(PRESS RELEASE) – The Trinidad-based Caribbean Public Health Agency (CARPHA), which is the regional reference laboratory for testing for the novel coronavirus (COVID-19), said Wednesday it carries out testing for 18 Caribbean member states includng St Kitts and Nevis.

According to CARPHA’s Executive Director, Dr Joy St John at a press briefng, the agency handles all regional testing for suspected cases for 18 member states.

She said that the Agency, however, is not responsible for disseminating results to the public, as test results are returned to member states only for dissemination.

CARPHA said: “Samples can only be sent to CARPHA from the designated national public health laboratory in a country.”
The average turnaround time for testing is 24-48 hours

CARPHA said once samples are received, results can be produced within 24-48 hours.

Dr Lisa Indar, Assistant Director, Surveillance Disease Prevention and Control, at CARPHA, said so far the turnaround time for test results, once samples are received by the Agency, are around 17 hours.

The Agency said the COVID-19 results are immediately sent to the Chief Medical Officers at the Ministries of Health, who are responsible for the dissemination.

CARPHA said it cannot and will not disseminate any country’s results directly to patients or individuals. It is an ethical breach and constitutes a violation of the Agency’s ethical standards to share confidential patient information with unauthorized persons.

The agency said persons should contact their local Ministry of Health to ascertain what is the process for getting COVID-19 test results.

Dr Lisa Indar said there are three criteria which CARPHA uses to accept samples for testing, as per WHO:

“CARPHA’s acceptance criteria is based on the WHO guidelines…that is, you must have fever and respiratory illness, together with travel history, or been in contact with a (suspected or positive) case, or you (can) have these symptoms with no other explanation.”

According to WHO, the criteria for suspected cases include:

A. A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath), AND a history of travel to or residence in a location reporting community transmission of COVID-19 disease during the 14 days prior to symptom onset;

OR

B. A patient with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-19 case (see definition of contact) in the last 14 days prior to symptom onset;

OR

C. A patient with severe acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath; AND requiring hospitalization) AND in the absence of an alternative diagnosis that fully explains the clinical presentation.

Dr Indar said samples must be taken between zero to 10 days of the onset of symptoms as this will assist in detecting the amount of viral load present.

Dr Indar said the correct forms must be filled out and the best practices adhered to.

Dr Indar said samples which qualify for rejection include samples which are taken from patients who do not fulfil the WHO definition or are asymptomatic.

Asymptomatic cases are not tested as WHO guidelines have not included it in its guidelines, although this may be updated.

“While we await this (update), we follow the WHO guidelines of not testing asymptomatic cases.”

Samples which extend beyond the 10-day period for testing or samples which were not prepared under best practises or with the correct forms can also be rejected.

Dr Indar said each kit provided has approximately 40-50 tests in them. The COVID-19 RT-PCR test is a two-phase process which requires two sets of kits, one for extraction and another for amplification.

The amplification process confirms primarily that the pathogen is a coronavirus and then to confirm that it is COVID-19.

She said the first step confirming that it is a coronavirus must be done in order to proceed to the next step.

Dr Indar said there are enough kits for the first step for the next three weeks, and enough for the second step for a further eight to 10 weeks, as of April 1, 2020.

Dr Indar said they have been impacted by a global shortage of reagents, however, she assured that the agency has enough media in stock for three weeks. She said CARPHA is actively looking for more media.

“CARPHA is committed to providing science-based results based on WHO-approved test.