JAKARTA: The Indonesian Health Ministry said it has all the required resources to test patients for the novel coronavirus.
This came after media reports suggesting that Indonesia, which has no cases detected so far, lacks testing kits to rapidly detect any infections.
The Health Ministry’s chief of biomedical research centre, Dr Vivi Setiawaty said Indonesia has followed guidelines set by the World Health Organization (WHO) since late December, when the new coronavirus strain was detected.
“Ever since the outbreak occurred, the WHO has issued guidelines on how to detect the virus. The WHO issued a checklist and … (WHO) indicated that Indonesia is deemed capable of detecting the coronavirus,” she said during a Monday (Feb 3) press conference.
“We have all the equipment needed.”
Dr Setiawaty said the WHO checklist includes the acquisition of particular reagents - a substance or compound used in chemical analysis - which will react to coronavirus.
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“We have run through the checklist of what reagents we need so we can run the tests. Indonesia has acquired such reagents and we can run the tests according to the recommendations issued by WHO,” the doctor added.
Dr Setiawaty said the ministry’s laboratory is currently capable of testing up to 1,200 samples. She also said that the facility and all the workers performing the tests have received WHO certification.
“The lab has been accredited for emerging and re-emerging diseases, such as the novel coronavirus,” she said.
To minimise errors, Dr Setiawaty noted that patients are tested multiple times and results are known in two days.
She said 38 people have been tested so far in Indonesia and all tested negative.
More than 20,000 people have been infected by the virus, believed to have emerged in December from a market in the Chinese city of Wuhan. More than 400 people have died from the outbreak.
WHO has declared the flu-like virus a global emergency as the virus spread to more than 20 countries including those as far away as Finland, France, the United States and the United Kingdom.
But Indonesia, a country of 264 million people, appeared to have been spared from the outbreak, even as neighbouring countries like Singapore, Malaysia, the Philippines and Australia have confirmed cases of the coronavirus.
There are concerns on the ground over whether there may be loopholes in the Indonesian system, in terms of pandemic preparedness and virus testing.
“We hope that Indonesia continues to be free from the outbreak,” Dr Windra Waworuntu, the Indonesian Health Ministry’s director for communicable diseases told reporters at the same press conference, adding that Indonesia is ready should an outbreak occur in the country.
“We have been communicating with other institutions. We are working with hospitals. We have checked the readiness of all health workers in the country. We continuously monitor the spread of the virus. We continuously monitor the number of confirmed cases and deaths around the world,” she said.
“There are international laws which we have to adhere to. We are following WHO guidelines.”
VIRUS DETECTION PROCESS CAN TAKE AT LEAST TWO DAYS
Testing for the novel coronavirus is a tedious process.
Professor Raden Wasito, a pathologist from Yogyakarta’s Gadjah Mada University who has been studying a wide variety of coronaviruses since 1988, said the suspected virus will normally be introduced to a corresponding antibody and see if the two react.
For instance, if the virus is suspected to be Severe Acute Respiratory Syndrome (SARS), then it will be introduced to SARS antibody.
“The problem is we don’t have an antibody for Wuhan coronavirus. No country has it. It hasn’t been discovered,” Prof Wasito said.
This means that scientists around the world rely on the use of reagents and genetic sequencing to identify the novel coronavirus, a process which can take at least two days.
To do that, the DNA or RNA sample of the virus will first have to be amplified so there is a large enough amount to study, said Professor Amin Soebandrio, a microbiologist with the Eijkman Institute, one of only two facilities certified to detect emerging viruses in Indonesia.
Once millions of DNA or RNA copies are produced, they are introduced to a particular set of reagents to see if it causes a reaction, he told CNA.
This step will determine whether a virus comes from the coronavirus family, which includes SARS, MERS (Middle East Respiratory Syndrome) and viruses which only infect animals.
“There are more than 200 types of coronaviruses. If it comes out positive for coronavirus, we then need to know which type.
“And that is where the confirmation stage comes in, by looking at the genetic sequence of the virus and comparing it with the references provided by WHO,” Prof Soebandrio said.
He added that Indonesia uses the same method as the rest of the world.
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METHODS NOT FOOLPROOF
Nonetheless, Prof Wasito warned that the method currently employed is not without its flaws.
A virus needs a host to survive, and in a process which requires a virus sample to spend days inside a lab, there is a chance of its RNA falling apart.
“If the virus is dead or if its tissue is broken, the virus will produce an enzyme called RNase which destroys the RNA,” he said.
“When a virus with a damaged RNA is tested, a false positive is possible and conversely it could also lead to a false negative.”
Dr Setiawaty of the Health Ministry’s biomedical research centre said to prevent a false outcome, patients have to be tested multiple times.
“We collect samples from every patient at least twice, a day apart,” she said, adding that more tests will be conducted if the outcomes of both tests are inconsistent.
Dr Setiawaty said her laboratory is taking all the precautions needed to accurately test patients.
“We make sure that the samples don’t get contaminated. We have been working very meticulously to ensure the accuracy of our tests.”