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Govt to keep oropharyngeal sampling despite incident

2020-07-23 03:20     Comment:1

Addressing yesterday’s press conference about Macau’s novel coronavirus situation, Alvis Lo Iek Long, a clinical director of the public Conde de São Januário Hospital Centre, announced that the government has decided not to cancel sampling via oropharyngeal swabs in its nucleic acid testing (NAT) scheme, after considering residents’ preferences in having their samples collected for a COVID-19 test by this method.

However, Lo said that if Macau’s COVID-19 situation changed in the future like the one in Hong Kong – which is being hard hit by a citywide outbreak, residents would have their samples collected under the Macau government’s NAT scheme only via nasopharyngeal swabs, which ensure more accurate results than oropharyngeal swabs.

Lo’s remarks came after the local government said in a statement on Tuesday night that the Health Bureau (SSM) would require all COVID-19 testing institutions in the city to collect samples from those undergoing their nucleic acid tests only via nasopharyngeal swabs – i.e. to no longer take oropharyngeal swabs, after a seven-year-old boy accidentally bit off the swab and swallowed its tip on Tuesday morning when he was having his sample collected for a COVID-19 test via an oropharyngeal swab at the NAT programme’s main testing station in the Taipa Ferry Terminal in Pac On.

The Health Bureau has commissioned a third-party testing institution – Kuok Kim (Macau) Hygiene Examination Company Limited – to carry out COVID-19 testing at the Pac On testing station under its NAT scheme, which was launched on May 7.

A new testing station for the government’s NAT scheme, which is located at the Macau Forum complex in Zape, came into operation on Tuesday with the aim of diverting the flow of people from the Pac On testing station. The new Macau Forum testing station is temporarily being operated by the Health Bureau before it commissions another third-party testing institution in the near future to carry out COVID-19 testing there.

Residents who plan to visit Guangdong have to make an appointment online to be tested for COVID-19 under the Macau government’s NAT scheme so that they can present a NAT certificate confirming that they have tested negative for COVID-19 when crossing the Macau-Zhuhai border. In addition to the COVID-19 testing at the Macau Forum testing station, the Health Bureau has been carrying out nucleic acid tests for certain groups of people such as confirmed and suspected COVID-19 patients, those who have been in close contact with confirmed COVID-19 patients, those with a fever or any respiratory symptoms, newly hospitalised patients, and those undergoing quarantine.

Tuesday’s statement pointed out that the Health Bureau has been collecting samples from those undergoing their nucleic acid tests via nasopharyngeal swabs, adding that sampling via nasopharyngeal swabs has advantages over sampling via oropharyngeal swabs. The statement said that a nasopharyngeal swab can remain in the pharynx for a longer period of time to obtain more sufficient samples than an oropharyngeal swab, adding that therefore a person who has been infected with the novel coronavirus disease is more likely to test positive for COVID-19 if he or she has had his or her sample collected via a nasopharyngeal swab rather than via an oropharyngeal swab – i.e. enabling a higher rate of positive results.

During yesterday’s press conference, Lo said that after considering residents’ various preferences in the two sampling methods – oropharyngeal swabs and nasopharyngeal swabs, the government has decided to “keep the current sampling arrangement unchanged” – i.e. sampling via oropharyngeal swabs and sampling via nasopharyngeal swabs will remain in place.

Lo was quick to underline that sampling via nasopharyngeal swabs is “definitely” better than sampling via oropharyngeal swabs in terms of the accuracy in test results and safety in the sampling process. Lo said that while some residents may feel less uncomfortable in sampling via oropharyngeal swabs, there is a concern that an oropharyngeal swab cannot remain in the pharynx for a long enough period of time which in turn adversely affects the accuracy rates in test results.

Lo noted that as the Health Bureau has determined that Macau-Zhuhai cross-border commuters merely involve an “extremely” low risk of COVID-19 infection so that the oropharyngeal sampling’s lower rate of positive results was still “within an acceptable range”. However, Lo said that Macau would need to only adopt sampling via nasopharyngeal swabs if Macau’s COVID-19 situation changed in the future like the current situation in a neighbouring region (Hong Kong), in which case the Macau health authorities would need to be sure whether a particular person who has undergone a COVID-19 test has in reality been infected with the novel coronavirus disease.

NAT quota raised to 11,000 per day

Meanwhile, Lo also announced that the government has raised the quota for its NAT scheme’s online appointment system to 11,000 people per day, adding that it believes that this can meet the demand by local residents to cross the Macau-Zhuhai border. Lo pointed out that the government just raised the quota from 5,000 people per day to 7,500 people per day on Monday, before raising it to 11,000 in a short period of time.

Lo said that while Macau currently can test up to 16,000 per day for COVID-19, the Health Bureau needed to keep some places readily available for emergency situations in response to the possible sudden deterioration of Macau’s COVID-19 situation, adding that therefore the bureau has set the quota for its NAT scheme at 11,000 people per day for the time being.

Lo said that Macau’s COVID-19 testing capability of 16,000 people per days means 2,400 people per 100,000 people, higher than Hong Kong with 105 people per 100,000 people and Beijing with 1,400 people per 100,000 people (the highest in the mainland).

Concerning a report by local Chinese-language newspaper Macao Daily News that the boy’s father has complained about Tuesday’s incident at the Pac On testing station, Lo said that the Health Bureau has preliminarily determined that the case was not a medical incident. Lo pointed out that the bureau has ordered the testing institution – Kuok Kim (Macau) Hygiene Examination Company Limited – to submit a report about the case.

Lo underlined that a medical incident comprises three conditions, namely 1) the medical staff members have committed mistakes in the carrying out their medical task, 2) the task has caused damage to the patient, and 3) the damage is caused by the mistakes. Lo said that after studying the case, the Health Bureau has preliminarily determined that the case belongs to a normal complication which is expected to happen with children who are having their sample collected for a COVID-19 test via oropharyngeal swabs so that it did not constitute a medical incident.

Lo also said that it would be unfair to the medical staff members who collect samples from those undergoing their nucleic acid tests at the Pac On testing station if people rushed into considering the case as a medical incident. Lo pointed out that about 200,000 nucleic acid tests have been carried out in Macau – with just one incident so far.

The boy’s father called Macao Daily News on Tuesday complaining about the incident, saying that as it was a medical incident so that he had reported the case to the police and decided to file a “criminal complaint” against the testing institution.

Helicopter ride registration crashes

Meanwhile, Lau Fong Chi from the Macau Government Tourism Office (MGTO) confirmed during yesterday’s press conference that no residents had been able to sign up for the helicopter itinerary of its Macau tour scheme. Lau noted that the registration of the scheme’s second phase – the 10 new itineraries – started at 10:30 a.m. yesterday, adding that the scheme’s computer system was overloaded as too many people tried to register for the helicopter ride via local travel agencies at the same time after yesterday morning’s start of the registration.

Lau said that as the system crashed due to overloading, her office had decided to suspend the registration for the helicopter rides.

Meanwhile, the office said in a statement last night that the registration for the helicopter itinerary will resume at 3 p.m. today at the 150 local travel agencies which have joined the programme.

The statement said that as the helicopter itinerary has now only 700 places, those who have registered for it via travel agencies will have to enter a lucky draw on Monday to determine whether they can have a helicopter ride.

The office also said that it would continue to discuss with the helicopter operator the possible increase in the number of places for the itinerary, in which case those who are allocated a lower rank in the lucky draw would still have a chance to go on a helicopter ride.


Alvis Lo Iek Long, one of the three clinical directors of the public Conde de São Januário Hospital Centre, addresses yesterday’s press conference at the Health Bureau (SSM) about the city’s novel coronavirus (COVID-19) situation. Photo: Tony Wong

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  • visitors2020072603:072020-07-26 03:07

    During the press conference, Lo also noted that the government has been constantly increasing the daily quota for its NAT scheme’s online appointment system, adding that therefore if all residents underwent their nucleic acid tests at the Pac On testing station, large crowds would occur there. Lo said that therefore the government will, if needed, divert some of those undergoing their nucleic acid tests from the Pac On testing station to the Macau Forum testing station, where only four groups of local residents - senior citizens aged at least 65, minors aged below 18, people with disabilities, and those suffering from “special diseases” (namely infectious diseases, drug addiction, tumours and psychiatric diseases) - can choose to undergo their nucleic acid tests when making an appointment online. Lo appointed out that actually the government diverted some of those other than the four groups of residents at the Pac On testing station to the Macau Forum testing station on Tuesday.

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