Will you be alive by the time the vaccine gets here?

Sep 05, 2020 Features / Columnists, Peeping Tom

The results of 500 COVID-19 test results were expected to be returned yesterday from the Caribbean Public Health Agency (CARPHA) which operates a reference laboratory. Those results will give a better idea of the magnitude of the crisis facing the country.
It was unfortunate that the former government did not make use of this laboratory as a means of boosting its testing capacity. This oversight is one of the many inexplicable decisions of the former administration and someone should answer, on their behalf, why more tests were not done and why greater use was not made of CARPHA.
Low levels of testing were always going to backfire. Low levels of testing underestimate the infectious threat. When coupled with limited contact-tracing, low levels of testing allow the exponential spread of the disease, which is what we are now witnessing.
Regardless of the situation which the new government inherited, it is its responsibility to bend the curve to the right by reducing the infection rate. The number of deaths also needs to be addressed because, regardless of the spread, the number of deaths locally represents an outlier.
The government was not quickly up to speed. The promised holistic strategy took too long to be unrolled and when it did, it had lots of ‘holes’. The logjam of tests which has resulted should have been avoided since this contributes to higher deaths. International medical help, from countries such as Cuba, should have already been sourced since there is a lack of sufficiently trained medical personnel. And we are yet to learn about the regional strategies. It has been acknowledged that a one-size-fits-all approach will not work in Guyana given the high incidence of the disease in some Regions.
Region 4 has now reassumed its place as the epicenter of the local epidemic. As Guyana’s most populous region, the virus’ impact is going to be most severe in this Region.
The return of the 500 samples from CARPHA will most likely lead to a significant rise in the number of confirmed positive cases, including that for Region 4. This is to be expected with such a large block of samples. But it can also be useful in another regard.
The number of tests sent to CARPHA may not be representative of the national incidence of the infection. But the results of the testing can provide a general idea of this incidence. The numbers may come back on the high side since more symptomatic cases would be tested than is usual in such a large sample. But that can be offset by the equally large number of asymptomatic persons out there who may not know that they are infected.
If for example, 20% of the samples return positive, this would provide the Ministry with an idea that perhaps the country may have as many as 150,000 positive cases. And they should start planning for responding to such a figure.
Early during the pandemic, a random sampling of persons in New York State was done. And it found that the incidence was slightly less than 20%. New York State has since made a remarkable recovery. The State only had seven deaths on Thursday compared to more than 167, 152 and 189 in California, Florida and Texas respectively. New York registered less than half of a million infected cases, compared to California which has more than 700,000 and Texas 655,000 and Florida 637,000. But New York State has had the highest number of deaths – more than 33,000 – compared with 13,000 plus in California and Texas and less than 12,000 in Florida.
Guyana needed to do a random sample of tests in order to get a more accurate gauge of how widespread the infection is. The problem, however, is that rapid testing is not accurate and you do not want to be using precious PCR resources doing random sampling while there is a backlog of more than 1,000 test results.
The results from CARPHA can be used as a sort of baseline for modelling purposes. The former APNU+AFC had used a very conservative model which estimated 1,200 cases. Another model had projected as many as 20,000 cases. Given what is taking place now, Guyana could end up with a figure between these extremes. Twelve hundred was always going to be a low number given the lack of an effective lockdown between March and August. But 20,000 too is a frightening figure to contemplate since this will overwhelm the public health system and result in more than 1,000 deaths.

(The views expressed in this article are those of the author and do not necessarily reflect the opinions of this newspaper.)

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