Can reasoned mass testing impact covid-19 outcomes in wide community contexts? An evidence-based opinion

Assessing the comparability of cycle threshold values derived from five external quality assessment rounds for omicron nucleic acid testing

BACKGROUND

A variety of open-system real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays for several acute respiratory syndrome coronavirus 2 are currently in use. This study aimed to ensure the quality of omicron nucleic acid testing and to assess the comparability of cycle threshold (Ct) values derived from RT-PCR.

METHODS

Five external quality assessment (EQA) rounds using the omicron virus-like particles were organized between February 2022 and June 2022.

RESULTS

A total of 1401 qualitative EQA reports have been collected. The overall positive percentage agreement was 99.72%, the negative percentage agreement was 99.75%, and the percent agreement was 99.73%. This study observed a significant variance in Ct values derived from different test systems. There was a wide heterogeneity in PCR efficiency among different RT-PCR kits and inter-laboratories.

CONCLUSION

There was strong concordance among laboratories performing qualitative omicron nucleic acid testing. Ct values from qualitative RT-PCR tests should not be used for clinical or epidemiological decision-making to avoid the potential for misinterpretation of the results.

Vigilância em Saúde no âmbito da atenção primária para enfrentamento da pandemia da Covid-19: revisão documental

RESUMO A implementação de medidas não farmacológicas para o combate à pandemia da doença pelo coronavírus 2019 tem sido fundamental. No Brasil, é mister pensar na integração Atenção Primária à Saúde (APS) com as ações de Vigilância em Saúde. O objetivo desta revisão foi analisar os documentos normativos produzidos pelo governo federal para o combate à pandemia da Covid-19 sobre a Vigilância em Saúde no âmbito da atenção primária. Foi realizada uma revisão dos documentos oficiais publicados pelo governo federal à temática, em que foram identificados 21 documentos. Destaca-se maior apoio à implementação de ações de detecção e notificação dos casos e contatos intramuros do que à busca ativa na comunidade, às ações educativas no território, às ações de engajamento com a comunidade, ao fortalecimento à adesão às medidas preventivas, à melhoria do fluxo de informações ou ao apoio aos equipamentos sociais da comunidade. Pouco se tem produzido sobre a articulação da APS com as equipes de vigilância do município. Esses achados reforçam o alertado por outros autores sobre a insuficiente importância atribuída à APS no País, especialmente quanto à Vigilância em Saúde. O Brasil tem uma das piores gestões da crise sanitária, sendo urgente fortalecer as ações de vigilância.

Health Surveillance within the Primary Healthcare scope to face the Covid-19 pandemics: a document review

ABSTRACT Health Surveillance strategies are crucial to organize a strong national response against the coronavirus disease 2019. In Brazil, it is necessary to think about the integration of the Primary Health Care (PHC) and local Health Surveillance. This review aims to analyze the normative documents produced by the Federal Government on this topic. Official documents published by the Federal Government were reviewed, finding 21 related. It was identified a greater support for implementation of intramural actions related to detection and notification of cases and contacts than for active search of community Covid-19 cases, local educational actions, community engagement, strengthening adherence to preventive measures, improvement of information sharing, or support of community’s social facilities. Little was produced about the articulation of PHC with local surveillance teams. Our findings reinforce what was found by other authors, who attested the insufficient importance attributed to PHC in Brazil, especially with regard to Health Surveillance actions. Unfortunately, our country has stood out for one of the worst managements of the health crisis in the world, and there is an urgent need to strengthen surveillance actions based on a strong, capillary, and community-based PHC.