In pursuit of expanding the country’s testing capacity and ensuring immediate and efficient implementation of PDITR strategies, the Department of Health (DOH) has issued Department Memorandum (DM) No. 2021-0161 detailing guidelines on the use and administration of Saliva-based Reverse Transcription Polymerase Chain Reaction (RT-PCR) testing.

Under the DM No. 2021-0161, only licensed COVID-19 laboratories certified by the Research Institute for Tropical Medicine (RITM) are allowed to perform saliva-based RT-PCR. Furthermore, point-of-care clinics, specimen collecting facilities, and disease reporting units can perform saliva specimen collection, provided that the specimen collectors have undergone training from the referral licensed COVID-19 laboratory certified to perform saliva testing. Additionally, said laboratories or facilities may only use test kits which have passed the performance validation conducted by the RITM or other RITM-recognized laboratories, and have a special certification from the Food and Drug Administration.

Moreover, DOH reiterates that only trained saliva specimen collectors should administer the test and only medical doctors should interpret the results of these tests as results need to be correlated with the overall clinical and epidemiological context of the patient.

DOH also maintains that nasopharyngeal and oropharyngeal swab specimens remain as the standard specimen for the diagnosis of COVID-19 through RT-PCR testing. The conduct of saliva tests should only be done on certain conditions and are deemed valid when such conditions are met. As stipulated in the guidelines, morning saliva is preferred as specimen due to higher viral load but this should not prevent specimen collection at any other time. Proper collection procedure should also be strictly observed where patients should not eat, drink, brush their teeth, use mouthwash or smoke for at least 30 minutes before sample collection.