The Scientific Coalition of Puerto Rico, appointed by Governor Pedro R. Pierluisi, today presented to the executive and the Department of Health an analysis and recommendations on strategies for diagnostic testing of VOCID-19 to be conducted in Puerto Rico during this second year of the pandemic. One recommendation is not to use serological or rapid tests in any context as a diagnostic test for COVID-19.
“Science has come a long way in the past year, including virus detection strategies. According to Executive Order OE-2021-001, where Governor Pedro R. Pierluisi orders the Secretary of Health to create, design and run a program that results in the massive administration of tests to detect COVID-19, we presented an analysis of where Puerto Rico is on the subject of testing, how science has advanced and we make timely recommendations to create robust systems that allow to diagnose the behavior of the virus during the reopening processes in this next year, and to detect possible rises of infections “, expressed Marcos López, PhD, member of the Scientific Coalition of Puerto Rico.
Coalition members understand that strategies need to be adjusted to achieve three goals: 1) greater accessibility to diagnostic tests, 2) distribution and use of tests at key points during reopening processes, and 3) adjustments in the use of scientific tests and strategies to monitor the virus and its variants.
“We began our analysis by examining what tests have been done in Puerto Rico during the pandemic, the opportunities and the challenges, in the context of where science is today. There have been difficult times of a shortage of evidence in Puerto Rico. , and times, like the ones we are going through today, where there is an abundance of evidence but people are not getting enough evidence.This supply and demand, and this accessibility, should stabilize, understanding that, contrary to when it began pandemic, there are already over 300 tests authorized for use in the United States and Puerto Rico.There is no reason why a person who wants to get a test, can not be done.One of the unique aspects in Puerto Rico is the “The number of private laboratories we have throughout the island and how this increases accessibility to the population. In fact, more than 1.7 million diagnostic molecular tests have already been carried out,” said Barbara Segarra, co. worker of the Scientific Coalition of Puerto Rico.
The Coalition emphasizes that 84% of all tests performed in Puerto Rico during the pandemic were performed in private clinical laboratories or academic centers. The moments of ‘scarcity’ of tests, which affected the public so much, arose in part from administrative barriers that prevented access to reagents or the execution of tests in these laboratories in the private sector. Some of these barriers still exist and limit access to tests, barriers such as the requirement in some contexts of a medical order to have a test, misinformation about the type of test to be performed. be doing or what is not authorized for certain tests 1 recovery, by medical plans, on the sampling. The Coalition recommends that these barriers be removed and that alliances be refined, as has already been done in most jurisdictions in the United States and other parts of the world, between the Department of Health and the private sector to extend access of the tests to the citizenry.
The Coalition understands that the type of evidence that needs to be emphasized must change as access to evidence and the scientific knowledge associated with it have changed.
“Serological tests are not diagnostic tests. We do not recommend the use of serological testing as a diagnostic tool in any context. We understand that some vaccinated citizens are undergoing serological testing to establish immunity after vaccination. We emphasize that these tests do not necessarily measure the neutralizing antibodies that arise after vaccination, and we recommend avoiding this practice, “said Mildred Lozada, a member of the Puerto Rico Scientific Coalition.
“On the other hand, we recognize the existence of new variants and the need to have systems that allow us to identify them. We recommend the implementation of surveillance programs based on molecular epidemiology focused on variants of COVID-19 to contain community infections and the evaluation of the transmission dynamics of these, “expressed Dr. Kenira Thompson of the Scientific Coalition. “Programs should include virus isolation and neutralization analysis of vaccinated patient serum libraries, by age ranges, and plasma of recovered patients to establish whether the neutralizing antibodies our population is producing, are able to neutralize circulating variants or strains, and have also supported surveillance and research projects that result in the construction of libraries of vaccinated patient sera and the performance of IgG / IgM serological tests, pre- and post-vaccination. This will help us understand the extent to which people are or are not generating anti-SARS-CoV-2 antibodies.We understand that these strategies are the correct and rigorous way to monitor immunity in Puerto Rico, and in the context of the variants “.
In addition, the Coalition recognized that there are other new ways to integrate science into virus monitoring that have not yet been used in Puerto Rico, and that they should be integrated to strengthen the systems of surveillance. For example, the Coalition recommended that the distribution of evidence and strategies be adjusted to the context of openings including their strategic use in airports, schools, government agencies or the private sector. He recommended the integration of methods, such as pooling or “pooling”, for monitoring and group contexts, such as reopening schools. He also recommended the implementation of new environmental wastewater epidemiology programs to monitor foci of infection and establish possible outbreaks by detecting the presence of SARS-CoV-2 virus in these samples. The process may even include tracking mutations in some variants, as well as determining their relative concentration.
“The pandemic is not over, but in Puerto Rico we have the scientific knowledge to be able to monitor the behaviors of viruses and make the necessary adjustments to protect the population.. A year after this pandemic, we recommend new surveillance so that we are not again in circumstances where there is a shortage of resources or access to evidence that does not allow us to understand virus behaviors and make science-based decisions. We urge the Department of Health to implement these new programs, which will increase their capacity and access to testing by citizens. We also urge the public to continue precautionary measures to protect themselves from infections and to continue testing when they are available or when they have symptoms. This will allow us to identify the foci of possible infections and protect lives during the reopening processes, in the context of variants and as we reach herd immunity, “concluded Daniel Colom Ramos, president of the Puerto Rico Scientific Coalition.