November 28, 2020

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Reagent limitation would force to prioritize who will have molecular testing


There is a real limitation of reagents to make molecular tests of COVID-19 and it will be necessary to design a sound strategy to prioritize who will be tested, while with other people one would have to choose to do other types of tests that they assist in making a diagnosis, including serological testing against the dangerous coronavirus.

As explained by doctor and medical technologist Juan Rexach, president of the Association of Clinical Laboratories, the shortage situation is due to the companies that distribute these reagents they had been prioritizing areas with the greatest impact of the virus, and reducing shipments to those in the best situation, as was the case in Puerto Rico until a few weeks ago.

"First of all, I have to distinguish between community clinical laboratories and the reference laboratories, which are the ones that mostly process these molecular tests, and there are about five here in Puerto Rico. We are the face, the ones who take the samples, and send them to the reference laboratories. And they depend on the reagents shipped by companies in the United States. And there the situation is very complicated, "said the doctor.

" So these companies decided to limit the delivery quantities to some areas, to prioritize others. And they were taking a lot for the percent positivity, as reported by the regions. So they, taking into account that Puerto Rico had very low percentages, up to just 1% not long ago, because they were sending much less reagents, "he continued.

" So, when experiencing such a sudden rise in cases, then there is this unfortunate combination, of many cases and less supplies of reagents, "added Rexach.

He maintained that the reference laboratories are already making multiple efforts to meet the high demand for tests that are currently taking place.

"Reference laboratories have requested more reagents, but as far as that can be solved, because we are limited," he said. “It is not that there are no reagents. There are, but limited. And they will continue to arrive, but in a limited way. "

He asserted that, as the limitation coincided with the rise in cases," it remains to be seen how this is handled. "

At the moment, however, it has not There is an official indication as to whom the molecular test should be applied. It is expected that the Health Department will issue these guidelines for the management of molecular tests at any moment.

“Yes, recommendations have been made to prioritize molecular tests to suspected cases with symptoms, to pregnant women, patients who are going to undergo surgical procedures, immunocompromised patients, kidney patients. As well as evaluating possible options for other people, such as the use of serological tests.

"We understand that there must be a priority list for the use of molecular tests, due to the limitations we have," insisted the specialist.

He was of the opinion that the molecular test should be done for those people who have been in close contact with people confirmed as positive, but cautioned that people should understand that being close to someone infected with COVID-19 does not necessarily mean that it will spread, since that depends on various factors, including the recommended use of masks and the practice of social distancing and frequent handwashing.

“We are seeing that very worried people arrive at the laboratories. And unfortunately even violent incidents have already occurred in laboratories. And there are laboratories that have had to hire security. People have to understand that a sample cannot be taken if there is no reference laboratory that will receive and process that sample. If that doesn't happen, that sample will be lost, "he said.

" And I remind people that the laboratories continue to offer other additional tests that assist in the diagnostic protocol. And we also have serological tests, which although they have their limitations, help if used correctly, "said the doctor.

" And yes, there are more cases. They're going up. We are doing more tests. And the projections are that they will continue to increase. But the situation is not that there is no evidence available, it is that they are limited and must be prioritized, "he insisted.

" So we must understand that the use of the mask, social distancing, and handwashing are still essential. . And of course, if you feel bad and have any symptoms, then go to your doctor, "he urged.

Rexach also recalled that people should also understand that just because they have certain symptoms does not necessarily mean that they have COVID-19, because there are other Viruses and diseases that produce similar symptoms and are present, such as influenza, dengue, zika, chikungunya. “All of that is still with us.”

“So now is the time to take action as citizens, to follow those important recommendations. It is up to us to have this semi-normality living with COVID-19, "insisted the doctor.



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