COVID-19: UWI management expert weighs in on testing, masks

Dr Devonish was quick to point out that he is not making a case for the authorities to completely change or switch priorities from examining symptomatic and other vulnerable or severe cases, but rather to adopt a mixed approach to their testing protocols or regime.

He declared: “If we are really to know the true state of community-level transmission (if such exists) – a mixed criteria approach to testing which involves focusing resources on assessing both ‘symptomatic, referred, or traced cases,’ including front-line health care workers, and random samples of asymptomatic cases in the general population guided by some pragmatic and scientific set of criteria.”

He then outlined the advantage of a random, community-level testing approach.

“If a person with no clear symptoms was randomly selected from the population and was found to be positive, Government would have better evidence of community transmission, better opportunities to improve and update the contact tracing efforts and activities, better data on informing decisions on whether to update/expand current health care resources for treating those affected by the disease and better information for calibrating shutdown or reopening decisions regarding social and economic activity in the country,” Dr Devonish said.

The UWI management lecturer recommended that the actual mix (the ratio of resources retained for symptomatic vs. asymptomatic cases), can be decided by the relevant expert.

He said: “I would suggest that this mix is updated/tweaked as capacities shift positively and more resources become accessible and in place within the country (favourably towards the random testing/community-level testing regime

“The actual mix (the ratio of resources retained for symptomatic vs. asymptomatic cases) can be decided by the relevant experts but I would suggest that this mix is updated/tweaked as capacities shift positively and more resources become accessible and in place within the country (favourably towards the random testing/community-level testing regime)

“However, if supplies/resources become more constrained, priority should shift back to the restricted symptomatic-type criteria.

Dr Devonish identified another benefit emerging from a mixed approach.

“One other benefit of the mixed-criteria approach is that if we do find, through random tests, multiple confirmed asymptomatic or pre-symptomatic cases in the population – we can expect a more favourable change in the public response to the current distancing and confinement measures, members of the public would now have a better understanding of the true nature of the multiple risks and avenues of transmission of the virus,” he explained.

He argued that if random testing is approached, several guidelines can be taken to maintain some efficiency including focusing on gathering random samples in wider communities in which contacts were traced and previously confirmed cases were known to have visited or operated and setting up multiple testing sites with clear protocols to spread out the possible demand of persons coming to be tested.

Dr Devonish also listed a third guideline which recommends increasing the size and numbers of random samples and random testing behaviour only as resources or capacities increase.

He said random testing should be done in an incremental, graduated fashion as the capacity to test increases.

Turning his attention to the wearing of masks, the management studies expert concluded the paper by suggesting that the need for wearing masks in public would be better appreciated by people during this time as this precaution is best suited for individuals who might be carrying the virus but appear healthy.