Bad news about the COVID-19 epidemic in Puerto Rico came this morning as a bucket of cold water: the Health Department has been incorrectly reporting data on infections on the Island for the past four weeks.
The Secretary of Health, Lorenzo González, recognized today the Investigative Journalism Center (CPI) that the agency he heads has been mixing the results of molecular tests, which are confirmatory that the person has the virus, with the results of rapid or serological tests, the result of which according to the Federal Food and Drug Administration ( FDA) is not conclusive. The implication of this is that there has been a double count, perhaps even triple, of the results in government reports on COVID-19. For example, a person who had a rapid test that was positive and then had a molecular test confirming that positive is counted in the numbers reported by the Government as two separate cases, when in reality it is only one.
The CPI asked if the current number of confirmed cases of COVID-19 in Puerto Rico has a double or even triple count.
“Yes, of course it does,” said the Secretary. He explained that there are patients who test positive and when they recover, they undergo another test to see if it is already negative. “That patient has had two, potentially three tests,” he said, confirming that the results of those two or up to three tests would individually enter the figures, despite being from the same patient.
“That is the reality of the existing system. We definitely have to debug it, ”said González.
So the data so far in Puerto Rico is not reliable, questioned the CPI.
“Well, it’s the data we have,” admitted the official. “All 50 states in the United States, and I’m not defending myself; like the rest of the world, today nobody has data accurate ”.
Regarding the expressions in a press conference yesterday in which he and Governor Wanda Vázquez Garced, when questioned by the CPI about the figures, assured that the numbers they provided were correct, González said today: “I am not going to defend the indefensible, that They will never see it from me, so yes, we have things that we have to improve. I tell you that from the heart. So when we spoke yesterday with the boys, with all the people who are here devoted to doing this, I said to them, ‘You are right, no matter how much I would have argued [ayer]’Although I don’t argue with anyone, it was a little bit of human warmth. But you were right. So yes, I give it to you. And using this, we have to solve [y tener] categorically clear protocols. We have to solve the double whammy, the double tests that we have, how we debug the system, and we have been working on it since yesterday. How to debug the system so that there is no double result ”.
To this day, Puerto Rico has 1,068 confirmed positive cases of COVID-19. Within that number, there are 170 cases that were not confirmed with a molecular test or “PCR”, according to the data that Salud provided today.
The CPI revealed this week that the Department of Health lacks an effective and centralized process for receiving and reporting the results of rapid tests, which has so far prevented the agency from giving reliable information. Although thousands of rapid tests have been distributed to hospitals and health centers, the Government of Puerto Rico also had no control over what happened to these tests once they were distributed.
The Secretary accepted these problems and said that he has known about them since he came to the agency, although almost three weeks later, he admitted that they have not been resolved.
“I was not giving the necessary follow-up,” the Secretary had to acknowledge the CPI. He said that after the CPI’s questions, he realized yesterday that the numbers that the agency had been presenting were incorrect.
González and his team announced that the agency is working on a new protocol to report the results of tests in a segmented manner (molecular versus serological) and that they would be rectifying the data provided so far.
According to Health data detailed for the first time this Friday to the CPI, 2,267 rapid tests have been carried out out of a total of 351,500 that have been purchased. Of the number of tests performed, 170 positives entered the official count of confirmed cases of COVID-19, without all having a confirmatory molecular test. González explained that in Puerto Rico rapid or serological tests have been used and if they show positive, a molecular or “PCR” is not performed to ensure that the patient has the disease and was not a false positive.
The Secretary’s instruction is: “If the fast gives me positive, it is positive.”
But this would go against current protocols for managing the pandemic, as admitted by the government epidemiologist, David Capó, and Jessica Cabrera, director of the Biosafety Office.
“In terms of protocol, it is supposed to be confirmed with PCR“Hood explained. And he added: “It is assumed that the positives and the negatives are confirmed, that they are all confirmed.”
Cabrera agreed: “Usually one uses the rapid test for surveillance. The [Secretario] He understands that if it is positive, he is adding it to the figure. “
“And is that correct, epidemiologist?” Questioned the CPI.
“It’s supposed to be confirmed,” said Cabrera.
“It is assumed that they are confirmed, the positives and the negatives, that they are all confirmed,” added Capó.
“Did you know that today there are positive cases of rapid tests inserted in these numbers?” The CPI told Capó.
“Well, right now we are in this process …”, he indicated.
By way of exception, the protocol that is being followed with the tests that are done at the airport and those that are made to emergency workers is to perform only molecular tests, in order to have reliable confirmation.
However, this protocol is not being followed with the rest of the population.
Hood said Friday that the DS is evaluating changing the instructions to hospitals and health centers.
“Is it possible for you to change the numbers, and arrange them to reflect separate positive rapid tests from molecular ones?” He was asked. “What we are considering is to notify separately … It is supposed to confirm all the speedways that came out positive,” he replied.
Unused distributed tests
Another problem with rapid tests is that the government has distributed thousands of these tests, but it was not known if they were being used. Of the nearly 100,000 tests that have been distributed to date – including over 7,000 tests for more than two weeks – only 2,267 have been used.
“We have, for practical purposes, 97,000 tests distributed in Puerto Rico that are not generating any benefit for us,” said González, who admitted that although he knows to which places he distributed rapid tests, “it is not categorically clear how much of what was distributed is being produced. being tested and being used. “
“When we look back now, and you realize that 100,000 rapid tests were distributed here and are on the periphery. They are not generating any response for Puerto Rico. This is real. That is a valid point and I give it to you 100%. You made us think clearly. Obviously, the argument is ‘if they are, why aren’t hospitals and centers using it?’ ”
So far, Puerto Rico has the lowest number of tests conducted when compared to the states and territories of the United States, according to data compiled by the Center for a New Economy.
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