"The lockdown helps, sure, but how many have already been infected because we did not test earlier?"
It could, and would likely grow much more, and much faster, in the days to come. I refer to the extent of the COVID-19 epidemic as it affects the Philippines.
I write this at 9:00 am of Tuesday, the 24th of March. Thirty days before, on February 25, in fact not until March 5, did our health officials confirm that the number 3 had become 5, with one death, that of a foreigner, confirmed.
Looking further back, on January 30, our health officials announced the first case of the then unofficially named viral disease. By March 7, there was a sixth case; the following day, there were four more cases, and then 10, then 11 more, then 16 more—in daily cadence.
On March 12, government declared an NCR-wide lockdown, after 52 cases were confirmed officially. By the night of March 17, it was a Luzon-wide lockdown, with evidence of widespread community transmission (187 cases) which was unknown and undetected (at least officially) from January 30 to the middle of March.
Government had to take the extreme measure because our health officials, clearly, did not know the extent of the contagion. The only solution left was to lock everybody down in their homes to prevent the further spread of the disease.
That was just a week ago. Now we have 552 cases, with 35 deaths, including medical professionals.
Because doctors continue to serve the sick, having taken the Oath of Hippocrates, they and their assists, nurses and other health workers, have now been exposed to extreme danger of contagion. In fact, as we write, at least three of them have died. Others are confined because they had become victims of the COVID as well.
We grieve for them, and we worry for the state of the rest of them, because we cannot fathom the end of this, and we realize that our health system is breaking at the seams, our health officials themselves seemingly paralyzed by doubts on how to act and act quickly.
The medical situation is severe. Hospitals have raised the alarm about the abject lack of test kits and personal protective equipment, about the lack of hospital beds and ventilators, about the physical fatigue of heroic workers continuing to do their best under almost impossible, and surely unhealthy conditions.
Yet for months since January 30, the DOH only had 2,000 test kits, and only the other day did our DFA Secretary profusely thank China after posing with its envoy when a hundred thousand test kits arrived at the international airport.
So now we have more test kits, but whether they are enough or not is a question less difficult to answer than whether we can ramp up our testing protocols enough to contain what has already become un-containable. The lockdown helps, sure, but how many have already been infected because we did not test earlier?
Sure, other nations did not see it coming. The President of the United States of America was lying through his teeth for a month or more, assuring his people they were “immune enough” to the “Chinese virus.” Now, the biggest state with 40 million souls, California, where a million Filipinos reside, has been locked down. And New York City, the “capital of the world.”
Even the head of the World Health Organization, Tedros Ghebreyesus, did not push the pandemic button until the 11th of March. And thereafter admonish the nations by then reeling under the uncontrolled contagion, to “test, test, test.”
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Zhong Nanshan, a noted Chinese specialist, said that “if preventive measures had been taken in December or January, the pandemic would be much smaller.”
A University of Southampton (UK) study showed that if interventions had been conducted a week, two weeks, or three weeks earlier, cases “could have been reduced by 66 percent, 86 percent, and 95 percent, respectively, significantly limiting the geographical spread of the disease”.
But there is little use crying over present realities because of past inaction. What matters now is what could be done; what should be done. And quickly.
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“I wish to reiterate that we do not have any confirmed case of the COVID-19 in the country as of the moment. But I need to mention this time and again, it’s perhaps not a question of if but rather a question of when. So that’s why we cannot afford to let our guards down despite the fact that we still don’t have local transmission, and in fact, all three cases have been clearly established to be imported ones,” Secretary Francisco Duque told reporters during the “Laging Handa” press briefing in Malacañang Palace.
That was a month and a half ago.
Now let me quote excerpts from an article published by the world-renowned California Institute of Technology on March 20, 2020, quoting Caltech trustee David Ho of the Aaron Diamond AIDS Research Center, Columbia University, an expert on viral epidemics. It is particularly useful now that the numbers being reported about the spread of the viral disease have risen exponentially.
Q: “What are the tests we need to detect coronavirus infection?”
A: “Everybody’s talking about testing that’s actually referring to PCR (polymerase chain reaction), looking for viral RNA to determine whether a person is infected. But there’s still no talk of antibody testing to determine which people have had it and are immune, and that is another crucial tool we need to combat the epidemic.”
Q: “How long before the U.S. sees test availability similar to what South Korea has implemented?”
A: “The PCR testing, which is the one that is approved…has a turn-around time of typically 72 hours (more in the Philippines, btw, with politically privileged persons interfering). In that period, it’s very, very hard to manage patients and their contacts. It’s a nightmare for health workers.
“We need point of care tests. Those kinds of tests are available for HIV and many other diseases: you use a finger-stick, drop the blood on a small device, and have a read-out in 15 minutes. These tests measure antibody response to the virus and are extremely useful.
“In China, South Korea and in Europe, those tests are used. The manufacturers for this rapid test are producing a million (test kits) a day. It’s there, but in the name of protecting the public, the FDA (U.S.) has moved very, very slowly. That delay, in my view, has caused more harm than good.”
Q: “Can you elaborate on point-of-care testing?”
A: “It’s almost like a home pregnancy test … The test that I’m specifically referring to, coming out of China, South Korea and approved in Europe, is an antibody test.
“You put a drop of blood on a plastic slide, add another drop of the buffer that comes with the test kit, and you let it sit for 15 minutes. Then you look at the bands. You’re negative if you have just one band, or you’re positive if you have more than one band. The test also tells you the type of antibody.
“This kind of test is available all over the world for HIV. The technology is there, the tests are there. But they are not (US) FDA approved. While I think they are fairly close to getting approved, we have let several weeks go by and to me that’s tragic.”
Postscript: It is now 10:11 a.m. as I end this article. The latest report states there are officially, now 552 positive for COVID-19.