Doctors worried too few tests for COVID to give a true picture of community transmission

Scientists are seeing no real evidence of an improvement in Barbados’ COVID-19 situation, despite a clear reduction in the number of positive cases on the country’s daily dashboards.

Instead, epidemiologist Dr Lynda Williams and virologist Dr Brendan Larder believe the true infection figures are being hidden behind a grossly insufficient number of daily tests being conducted. They are also concerned that the rate of death is continuing to increase.

Dr Williams also raised concerns about the continued absence of strict entry protocols at the borders or variant testing, in the midst of the new COVID-19 as the new strain, Omicron, spreads across Europe and North America.

In recent days, the number of daily recorded infections has been trending downward from more than 400 per day in early November to as low as 115 recorded on Sunday. There has also been a sharp decline in the daily number of tests being taken from around 2,000 throughout October and early November to less than 1,100 on some days.

Dr Williams pointed out the reduced testing coincides with the recent removal of a law requiring that incoming passengers be tested. She said this was evidence that the appearance of travel tests in the daily statistics had made the positivity rates look better than they actually were.

To get a truer sense of the country’s situation, the epidemiologist, who is president of the Barbados Association of Medical Practitioners (BAMP), suggests widespread surveillance testing across the country.

“To tell you the truth, I would really like to see Barbados testing upward of 3,000 people a day to give us a better understanding of what is happening in the country and we said that from the beginning. We are testing a thousand people, 1500 people, 1200 people, but we really are not testing,” declared Dr Williams.

“What we have done from the beginning, is just test the people who have a reason to be tested… either primary contacts or symptomatic. But when you do that, you are only getting a skewed subset of people as opposed to widespread testing in some areas, where you can pick up whether or not you are capturing people. We have never done it, and that’s why our figures will always continue to be low. It’s because of who we’re testing.

“We also continue to call for the variant testing and the type of regular reporting that we have called for over and over again. Now look, there’s a new variant coming out and if we do no surveillance at the borders, how will we even know that it’s here,” Dr Williams lamented.

One medical practitioner warned of troubling reports of citizens opting for private rapid tests instead of PCR tests and receiving treatment in circumstances where their cases would not be recorded in the country’s statistics.

“This is all unofficial. So therefore they are not coming to the attention of the system.  They are taking their chances and some are surviving, but some are presenting later on with extreme conditions,” said one practitioner, who opted to speak on condition of anonymity.

Dr Larder, who has been monitoring the situation from the United Kingdom observed a troubling “slowdown” of data on the country’s virus situation and noted that the numbers are simply unlikely to be a reflection of the level of community transmission. Nevertheless, he said the positivity rates hovering between ten and 17 per cent provide a truer indication of the magnitude of the problem.

“Unfortunately, for a while now, it has looked like the number of tests that have been done per day has really been on the slide, so it makes it look like there have been less positives and it makes it look like the rates of transmission have gone down, which isn’t necessarily the case, because the positivity rate is really still quite high,” he told Barbados TODAY.

“My understanding with the government’s testing facilities at the Best-dos-Santos Laboratories is that that capacity is around 3,000 tests per day, but also on top of that, there are private labs as well. So if you really wanted to harness maximum testing capacity, you have to look at all of those labs together and that could be maybe 5,000 tests a day or something like that.

The veteran virologist believes the high rates of death, especially among people who are ill, are a clear indication that many are still coming for treatment for the virus when it’s too late.