New tests Samoa's coronavirus hope

With the complete closure of its borders Samoa also closed the window for sending further suspected coronavirus tests to New Zealand, leaving it reliant on the arrival of an emerging method of testing for the disease. 

The Government's approach will entail the use of a new form of testing kit that does not meet W.H.O. diagnostic standards, but has increasingly got the tick of approval from health authorities in Japan, the United Kingdom (U.K.) and Australia.

The new rapid tests can detect coronavirus antibodies in a patient’s blood in under 15 minutes.

The Samoan Government has ordered 500 of the kits and the Chinese Embassy has itself ordered another 200 as a donation but delays in air cargo mean their arrival time is uncertain, a spokeswoman for the Embassy said on Wednesday. 

But the tests are not without controversy. They have divided national and international authorities on their efficacy at a time when the world is facing a vast shortage of testing capacity and when Samoa is fast out of options for further detections. 

“Potentially this test may tell people ‘I am negative so I have nothing to worry about’ and they might be infected because antibodies are not developed yet, and the person will go and contaminate others,”  says Dr. Rasul Baghirov, World Health Organisation country representative for Samoa

“That is why having this test in mass production is a bit tricky, it might be misleading people”.

Dr. Rasul's concern about the antibody tests is that unlike gene testing for the virus, antibodies do not form as soon as someone is infected, taking days to appear, and will remain present long after they are well again. 

Rapid tests can be incredibly useful research tools to test the full extent of a country's infection rate after the pandemic is over, he said, but as a diagnostic tool they should be treated with caution.

But they may be Samoa’s only option. 

Typically tests are analysed by looking for sequences of the virus in a patient’s bodily fluids to look for patterns that match that of the virus in what is known as a PCR 200 machine. That process takes about six hours.

Without such a machine Samoa cannot take such tests.

But by moving to import the rapid test blood-based test kits Samoa will be joining countries such as Australia, a country whose health regulator, the Therapeutic Goods Administration gave the kits urgent approval this week.

The country will import 500,000 of them for use to relieve the strain on the traditional testing system; a lack of access to testing is a common complaint in countries such as the U.K and America.

In a statement, the Australian health department said the “expedited” approval of the testing kits was “based on evidence provided to the TGA at the time of application”.

The United Kingdom has imported 3.5 million of the kits this week. While they are still undergoing final approval in that country they are expected to be used to screen health workers suspected of having the virus.

Speaking to the Huffington Post, Professor Trudie Lang, director of the Global Health Network, University of Oxford, said that these types of tests would be “transformational” in the fight against the virus. 

She said: “We can make sure we’ve got doctors or nurses who can work safely in hospitals. People wouldn't have to isolate unnecessarily at home for 14 days, because you’ll be able to tell very quickly if people have cleared it or not.”

The antibody tests were developed by Chinese researchers at the peak of the virus’ outbreak in the central city of Wuhan and were only given the tick of approval by Chinese regulators in January.

China is overseeing the mass sale or donation of rapid testing kits to countries such as Indonesia. 

A study in the peer-reviewed Journal of Medical Virology said the antibody tests could return results within 15 minutes, much faster than the current standard testing. It found that the tests have a “sensitivity” rating of 90 per cent.

But that may not be the extent of Samoa’s options.

“There is a third way to test that is being quickly developed and that the WHO does recommend, and it could be done in Samoa because there is the machine [which is] being used to detect other infections,” Dr. Baghirov said. 

The test is done with a machine called GeneXpert, which is often used to detect tuberculosis. 

The machine uses cartridges to test swab samples for the virus genetic material, similar to a PCR machine. 

“Private practices have this machine and there is also one in [the national] hospital. What we don’t have is the cartridges.

 “The [test has] been developed but there is a minimum availability of these cartridges. What W.H.O. is doing at the moment is beginning mass production. W.H.O. is committed to supply those cartridges to countries, including Samoa.” 

When the GeneXpert cartridges will be available is not known.

But the Director General of the Ministry of Health, Leauasa Take Naseri, confirmed that since the shutdown of flights to New Zealand, Samoa is now awaiting the arrival of rapid testing kits. 

“So for example of [the two] specimens we did yesterday but the flight had already left,” he said. 

“So we are storing them in the lab (in Samoa).” 

Leausa said China has offered to donate five hundred testing kits. 

“So when these kits arrive, we will use them to test these, just like all the assessments being done now,” he said. 

He did not say when the kits from China would arrive. 

The Director General said they expect more suspected cases, especially given the approach they are taking towards ensuring nothing is left to chance. “Even if we get more suspected cases tonight and tomorrow, we will pile them up (in the lab) so we can use these kits.”