A responsive and rigorous testing system is necessary to prevent the spread of communicable diseases. Testing information triggers the identification, isolation, treatment, and referral of cases, and is therefore critical to decision-making. It also helps experts and key responders monitor the prevalence, spread, and contagiousness of a virus such as COVID-19 on a wider scale in order to intervene and act accordingly. To diagnose COVID-19, there are three types of tests that health workers conduct.

Antigen tests are immunoassays or biochemical tests that detect specific molecules through the use of antibodies or antigens. The test can be performed using nasal and/or nasopharyngeal swab, and saliva samples. This kind of test can be performed by trained and authorized medical professionals and also bought over-the-counter from authorized manufacturers. Results are available 15-30 minutes upon testing.

Antigen tests are most helpful in congregate settings when immediate results might be needed. However, it can only detect COVID-19-positive patients when they have high amounts of the virus within the body, usually within one week of the onset of symptoms. Those with low amounts of virus in the body or were tested more than a week after the onset of symptoms can receive false-negative results. An RT-PCR will still be recommended by the healthcare provider for the confirmation of results.

Establishing a COVID-19 laboratory

Marikina City's Molecular Diagnostics Laboratory Source: Aldrin Casinas, Manila Bulletin

Testing for SARS-CoV-2 requires a Biosafety Laboratory Level II facility with biosafety cabinets, PCR cabinets, real-time PCR machines, and personnel trained in performing the procedure. LGUs that do not have their own testing laboratories have to coordinate with other health facilities that have the capacity for testing while the LGUs manage the cases on the ground through isolation and quarantine protocols. For those with resources to set up their own COVID-19 testing center, the following guidance is provided by the Research Institute for Tropical Medicine (RITM), the country’s National Reference Laboratory

As early as April 2020, Mayor Rex Gatchalian was already advocating for mass testing for Valenzuela. At that time, the country’s testing capacity was still very limited and the city was challenged with the prolonged turnaround time for test results to come out. The local government then set aside Php 127 million to conduct mass testing. Initially, they depended on private laboratories and other imported testing kits available in the market. Then, through a partnership with The Medical City, they were able to secure at least 25 tests per day. For Mayor Gatchalian, having this facility available eased the anxiety of the people since the release of results was quicker. With  more control over the testing process, the City Government was also able to organize the subsequent protocols for targeted lockdown of households with COVID-19 positive patients.

Eventually, the local government established its own molecular laboratory and began sourcing its testing kits from the Department of Health (DOH) for free. The city’s laboratory can now process 800 samples a day. Aside from this, local officials rolled out a mass testing initiative for 5,000 families in three relocation sites with high population density in Valenzuela City, prioritizing them since they are home to many workers serving different industries. According to the local chief executive, they followed the DOH advice to “seek them out rather than waiting for them to get sick.”

Mayor Marcy Teodoro was among the early advocates of mass testing when the pandemic started. He reiterated that testing was the only way to know who had the virus in the community. Anticipating that the country’s primary testing facility will be likely overwhelmed by samples coming in from the different regions, Mayor Teodoro then endeavored to put up their own Molecular Laboratory to be able to test the people in Marikina. Despite hurdles and delays in the approval process, the Marikina Molecular Laboratory is now fully functional and can process 600 to 1000 specimens per day.