Coronavirus confusion continues

Prime Minister Tuilaepa Dr. Sailele Malielegaoi says the test results from Samoa’s suspected COVID-19 swabs taken from a sailor have come back from New Zealand showing both negative and positive results.

Speaking at a press conference on Tuesday, Tuilaepa said the same results where the sailor tested both positive and negative came back; therefore blood samples will now have to be sent to New Zealand for further analysis.

The Prime Minister was accompanied at the press conference by the Ministry of Health [M.O.H.] Director General, Leausa Dr. Take Naseri and the National Emergency Operations Centre [N.E.O.C.] Interim Chairman Agafili Shem Leo.

“We just finished a Cabinet meeting which discussed the results of the samples sent to New Zealand,” he said. 

He added that the results from New Zealand arrived on Tuesday. 

“We just received the results today [Tuesday] and it has shown the same outcome from the tests done overseas and locally.”

He then made reference to the sailor who tested positive five days later upon arrival in the country, “which means the virus was active.”

“But after being tested 12 hours later there was no virus, and another test also highlighted the same result.

“The test showed that in the left side of his nostril it was negative while in the right side it is positive.”

Tuilaepa added that the test results have caused confusion, and the samples that were sent to New Zealand came back with the same results as that of the Scientific Research Organisation of Samoa [S.R.O.S.].

The Prime Minister also mentioned that the outcome has led to plans by the Cabinet to send blood samples to determine exactly the status of the sailor.

“We can only send them on Friday [through a flight from Samoa] so we will receive the results on Monday next week,” he said. 

Furthermore, he added that this is not new and that it also happens in overseas countries like New Zealand.

“We will continue to investigate whether the virus is still active or not but we will only know the answer to that question next week," the Prime Minister said.

“There’s something called false positive and a false negative as well which means something is wrong. But what is important to note is that no outcome is final.” 

Rumours that the Government “is hiding the results” were also dismissed by Tuilaepa, who claimed that sometimes the ones spreading unsubstantiated reports “are you guys” [the media].

“We shall wait until Monday to find out what the result is.”

A total of 3,214 Samoan citizens have been repatriated since the border closures, Tuilaepa added.

"Cabinet will decide tomorrow [Wednesday] the fate for the repatriation flight from America which will bring 290 passengers whether to postpone or to continue.”

The Prime Minister emphasised that there is a high risk of citizens getting infected with reports of chaos in America, which will lead to Cabinet making a decision on Wednesday.

“I have mentioned this because there could be a decision from Cabinet that might lead to cancelling the flight,” he said.

“But with whatever decision that the Cabinet will make, we will also meet and reveal it tomorrow [Wednesday]. 

“Cabinet will not take lightly the flight coming from America and with so many people affected by this virus. We pray that God whispers a decision to Cabinet Ministers on their decisions.”

When the Prime Minister was asked what the unclear test results meant for the sailor, Tuilaepa said that it could mean that on one side of his nostril the virus is not active, while the other side it is active and present.

“Samoa will continue as normal with current restrictions imposed with faith in God and do not panic," he said. 

Leausa told the media that all the test kits used are from the World Health Organisation which is being used worldwide.

Asked whether Samoa has enough test kits, he indicated that it is not enough to test the whole country and is being allocated for suspected cases and repatriated people.

Additionally, when he was asked why they did not send blood tests before with the nasal swabs, Leausa said it is to limit the spread of the virus from the person conducting the blood sample.

“If there was a strong indication to conduct a blood sample then we would have done it.

The M.O.H. Chief added that the results from New Zealand would have cemented the need for more tests but it has come back with the same results.

“There are hardly any tests of COVID-19 done through blood samples,” he said. 

Tuilaepa added that when they sent the tests overseas, it was because they wanted to see if there was a different outcome but it came out the same results. 

An expert in infectious disease and microbiologist, Associate Professor Dr. Siouxsie Wiles, told the Samoa Observer that it is important to note whether the test that was positive came out quickly or quite late.

“There are people that have tested negative on the nostril but positive on the lungs but they tend to be quite sick people,” she said in an interview.

“People can test positive very early on in infection. That's when it’s [a] very low [level of the virus] and very late in infection or even when they [have] cleared an infection and came at a late stage when there is a low [level of the virus], and at that late stage, they can test positive one day and negative the next day.

“If that test was a really high positive suggesting it was actually an infectious case then it is a little bit curious, it may just be to do with where the swab was taken from.”

The microbiologist explained that the COVID-19 testing methodology can shape test outcomes.

“It goes down and to the back of the nose, it may well just be that not many cells around there were infected that they managed to get their swabs from, but it’s all about the positive test what it really looks like," she said. 

“What we need to know is whether the positive that came up positive really fast then there’s lots of virus present or whether it came up positive really slowly in which case there’s not a lot of virus present that’s the important information missing.

“Over here when a test comes up positive but very late they then call it a weak positive and it is more likely to be a historical infection – it means that somebody who has been infected in the past is no longer infectious, the test is just picking up bits of viral genetic material that is still present in the body.”

Dr. Wiles also mentioned that a person like that can be positive one day and negative the next day but it’s all about how quickly the test comes up because it is an indication of how much of the virus is present: an active amount or the remainder of a destroyed virus.

“It could also be that, sometimes that the swabs do not necessarily get the right cells, that’s also about how much viral material if the cells are infected, how much viral material you can get from it," she said. 

If the positive test was high or it came out quickly as positive, she said that it would suggest that there was a viable virus there and the person should be treated as a positive.

When asked if there should be a concern if the positive test was a case of a historical infection, Dr. Wiles said that it all depends when the infection occurred.  

She noted that blood samples could be a means of looking for antibodies to confirm whether somebody has had a historical infection. 

“If they are found to have antibodies then you really start making antibodies a week or so after infection that will then suggest that this person has had an infection in the past," Associate Professor Wiles said. 

“That’s what happens here in New Zealand; if we get a weak positive and they take a blood sample that gives evidence of an infection before they arrive in the country.”  

Last week it was reported in the American media that American soul songstress Erykah Badu had fallen victim to similarly conflicting test results, telling fans that only a swab taken from her left nostril had returned a positive result, while the other had not, the New York Daily News reported. 

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