Coronavirus: what does a 'presumptive positive' PCR test result mean?


Gillian Duncan
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The polymerase chain reaction, or PCR, test is considered to be the gold standard for a Covid-19 diagnosis.

A positive result means you probably have Covid-19, whereas a negative test means you more than likely did not have the virus at the time of testing.

But there is a third possible result: PP, or presumptive positive. But what does that mean?

The National explains.

What is a PCR test?

It seeks to detect the presence of the Sars-CoV-2 virus, which causes Covid-19.

Sample collection is done using a swab on a long stick to collect respiratory material found inside the nose.

The sample is then sealed in a tube and sent off for analysis.

What happens next?

The lab performs a procedure called extraction, where they isolate genetic material from the sample to check if any virus is present.

Special chemicals are then used to create a reaction that makes millions of copies of a portion of the Sars-Cov-2 virus’s genetic material. One chemical creates a reaction that lights up in a fluorescent colour if the virus is detected.

What does a PP, or presumptive positive, result mean?

The result is inconclusive.

"It might be positive but it needs to be repeated again in three days," said Dr Engy Iskandar, a specialist in internal medicine at Dubai's International Modern Hospital.

"In Covid-19 tests, they look for several genes. If they find only one it means it is presumptive positive and it is not confirmed yet."

Doctors said all PCR testing looks for genes specific to Covid-19, but tests could pick up those in general coronaviruses too.

"A presumptive positive result indicates that not all genes were detected," said Dr Heba Sami, head of laboratory and consultant clinical pathologist at Saudi German Hospital, Ajman.

Once the presumptive positive result is obtained, the patient should self-quarantine and repeat the test within 72 hours

Perhaps genes specific to general coronaviruses were detected only. But it could alternatively indicate a low viral load, doctors said.

“As per National Crisis and Emergency Management Authority (NCEMA) guidelines provided by Dubai Health Authority, presumptive positive means only one of the multiple genes is isolated, or a low viral load is possible,” said Dr Surbhi Gupta, a specialist in clinical pathology at NMC Royal Hospital in Dubai.

At any event, anyone who receives this result should immediately begin quarantining and repeat the test in three days.

“Once the presumptive positive result is obtained, the patient should self-quarantine and repeat the test within 72 hours," Dr Gupta said.

Do all laboratories have the capacity to detect this result?

Yes, all testing facilities must be able to detect this.

“All testing laboratories have to provide it. It is part of NCEMA guidelines,” Dr Gupta said.

Is it common?

No. Laboratories say the result only accounts for a tiny percentage of samples.

“Based on the testing in our lab, the presumptive positive rate is 0.24 per cent,” Dr Gupta said.

Door to door with Abu Dhabi's testing squad 

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- Abdullah Ishnaneh, Partner, BSA Law 

Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

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Ms Davison came to Dubai from Kerala after her marriage in 1996 when she was 21-years-old

Since 2001, Ms Davison has worked at many affordable schools such as Our Own English High School in Sharjah, and The Apple International School and Amled School in Dubai

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Founders: Mike Dawson, Varuna Singh, and Benita Rowe

Based: Dubai

Sector: Education technology

Size: Five employees

Investment: $100,000 from the ExpoLive Innovation Grant programme in 2018 and an initial $30,000 pre-seed investment from the Turn8 Accelerator in 2014. Most of the projects are government funded.

Partners/incubators: Turn8 Accelerator; In5 Innovation Centre; Expo Live Innovation Impact Grant Programme; Dubai Future Accelerators; FHI 360; VSO and Consult and Coach for a Cause (C3)

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