New normal

It’s the day after Easter. But it is just another day at home contemplating at least another two weeks of enhanced community quarantine.

After digesting everything I have read and heard from many sources about this coronavirus pandemic, I am ready to accept a new normal. For seniors like me, we most likely won’t be able to go out of our homes in the foreseeable future.

Listening to the scientists, it seems this coronavirus will be around for a while. Until we get a good vaccine, I will probably never be able to get out of the house without being somewhat paranoid.

For sure I will be wearing a mask for a long while and will have to treat everyone like a potential carrier. Everyone will probably think of me the same way.

Physical distancing will be the norm. No more shaking of hands, beso beso or hugging. No parties. No conferences. Limited travel, if at all.

 Our officials tell us they need two more weeks of lockdown… They need to do a more widespread testing because we do not know the infection rate in our population. We do not know the infection rate among age, socio-economic and other demographic groups.

But testing means different things to different people. Some doctors, including the Secretary of Health, insist we should only do the gold standard of testing… one that looks for traces of the RNA of the virus from nasal and throat swabs. That takes time, is expensive, and for the longest time we didn’t have enough test kits.

This gold standard test is useful for doctors who want to know if a patient is infected so they will know what course of treatment to take. The patient could just have ordinary flu and not require isolation.

Insisting on doing this kind of test alone, as Sec  Francisco Duque did, and to cover only those who are sick or probably infected is not enough. We need to see the big picture… how widespread the virus is in the community and where the infection hot spots are.

Our crisis managers, like General Carlito Galvez, needs such information to decide on whether a lockdown should cover everyone or just segments of the population… whether schools and some more businesses can reopen… how many more additional hospital beds, PPEs and respirators will be needed, where and when.

 We need the medical equivalent of an opinion poll… a random sampling of people that reflects the general population… but instead of their opinions being asked, their blood samples would instead be taken to be tested for presence of antibodies to the coronavirus.

That would let us know the extent of infection in the population and the hotspots, how many in the population carry the antibodies. We want to know who the vulnerable people are.

Mass scientific testing will deliver data needed to help General Galvez make informed decisions. Remember that his mandate is to protect the population from the virus, while minimizing adverse economic impact for the nation. Otherwise, decisions will be made blindly.

Let us be clear. It is not one test or the other. We need these two tests for different purposes.

We need the gold standard test that DOH prefers to help doctors manage patients. We need the quick mass testing for antibodies to help General Galvez and IATF make decisions that affect non-medical aspects of national life impacted by the virus.

Right now, when the IATF says they need two more weeks of enhanced community quarantine, I hope they will use the time to do the testing we just described. Otherwise the next two weeks will be wasted. A decision to continue the lockout needs data only mass testing for antibodies can deliver.

Why? Because if we knew for example that Payatas is a hot spot, resources can be directed to that area to respond to the localized epidemic. Lockdowns can be localized so as not to paralyze the entire economy.

I was listening to an interview of a Stanford professor of medicine who also happens to have a PhD in economics. He thinks the drastic decisions now being made by governments have no scientific basis.

Dr. Jay Bhattacharya also wrote an article in the Wall Street Journal questioning the premise that “coronavirus would kill millions without shelter-in-place orders and quarantines.” In the article he suggests that “there’s little evidence to confirm that premise—and projections of the death toll could plausibly be orders of magnitude too high.”

He thinks the epidemiological models we are being presented are really just guessing how lethal this virus is in the absence of reliable data. We know how many people died, how many people were tested (documented infection). But we have not counted people who were infected, but have recovered.

Many people infected with the virus show little or no symptoms, they may think they just have a common cold and not seek medical attention, but they are already carriers of the virus. Mass testing may show how many they are.

As Dr Bhattacharya pointed out, universal quarantine is costly and is right now based on a guess. The choice, he said, is not dollars or life but life, or life because an economic collapse can also trigger a lot of deaths.

In the new normal, we should plan to do regular random tests the way Pulse Asia and SWS conduct their polls. LGUs should do these random tests and not depend on DOH so they can manage outbreaks better. Because this virus is said to likely be with us for a long time, we need to know where hot spots are developing.

In the US, the development of a comprehensive antibody testing system is the next phase of their efforts to reopen the country. It should be ours too.

Dr Anthony Fauci, the top US health official directing the response to the virus said:

“As we look forward, as we get to the point of at least considering opening up the country, as it were, it’s very important to appreciate and to understand how much that virus has penetrated the society.”

That’s one doctor who has a total view of the situation.

Our decision makers should listen to this Stanford professor to get another important perspective of their jobs.

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