Life and death in COVID time
FROM A DISTANCE - Carmen N. Pedrosa (The Philippine Star) - September 13, 2020 - 12:00am

All of us live and die in time. Although we are focused on the COVID-19 pandemic today and watch for data on how many have recovered and how many have died from the virus, the pandemic has made us more conscious of death and ironically also of life.

But statistics from world health groups tell a different story. There were  56.9 million deaths worldwide in 2016, more than half (54 percent) of which were due to known causes that have affected human beings.

Ischaemic heart disease and stroke are the world’s biggest killers, accounting for a combined 15.2 million deaths in 2016. These diseases have remained the leading causes of death globally in the last 15 years. How many of us have been surprised by the death of someone who looked healthy and active one day only to die a few hours later. The human body is fragile and longer life spans unpredictable.

Still we look at countries with life styles that prolong life. Living to 83 on average, the Japanese have long had one of the highest life expectancies. Okinawa, often called the “land of immortals,” has been a global center for longevity research, as these southern Japanese islands have more than 400 centenarians. Much credit for this has been given to the local diet, which includes plentiful tofu and sweet potato, and a small amount of fish. Active social circles among older residents and a strong community also contribute to lower levels of stress and a strong sense of belonging.

To reap these benefits, learning the language as an expat is critical, said Daniele Gatti, CEO of Velvet Media and long-time Japan resident.

“Japan has an amazing quality of life if you can get past the language hurdle to better understand the mentality” – which is more different from Western culture than most visitors think, he added. “Expats willing to move here should think seriously about putting a major time allocation into learning the language. It’s key to integrating deeper in the local society and living a full and meaningful life.”

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Should we aim for more tests under unsatisfactory conditions? Laboratory tests used for COVID-19 can be unreliable, although these are made compulsory for returning OFWs.

Can we trust the accuracy of lab test results? This has never been more true than it is now, given the attention on COVID-19 testing and its role in helping to halt the spread of the viral disease.

“As with all lab tests, a number of factors determine the accuracy of a COVID-19 test result. These include not only the instrument and chemical reagents used to perform the test, but also the timing and quality of specimen collection and the biology of the individual patient.”

That is why compulsory tests for a large group of individuals can be less accurate.

These numbers, however, are accurate under ideal conditions in which specimens have been collected from patients with either high viral loads or a complete absence of exposure.

Sensitivity and specificity under real-world conditions, in which patients are more variable and specimen collection may not be ideal, can often be lower than reported numbers. So numbers as published in news reports must consider these limitations.

Finally, there is early but inconclusive evidence that children and some individuals with mild or asymptomatic SARS-CoV-2 infections may be less likely to develop detectable antibodies.

Viruses were not known in the past, even by medical experts. It is now known as a microorganism that is smaller than a bacterium that cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself.

Because they detect molecules that are specific to SARS-CoV-2, the specificity of nucleic acid tests for COVID-19 is very high, meaning that a positive result can generally be trusted.

“The COVID-19 testing in the Philippines became a controversy when government officials were tested for COVID-19 in the first months of the pandemic in the country.

This violated the triage algorithm used by the Department of Health (DOH), which said that asymptomatic patients should not be tested, and should instead undergo a 14-day home quarantine. It was the “me first” mentality in practice.

By March 24, 2020, the Philippines had only tested 1,793 people because of the lack of testing kits. In some instances, the controversy involved family or staff members of these government officials, who had reportedly also gotten testing in violation of the algorithm.

Public officials receiving quick results on their tests was perceived to be tantamount to receiving priority treatment as numerous people considered as actual patients under investigation – many of whom were frontliners – were dying before their test results were out.

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