Test, isolate, trace

To make this drastic one-month 24/7 lockdown effective in limiting the increase of coronavirus disease 2019 or COVID-2019 cases, DOH must test more people. People with full blown symptoms have been sent home because hospitals cannot handle them and they also have no test kits.

At the very least, patients with symptoms of the disease should be tested and isolated right away. Otherwise, they will just infect their families, neighbors and their community. Test. Isolate. Trace.

Quezon City has declared a lockdown in a number of heavily populated barangays with essentially informal settlers because they have a number of identified cases. But our national numbers have not gone up significantly because those cases have not been tested.

Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, called for urgent action to ramp up efforts to identify, isolate and trace people they were in contact with.

Testing all suspected cases is a vital part of understanding the scale of the outbreak, how it is evolving and where the hotspots are.

“We have a simple message for all countries: test, test, test.” That is the backbone of the response, the WHO head emphasized.

“Test every suspected case, if they test positive, isolate them and find out who they have been in contact with two days before they developed symptoms and test those people, too,” he said.

Large-scale testing allows health services to quickly identify who have the disease and arrange for them to receive the care needed. Isolating known cases prevents them from infecting others. This slows the rate of transmission.

The World Economic Forum (WEF) observed that “effective testing programs allow governments and health authorities to understand how prevalent the disease is and how it is evolving. Tracking positive test results helps authorities make evidence-based decisions to slow the spread of the disease.”

Right now, our health officials are merely guessing because without testing, they are managing the epidemic blindly. We may be wasting our sacrifices in this lockdown.

Yet, DOH said last Friday there is no need for mass testing for COVID-19 for the meantime. They are saying that only because they do not have enough test kits.

The Chinese test kits only arrived early last Saturday. But we need more… a lot more.

As one observer noted: “We need to ramp up testing, do aggressive tracing of clusters, warning people exposed to clusters. We also need testing to verify if the current strategy is working. Otherwise, we are simply flying blind with this very socially and economically costly quarantine.”

Indeed, among the first groups of people we ought to test are the Chinese workers of POGO. This is not being sinophobic. A good number of them still poured into the country in January when the Wuhan crisis was full blown.

POGO workers are packed like sardines in small condo spaces. This virus is probably having a holiday and we do not even know or care.

We should take our lesson from Italy. The Heneral Lunacy blog recalls that there has been a large influx of Chinese immigrants to Lombardy, principally to the city of Prato, in the vicinity of Milan.

“Today, Prato has the second largest population of Chinese in Europe after Paris. Legal Chinese comprise 10 percent of the 200,000 population of Prato, 20 percent if you include the illegals. There are direct flights to China.

“Why is this relevant to the hunt for COVID-19 and for the Philippines?

“There is clearly a statistical correlation between the number of COVID-19 cases in northern Italy and the number of Chinese living there. In the Philippines there are reportedly around 200,000 POGOs mainly in the NCR, or five times the number of Chinese in Prato.

“If the correlation holds, we are in for a COVID-19 surprise: If we extrapolate the Italian numbers, the Philippines could see COVID-19 cases spike from 140 today to 20,000 and deaths rise to 4,000.

“These seem highly improbable surges -and well they might be- but not if you believe as I do the current numbers are significantly under reported for lack of testing. Remember the government reported only 10 cases just two weeks ago, now they are at 140, a 14 fold increase.

“Again, would the government have taken the extraordinary step of locking down 48.5 million Filipinos in Luzon if cases were as low as reported? Do the authorities know something we do not?

“If POGOs are a potential source of COVID-19 why are there no reported POGO infections and deaths in Manila?

“This may be because: 1) There is a shortage of testing in general. 2) The POGOs are young. They may have the symptoms (and are therefore carriers), but survive them because of their age. And 3) The POGOs deaths are unreported.

“Which brings me to my point: We can track the COVID-19 in the Philippines haphazardly and simply react when isolated cases emerge (by which time it is probably too late), or we can do so pro-actively, target focus and get ahead of the curve.

“We need to identify which population segments have the highest probability of contagion given their provenance and travel history, isolate and test them. We do so already for travelers from high risk nations and cruise ships, so why not do it for POGOs? It is not racial profiling nor discriminatory. It is just good risk management, a more efficient way of using scarce resources in an unknown environment.

“We have banned entry for other Chinese nationals so the Chinese government should not be offended. The testing should be a condition for POGO work visa.

“Tracking the COVID-19 epidemic is a difficult, expensive and time-consuming exercise. We have neither the money nor, more critically, the time to do so. We are on the clock. To succeed we must work harder, but more important, we must work smarter. So let us get on with it.”

Boo Chanco’s e-mail address is [email protected] Follow him on Twitter @boochanco