The Sunday Express editorial’s call for a Covid-19 strategy review, although long in coming, is most welcome. Last Saturday’s news conference did little to stem creeping public scepticism that the decision-makers have a clear vision on how to address this “resurgence” of the deadly virus.

The PM, perhaps reflecting on the socioeconomic and social impacts of the earlier lockdown, responded to a reporter’s question by flatly rejecting this suggestion as the next step if the month-old public health measures reinforced by hefty fines did not stem the rising tide of active cases and deaths.

Equally disturbing was the inability of the very knowledgeable Ministry of Health epidemiologist to indicate how well and how soon strategies minted 28 days ago would be seen to be working.

My suggestion is that the Government’s real need is to rebuild the public trust by responding to the grassroots realities with openness and reflexivity; in short, with transparency.

We must all understand the difference between “Covid-19 ­infection” and “­Covid-19 infectiousness”. Viruses thrive and survive by copying themselves.

A recent report by the Center of Evidence-Based Medicine posits that those with 10,000 copies of the virus detected in their airways are unlikely to spread the virus, even with sustained contact (according to their models, transmission would occur about 0.002 per cent of the time). Once the viral load climbs to ten million copies, there is a 40-per cent chance of transmission to a close contact; and about an 80-per cent chance at 100 million viral copies. Some may remain asymptomatic even at elevated levels.

By the time someone has had Covid-19 for several days—say, the six to eight days it takes to receive the results of a PCR test—the viral load has likely waned in his/her airways, to the point of being less transmissible. PCR testing recognises viral loads at all levels. Health Ministry technocrats are attuned to the life cycle of Covid-19, hence the new policy that those testing PCR-positive, with minimal or no symptoms, can quarantine at home for two to three weeks, then go back to work without a re-test.

The downside is that in the interval between testing and receiving results, these persons may be super-spreading infections before infectiousness wanes.

The need is for a test that identifies infectiousness. Such a test already exists—the ­rapid antigen test, which produces a result in 15 minutes or less at minimal cost (under US$5 per test).

Kenwyn Nicholls

via e-mail


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