Testing

Yesterday, one of our correspondents wrote a sketchy report about the Department of Health (DOH) claiming we now have the highest testing capacity in Asia. My deadline for this piece prevents me from getting more details about this claim.

It is not clear if the highest testing capacity here is in absolute or in per capita terms. It is also not clear if the capacity includes the “rapid tests” that have been deployed in large quantities mainly by the private sector. The “rapid tests” for antigens are cheaper, more easily deployable and produce results quicker. But they are less accurate than the swab tests, considered the “gold standard” by our health authorities.

The swab tests detect the presence of the virus itself. But they require the use of molecular laboratories and, at the onset of the pandemic, took too long to deliver the results of tests. Many patients died before their Covid-19 status could be confirmed.

In the beginning, we had only one molecular laboratory available, the Research Institute for Tropical Medicine. Over the last six months, we rapidly increased our laboratories to about 107. Many more are in the pipeline, with local governments making the bulk of the investments.

Providing these laboratories is more than just an infrastructure problem. We had to quickly train the manpower to make these laboratories usable. After that, we needed to build the system of reporting so that the nationwide numbers could be quickly reported.

All in all, whether or not we are first in testing capacity, it is clear we have mounted an impressive effort at this. Testing about 40,000 individuals a day is not a mean feat. Nor is it by any means a cheap exercise to sustain. We deserve whatever payoff there might be for the effort, be it by the flattening of the curve or the avoidance of that feared second wave.

Over the past 6 months, as government and the private sector frantically tried to grab this pandemic by the horns, the leftist groups cynically tried to score political points by demanding “mass testing.” They never bothered to define what “mass testing” means and simply used the phrase to conduct deceitful agitprop.

Did “mass testing” mean swabbing every Filipino at regular intervals? If so, how frequent should those intervals be, given that one may get infected minutes after getting tested? If this the most optimal use of our finite health care resources?

The agitators never told us. Demagogues never do.

Dr. Edsel Maurice Salvana occasionally issues very useful scientific updates on the pandemic that I receive through several of the Viber groups I participate in. In his last update, Dr. Salvana annotated on the question of “mass testing.”

Citing available research, “mass testing” 5 percent of the population every week will decrease transmission by only 2 percent. In our case, testing 5 percent or 5 million Filipinos every week will cost us P10 billion each week. That is neither optimal nor sustainable use of public health resources. The marginal gains in reducing infection rates cannot possibly justify the cost.

To achieve “mass testing” of 5 percent of the population, we will have to increase our laboratory capacity over a hundredfold from present levels. That is a staggering logistical requirement.

By contrast, effective contact tracing and isolation decreases infections by 64 percent. This, says the good doctor, is where we should put our efforts and resources in.

Testing, of course, is indispensable. But after a certain magnitude, we will have diminishing returns. We have probably reached that threshold in our testing capacity.

We can certainly ramp up our testing capacity when new technologies such as cheaper saliva test kits become available. I saw one estimate that places the cost of saliva test kits at P12. Compare that with the swab test that is available at an average cost of P5,000 each.

When new and cheaper testing technologies become available, our molecular laboratories built at a cost of billions could be rendered obsolete. This should give us pause when considering investing billions more on new molecular laboratories. It is likely we have the testing capacity we need, giving due course to optimality.

Those holding up placards demanding government provide free “mass testing” are mere nuisance. They are just out to score propaganda points. They do not know what they are talking about.

SkyCable

I thought it good news that PLDT might acquire SkyCable.

I subscribed to SkyCable as soon as it became available where I live. That made me a “loyal” (albeit unhappy) subscriber that entitled me to some “concierge” service.”

I always found the subscription rates a bit hefty, considering I mainly watch only CNN, BBC and Bloomberg.

From the beginning, I complained about why this cable service never modulated the volume across channels. Each time I switch channels, I had to adjust the sound level as well.

A few months ago, channels began disappearing from the service. Yet no one answered at SkyCable when I called. A few weeks ago, even the few channels I watched disappeared or were intermittent. I badgered the service provider.

Last week, a service person finally materialized. He checked my decoder and found nothing wrong with it. Another team, he said, would come the next day to check the cable line outside my home. They never came.

I am still waiting for someone to take my calls or for a repairman to materialize at my door. Each day, the quality of service deteriorates.

Someone more competent should take this apparently moribund service out of its misery.