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Monday, May 11, 2020

Solon bats for test, trace approach for Covid-19 management

ALBAY REP. . Joey Salceda, chairman of the House's Ways and Means Committee, said Monday the test, trace, isolate and treat approach is critical as the country considers the possibility of easing its strict quarantine restrictions.   

In a 70-page report to President Rodrigo Duterte, Salceda said “exhaustive” tracing and quick turnaround testing would have a more positive impact in reducing the spread of the coronavirus disease (Covid-19) than mobility factors, such as another extension of the enhanced community quarantine (ECQ).
Salceda said that the ECQ over areas with a high chance of outbreak served to buy the country “invaluable time” to boost its healthcare capacity, change its social behavior, and arrest the growth of infections until testing capabilities were developed.
“We can justifiably say that the country is now better prepared for the consequences of general quarantine with better testing and tracing than it is for the impacts of more extensions of enhanced community quarantine on economic ecosystems,” Salceda said.
“We need tools other than ECQ extensions. We need to really be exhaustive with testing and tracing. The national strategy has to shift to one where we leave no stone unturned when it comes to testing and tracing,” he added.
He stressed that the tradeoffs, at this stage, point to a shift to a general community quarantine (GCQ), given that lockdown extensions without a comprehensive plan moving forward will cause “very deep cuts” in the economy.
“By exhaustive, I mean to say, find every positive case actively. Test every possible contact. And then find the positives among the contacts. And the trace. Ad infinitum. Until isolation of hypothetical cases exceeds 90 percent,” he said.
He said the modeling study shows that a 50-percent reduction in mobility and a 90-percent isolation tendency for the infected yields the highest impact.
“It’s likely that we reduced mobility in the workplace by as much as 70 percent during ECQ and as much as 80 percent in transport. We can adjust up, so that reduction only becomes 50 percent, provided we can keep isolation tendency at 90 percent,” Salceda said.
He noted that the most important figure is the number of tests per case, citing that the top countries that handled the pandemic well were those that conducted the highest number of tests per case.
Salceda said the country may need to perform around 48,000 tests per day or at least 1.4 million tests over the next 30 days to actively seek cases.
“To be very effective in isolating all cases, we must begin actively finding where the cases are, as opposed to waiting for the symptomatic to suspect infection and report themselves, when self-reporting has become less likely no thanks to widespread stigmatization of Covid-19 suspects,” he said.
“Our estimates indicate that the best regime is a reduction in mobility and an increase in isolation to near 100 percent levels will decisively flatten the infection curve,” Salceda added.
Salceda pushed for a “systems-based” approach as opposed to “relying on individuals to behave well or communities to be able to contain the pandemic on their own.”
“You need significant investments in good systems: transport, healthcare, labor, and communications. The whole shift to ‘a new normal’, with the expectation that people will behave well, shifts the burden of defeating the disease on individuals,” he said.
“That approach may work on lifestyle diseases. It will not work on a pandemic. As is obvious in the international comparatives, Covid-19 spares countries with good systems,” he added.


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