Regarding The Pooling Test That The COVID-19 Task Force Will Carry Out

JAKARTA - The government is considering easing the Large-Scale Social Restrictions (PSBB) which have been implemented in four provinces and 72 districts / cities to stop the spread of COVID-19 in Indonesia.

Chairman of the Task Force for the Acceleration of Handling COVID-19 Doni Monardo asked President Joko Widodo to prepare four stages before implementing the PSBB easing.

The four stages designed by Doni prior to the easing of the PSBB started from the precondition stage. In this stage, the Task Force will involve epidemiologists, public health experts, sociologists, public communication experts and economists, to create simulations and academic studies on PSBB easing.

"So that the calculations they convey can be captured by the government," Doni said in a press conference broadcast on the Cabinet Secretariat YouTube account, Tuesday, May 12.

In this precondition stage, the Task Force together with a number of survey agencies will hold a COVID-19 pooling test in 8 provinces, namely North Sumatra, South Sulawesi, Bali, Banten, DKI Jakarta, West Java, Central Java and East Java. There are about 1,000 respondents who will be prepared to run this pooling test.

"These 1,000 respondents will represent all the people in each province. So that we will be able to get the data from the swab test, including a number of questions to be submitted," said Doni.

Then, the results of this test become a consideration for the Task Force to make decisions and provide input to related ministries / agencies and local governments on what to do next in handling COVID-19.

When the precondition stage is over, the Task Force will enter the advanced stage, which is to determine when the easing will take place. According to him, for regions that have implemented PSBB but the curve has not decreased, there will be no relaxation.

"If a region has not shown a decreasing curve, let alone sloping, then it is impossible for that region to be given the opportunity to relax," he said.

Then, the third stage is to determine priority areas that are allowed to carry out activities during the easing period. For example, in the field of food, especially markets, restaurants, or other activities to avoid layoffs for the community.

The final stage is the coordination of the central and local governments. This is considered important so that there is no rejection regarding the resulting decision.

"Do not let the central government give an easing, it turns out that there is rejection (in the regions). Likewise, the regions may decide to ask for easing, it turns out that the central government does not see the time yet. So central and regional coordination is our priority," he explained.

This pooling test or testing in groups has been carried out in West Sumatra Province. West Sumatra Governor Irwan Prayitno said this pooling test had been carried out on groups of people under surveillance (ODP) and people without symptoms (OTG). The result, he explained, was that specimen testing via PCR with the pooling test method was more efficient and saved time.

"The pooling test is an effort to make the examination of specimens more efficient and also cheaper, faster, and the results can be used as a reference," said Irwan after attending a limited online meeting with President Jokowi some time ago.

From the results of this test, the West Sumatra Provincial Government can reduce the number of spread of COVID-19 in its region. Because, the pooling test can look for those who are infected but their existence is hidden. In addition, the implementation is also considered to be more massive than individual tests.

However, recently this pooling test has received the spotlight because in a number of areas in West Sumatra that are free of COVID-19, there are actually positive patients.

Irwan argued that positive patients were not due to group testing. According to him, this positive patient contracted COVID-19 from migrants who came from other districts directly adjacent to West Sumatra.

"So if we get a negative pooling test result, it should be ideal if everyone in one area is blocked," he said.

"If they are intercepted, they will be interviewed first until they are confirmed to be negative. Because this is not done, what is already negative will turn out to be positive," added Irwan.

Epidemiologist from Australia's Griffith University Dicky Budiman explained that the pooling test is more familiarly called 'Dorfman Testing' as the name of the inventor. This method was invented in 1943, which was initially implemented in the second world war with surveillance techniques due to limited resources for conducting tests.

"Initially carried out during the second world war in screening American soldiers for syphile disease by means of a pooling test on their urine. Furthermore, this technique is also carried out on blood, as during the early HIV outbreak," said Dicky in a written statement as quoted by VOI. Tuesday, May 12.

Meanwhile, the COVID-19 pooling test is carried out by combining samples from several patients for one examination with one reagent for testing COVID-19. However, testing with this method will be more effective if the patients being examined come from a homogeneous population.

"This can be done in small, relatively homogeneous locations such as offices or factories or hospitals," he said.

Although not new, the World Health Organization (WHO) has not issued an official policy regarding the use of pooling tests in cases of corona virus detection.

However, Dicky warned, when the pooling test was taken, it should not exceed the number of samples in the WHO recommended group, namely 6 samples per one group. Then as a follow-up to this test, a number of other measures such as tracking the movement of the virus, dealing with it, carrying out isolation, and creating a prevention program are a must.

In addition, even though the pooling test makes testing more efficient, Dicky advised the authorities to be careful in implementing policies related to the spread of COVID-19. Moreover, this virus is still new and continues to mutate.

"Responding to COVID is not only about numbers but there are humans there who can be our families too. So every strategy that is carried out must be chosen and have scientific evidence based (scientific evidence)," he concluded.