SOMETIME in the next few weeks teachers and students are going to be part of a new study testing for asymptomatic people in the education sector.
At a press conference yesterday Health Minister Roger Cook said the McGowan Government had asked leading medical researchers to come up with a research package as part of the return back to schools.
Mr Cook did not say if any schools in the City of Wanneroo or the Shire of Gingin would take part but said he wanted the study to include a good representative sample right across the education sector.
He said the study, which would involve testing using nasal swabs, would provide scientific evidence that was needed to make good scientific choices.
“But in addition to that it should provide the community with greater confidence as they see a wider range of testing,’’ he said.
“But we need to see what that project looks like.
“We have ambitions to be ready to go for next week and obviously you’d appreciate there’s a lot of work being done behind the scenes to put that study together.”
He said the logistics such as where the testing would be carried out were still being worked out.
During a press conference on Monday Mr Cook said it was very expensive to test everyone to find asymptomatic people.
He had also been advised the low levels of the disease in the community testing everyone was not going to produce particularly meaningful data that would advance the understanding of the virus a great deal.
“What they are saying to us is that you can target cohorts around particular groups that you want to have a particular focus on – that might (be) health care workers or police officers certainly teachers – you might look at FIFO workers.
“As you potentially open up to the hospitality industry you look at hospitality workers – that is a better way to go.’’
Mr Cook said there was a bit of debate going on about whether the blood prick test should be used.
He said PCR testing was still the gold standard and that was why it was used through WA’s COVID clinics utilising the work of PathWest, GP referrals in all private pathology labs and he understood now in the private sector there were a few customers wanting to use it for their workforce.
The federal Department of Health’s Therapeutic Goods Administration (TGA) said tests for COVID-19 aimed to detect the causative virus, SARS-CoV-2, or an immune response to SARS-CoV-2.
The two main types of SARS-CoV-2 tests are nucleic acid detection tests – using qPCR to detect SARS-CoV-2 viral (Ribonucleic acid) RNA and serology tests – to detect IgM and/or IgG antibodies against SARS-CoV-2.
“The reliability of COVID-19 tests is uncertain due to the limited evidence base,’’ the website said.
“Available evidence mainly comes from symptomatic patients, and their clinical role in detecting asymptomatic carriers is unclear.’’
Yesterday Premier Mark McGowan said there were 68,000 working in the public and private school sector and only one worker had been infected with the virus.
The authors of SARS-CoV-2 infection in children published online in The New England Journal of Medicine on March 18 said data regarding the epidemiologic characteristics and clinical features of infected children was limited.
“(But) a recent review of 72,314 cases by the Chinese Center for Disease Control and Prevention showed that less than 1 per cent of the cases were in children younger than 10 years of age,’’ the authors said.
“In order to determine the spectrum of disease in children, we evaluated children infected with SARS-CoV-2 and treated at the Wuhan Children’s Hospital, the only center assigned by the central government for treating infected children under 16 years of age in Wuhan.
“Both symptomatic and asymptomatic children with known contact with persons having confirmed or suspected SARS-CoV-2 infection were evaluated.
“Nasopharyngeal or throat swabs were obtained for detection of SARS-CoV-2 RNA by established methods – the clinical outcomes were monitored up to March 8.
“Of the 1391 children assessed and tested from January 28 through February 26, 2020, a total of 171 (12.3 per cent) were confirmed to have SARS-CoV-2 infection.
“The median age of the infected children was 6.7 years.
“Fever was present in 41.5 per cent of the children at any time during the illness.
“Other common signs and symptoms included cough and pharyngeal erythema.
“A total of 27 patients (15.8 per cent) did not have any symptoms of infection or radiologic features of pneumonia.’’
In Estimates of the severity of coronavirus disease 2019: a model based analysis published in The Lancet, March 30 (this online corrected version first appeared at thelancet.com/infection on April 15) the authors said it was clear from the data that emerged from China that case fatality ratio increased substantially with age.
“Our results suggest a very low fatality ratio in those under the age of 20 years,’’ the authors said.
“As there are very few cases in this age group, it remains unclear whether this reflects a low risk of death or a difference in susceptibility, although early results indicate young people are not at lower risk of infection than adults.
“Serological testing in this age group will be crucial in the coming weeks to understand the significance of this age group in driving population transmission.’’
The paper COVID-19: What proportion are a asymptomatic? published by The Centre for Evidence-Based Medicine on April 6 (but which has not been peer-reviewed) said there was not a single reliable study to determine the number of asymptomatic people.
“It is likely we will only learn the true extent once population based antibody testing is undertaken,’’ the authors said.
