Responses to Questions from Webinar entitled “COVID-19 Outbreak in Africa: What You Need to Know and How to Stay Safe" part 1

Responses from Ashraf Grimwood, Chief Executive Officer, Kheth'Impilo, Cape Town, South Africa

What is your PCR TAT?

We are finding that for our CHCWs it is taking over 7 days due to several reasons as mentioned- infected lab staff, closing of one of the sites, huge load, but getting results out is so critical for epidemic control

Did you find temp screening was useful - the evidence seems to indicate not helpful.

We have just started this. I think more psychological than anything else. The symptom check and temperature much more sensitive.

Given the lessons learned from HIV with involvement of CHWs- re: Stigma. How could these lessons be integrated in the training of CHWs as well as community engagement at large? Surely Covid-19 has created another level of stigma?

The stigma has been more acute than HIV but I think as with HIV this will reduce as the majority of people get back to health. Education and support of the community health workers, regular debriefing with them in multidisciplinary teams help them in better managing patient stigma in the community

Responses from Wolfgang Preiser, Professor, Division of Medical Virology, Faculty of Medicine and Health Sciences/Stellenbosch University & National Health Laboratory Service Tygerberg (NHLS), Cape Town, South Africa

Given reports that coronavirus VL is higher in saliva than NP swab is consideration being given to saliva testing?

Several laboratories are trying this approach. One has to keep in mind that most papers at this stage are either not reviewed at all (pre-publication collections, such as preRxiv) or were reviewed very hastily. Usually one has more time and would await another publication that confirms, or does not confirm, the findings. But because of the haste we are in people are jumping at new leads – which is fine as long as you validate it in your setting. We are busy with that and so are several others, too.

What is the effect of delayed return of results?

It depends on who is being tested. Delay I would define as a turn-around time (patient – lab – patient/doctor) of more than 48 hours. There are obvious considerations e.g. isolation, contract tracing, quarantine etc. We try to fast-track urgent specimens e.g. from healthcare workers but the sheer numbers are often overwhelming, and the supply chain of kits and reagents is fragile.

Any experience on experience on Nasal and throat swab?

Nasopharyngeal swabs are apparently best, and we no longer ask for both these plus oropharyngeal ones. Perhaps saliva will make our lives easier (and safer for the healthcare workers who obtain the samples from patients) in future.

No really good data on antibody testing yet. There are a lot of tests being sold out there and only a few if any have been validated. But many groups are working on that and collecting suitable serum specimens so we will have that data soon. In the meantime it is clear that antibody testing cannot replace PCR for diagnosing acute cases, but it may play a role from the second week onwards. Whether someone with antibodies (beware false-positive results!) is immune, and for how long, we do not know yet. I would assume they are immune at least for a while but before tests are noyt known to be reliable, this should NOT be used. (Wolfgang)

Anyone with experience using Abbott platforms automated extraction versus manual extraction methods failure rate?

We do not use this, I would not know.

Responses to Questions from Webinar entitled “COVI...
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Wednesday, 12 August 2020
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