As those of you who read my blog a long six days ago will know, I was, and remain, deeply concerned about how our government, and others across Europe, have been handling the pandemic – and the truly horrendous collateral damage that will be caused by their policies of containment. Not that, given where they started, they could probably have done much else than at least try to enforce a global lockdown – but, why, oh why, did we have to start from there?…
Check in to Taiwan
In 2003 Taiwan suffered a severe outbreak of SARS (Severe Acute Respiratory Syndrome) – a not dissimilar condition to the current COVID-19 outbreak. In its aftermath Taiwan examined what had happened and established a rigorous protocol to manage any future similar outbreak: massive data collection based on very wide spread monitoring of temperature and testing of anyone with a raised temperature, all but universal allocation of face masks, strict and clear guidelines on travel, school attendance etc etc. At the first appearance of the COVID epidemic in Wuhan, all of this clicked into place.
As of yesterday, according to this interesting article in the I from an English woman living in Taiwan, there had only been 135 cases of the virus in the country and 2 fatalities – despite the fact that Taiwan is only 2,000 km from China – approximately the same distance as we are from Italy. Meanwhile, everyone is still at work and there has been no ‘lockdown’ or ‘social distancing’.
So if Taiwan had found a way to control the virus, why were other countries not doing the same?
International power games
Because in international fora, China has brought pressure to bear to exclude Taiwan from WHO technical working bodies and discussions on influenza vaccines. So although willing to do so, Taiwan had been unable to share its practical experiences and know how on dealing with respiratory epidemics. For more detail see this article in Time Magazine.
Testing, testing, testing…
Within Taiwan’s various protocols, rigorous and wide spread testing not only of those suspected of having the virus but of the wider population who might be harboring it but be a-symptomatic, seems to have been crucial. And that testing is indeed the key to control would be suggested by the experience of Vò, a small town of 3,000 inhabitants near Venice.
Italy’s first death from COVID-19 was in Vò. The authorities were so distressed by this that the whole town was quarantined and everyone, whether or not they showed signs of illness, was tested. The tests were processed at the University of Padua and it was realised that this was the perfect research situation. So they kept the town in lockdown and tested everyone again 9 days later. Whereas 89 people had tested positive in round one, only six did in round two and they were kept in isolation. All of them have now recovered.
‘We made an interesting finding.’ say researchers at Padua University in an article in yesterday’s Guardian. ‘At the time the first symptomatic case was diagnosed, a significant proportion of the population, about 3%, had already been infected – yet most of them were completely asymptomatic. Our study established a valuable principle: testing of all citizens, whether or not they have symptoms, provides a way to control this pandemic.’
Testing in the UK
So what testing are we doing in the UK? Virtually none.
Yes, the government say that they are now ramping testing up and hope to have 25,000 tests available very soon – but the first case of COVID-19 was diagnosed on the 31st January and we are now the 21st March. Two months later.
The result is that, unlike in Taiwan where they have detailed records of every incidence of the disease – we basically haven’t a clue. If you think you have the disease you are told to stay at home, self isolate and not clutter up the health service by asking for a test.
As as result, not only could we be grossly under, or indeed grossly overestimating the incidence, but hideous waste of valuable personnel occurs. For example, the two year old in a family where both parents are medics had a high temperature last night. Two year olds often get high temperatures and, predictably, he was fine by this morning. But because he had a temperature both of his parents have to self isolate (and not go to work in our overstretched health service) for two weeks. Why? Because they cannot get him tested to see whether he actually had the virus (very unlikely as he recovered so quickly) or merely a standard two year old’s occasional raised temperature.
What reliance on the figures or the science
I am certainly not a statistician or a scientist so am in no position to evaluate either.
However, I was interested in an article on the BBC News pages this morning by health correspondent Nick Triggle. Not only was he raising the issue of the collateral damage that the lockdown could be doing not just to social well being but to health, but he was also questioning the figures being quoted by government to justify the lock down.
I was also interested in a YouTube video that Sally (of Curlew Books) sent me from a German doctor who is asking whether we have properly evaluated how dangerous this virus actually is.
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