DOH says saliva-based Covid testing a potential alternative

The Department of Health (DOH) is recognizing the potential use of saliva as specimen for SARS-CoV-2 detection through RT-PCR after Sen. Richard J. Gordon, chairman and CEO of the Philippine Red Cross, urged the use of saliva test as an alternative for Covid-19 testing, which is faster and 99.9 percent reliable.

Gordon also said that saliva test will reduce the cost of Covid-19 testing.

Currently, the DOH said that nasopharyngeal (NPS) and oropharyngeal swab (OPS) are the recommended modes of specimen collection for the detection of Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2).

However, recently there has been growing evidence on the potential of saliva as an alternative specimen for Covid-19 testing.

Hence, to be able to establish its effectiveness supported by local evidence, there are two ongoing local studies on its use as an alternative specimen for Covid-19 testing led by the Research Institute for Tropical Medicine and the other by Philippine Red Cross. To date, RITM has yet to conclude its study while PRC has yet to consider the recommendations of the DOH and Covid-19 Laboratory Expert Panel (CLEP) based on its initial results.

HTAC recommendation

ON Tuesday, Gordon said they are hoping that the Health Technology Assessment Council (HTAC) would soon make a recommendation to the DOH in connection with the PRC’s application to be allowed to conduct saliva test for Covid-19.

“Health Technology Assessment Council ang nag-e-examine [is the one examining it], It’s taking them a long time, October 17 pa sinubmit ’yan at ginagamit na din ’yan sa ibang bansa [we submitted it on Ocotber 17 and other countries are also using it]. Over 1 million Covid testing has been done using that, at 99.9 percent…accuracy,” he said.

HTAC is an independent advisory body created to provide guidance to the DOH and the Philippine Health Insurance Corp. (PhilHealth) on the coverage of health interventions and technologies to be funded by the government. It is also mandated to undertake technology appraisals by determining their clinical and economic values in the Philippine health-care system, with the aim to improve overall health outcomes and ensure fairness, equity, and sustainability of coverage for all Filipino citizens.

Upon completion of both studies, results shall be assessed by the CLEP and the HTAC whose recommendations will help the DOH develop an evidence-based policy on the use of saliva as alternative specimen for Covid-19 testing.

Gordon further explained that the same machines used for RT-PCR testing would also be used without needing the nasal and pharyngeal swab that use test kits.

He mentioned that the University of Illinois launched a Manhattan Project—style effort to create a cheaper, faster Covid test. After running a successful pilot of the saliva test during the early part of summer, the university conducted more than 1 million Covid tests during the recently completed fall semester. The alternative delivers a result within hours rather than days at a total cost of $20 per test and is 99.9 percent accurate on specificity.

Pooled testing

The DOH recognizes specimen pooling strategies as an opportunity for greater Covid-19 testing efficiency by reducing turnaround time and saving on supplies.

In line with this, the DOH issued Department Memorandum 2020-0539 providing interim guidelines on the conduct of Covid-19 pooled testing based on the pooling protocols set by the Philippine Society of Pathologists Inc., RITM and DOH.

“Rest assured, the Department of Health will continue to support the conduct of studies and innovations that will help mitigate the spread of Covid-19 in our country,” the DOH assured.

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