risk factors, are key measures to reactivate the economy.
The specialist considers that returning to work should be done by risk groups of employees, the state of the prevalence of the disease in geographical areas where they work or reside, and, finally, the type of work they do. However, in unofficial reintegration schemes, the opposite is the case.
"It is of utmost importance pay more attention to the asymptomatic infected and continue educating our population on hygiene measures, handling and disposal of specific protective equipment, and emphasize that when confinement measures are withdrawn, we must seek social distancing, "said Pérez.
The OSES is an instance of investigation, reflection and dialogue on the different spheres of the social security system of the Dominican Republic. It is sponsored by entities in the sector, such as ARS Palic, Primera ARS, ARS Universal, the National Health Insurance (SENASA), and the AFP Popular and AFP Siembra. In addition, the World Bank (WB) and the Inter-American Development Bank (IDB) are part of the entity as observers.