POSTSCRIPT / May 19, 2020 / Tuesday

By FEDERICO D. PASCUAL JR.

Philippine STAR Columnist

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Mass testing isn’t just about numbers

HOW many random people must be checked for infection to achieve the “mass testing” being demanded by those growing impatient with the government’s laggard response to the spread of the coronavirus disease (Covid-19)?

The success of mass testing does not lie in rounding up a big number of people. If numbers were the only object, the police could just corral residents of contiguous thickly populated barangays and line up everybody for testing.

Coercive mass testing will not help us realize the finer points of ferreting out infected individuals for treatment, the tracing of those they had come in contact with, and preventing their becoming unwitting carriers.

But while the police and health personnel are engrossed in a selected target area for mass testing, what happens to other Covid-threatened places? Constrained by limited resources, testing teams cannot be sent everywhere.

Mass testing is not just the accumulation of names and numbers to achieve the desired “mass.” The test of the testing is in the wise selection of the target areas based on reported coronavirus breakouts, the population mix, density and other quantitative and qualitative criteria.

The pandemic teams chasing the coronavirus will strive to overtake it, pinpoint its location and drift, surround it and cut off its potential carriers. Data analysts will attempt to measure the elusive virus’ speed and direction.

The last time we heard officials explaining the valiant efforts of public health front liners, they were talking of aiming for a minimum of 30,000 tests per day, but that they have been able to do fewer than 15,000 each day, or only half of the goal.

We got the impression that that low performance is due to the limited number of test kits, trained personnel, and funds. It has been more than three months since the virus took down its first local victim yet we have not been able to fix those shortcomings.

As of April 14, the Department of Health had been able to conduct only 3,000 tests a day and was hoping for 8,000-10,000 by end of April. Some things are slowing them down.

Meantime, look at these worldOmeter data as of May 17, 15:24 GMT:

Country           Tests/M pop   Total Deaths   Deaths/M pop

*US                  36,311 tests    90,198             273
*Japan             1,900 tests      725                  6
*S. Korea         14,584 tests    262                  5
*China             (no data)         4,633               3
*Taiwan          2,906 tests      7                      0.3
*Hong Kong    22,470 tests    4                      0.5
*Singapore      42,133 tests    22                    4
*Indonesia      688 tests         1,148               4
*Philippines    1,966 tests      824                  8
*Malaysia        13,718 tests    113                  3
*Vietnam        2,828 tests      0                      0

(Updates at https://tinyurl.com/uydo7g3)

The ideal number of people to test is said to be 1,000 for every Covid case. Vietnam is close to that, doing 860 tests per case, or 275,000 tests to its 320 cases. That explains partly why only 288 persons in its 97,229,451 population have contracted the diseases and not one has died.

Compare Vietnam’s 860 tests per case to those of the US, 7.69 tests for every case; Philippines, 17.18; Hong Kong, 159.36; Taiwan, 157.28; South Korea, 67.66; Malaysia, 64.29; Japan, 14.72; Indonesia, 10.73; and Singapore, 8.78 tests per case.

The US has done 11,714,389 tests, or just 3.02 percent of its 330,764,077 population. That breaks down to 35,416 tests per one million of its population. The world’s greatest power sits uneasily at the very top of the chart with 1,523,544 cases and 90,889 deaths as of yesterday.

The Philippines is testing only 17 persons per case. Countries that test more persons, whether symptomatic or not, generally have a more systematic anti-Covid campaign and fewer deaths in proportion to their population (although there are other factors affecting the figures).

In the worldOmeter tabulation, part of which we run above, we picked the number of deaths and tests PER MILLION population to minimize possible distortion that population size might create. Errors or misrepresentations also occur when data is manipulated before submission.

As of May 15, there were 30 licensed laboratories in the Philippines equipped to perform the RT-PCR test while five laboratories were licensed to do testing using GeneXpert cartridges. Antigen test kits & PCR kits compared: https://tinyurl.com/y9swedr5

The DoH reported a total of 12,513 cases and 824 deaths on May 17. At the desired ratio of 1,000 tests for each case, there should be some 12 million ongoing tests. Averaging P3,500 per test kit (locally made), the testing campaign would entail P42 billion. The total cost will go even higher if some of the kits will be imported (unit price is reportedly P8,500).

We’re just talking of the cost of the test kits and add-ons. There will be concomitant expenses for logistics, training of the army of testers in the field, each of whom will need equipment and protective gear.

This is another time when we hope that President Duterte was right when he said in March or thereabouts that the coronavirus, if he had not urinated on it yet, would just go away like other viruses.

The President, who has been talking to his best friend in China, sounded optimistic when he mentioned that a vaccine would soon be developed and that he has been assured by his friend the Philippines would get some of the supply despite the expected heavy demand from all over the pandemic world.

Duterte did not say, however, how much the vaccine would cost Filipinos. Remember, there’s no such thing as a free Chinese lauriat.

* * *

(First published in the Philippine STAR of May 19, 2020)

Dear Sir Pascual, One big problem I see with testing followed by confinement and treatment when found positive is, What if the person has a natural ability to fend of the virus & develop natural immunity? The treatment will be a waste of meager resources (especially if most infected cases have that ability). The better alternative is not immediate confinement & treatment but a follow-up determination of whether there are pre-existing medical conditions (such as diabetes, obesity, hypertension, cancer, emphysema, COPD, etc & especially if there are maintenance medications). Pre-existing medical conditions (& especially taking maintenance medications) have, time & again, proven to be almost certain death, but not with cases of "perfect" health. Moreover, more & more findings are emerging showing the efficacy of sun exposure (but during times when your shadow is more than half of your height) and IV vitamin C infusion. I sun everyday & eat lots of fruits. Finally, the average death rate (from the Phil Stat Authority) since 2017 is 64-66 deaths hourly. Compute the hourly CoViD-19 deaths since the 1st case & you will see the impact is minimal to negligible — hardly a dent on our hourly death rate. As always, stay safe, hand wash frequently and thoroughly, avoid touching eyes (by wearing non-prescription eye glasses or goggles or a face shield), take care, and God bless us all (no exceptions)

Edgar

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