COVID-19 testing and crisis task forces

LAST WEEK’S commissioning of a new machine that increases by more than fivefold – to over 1,000 a day – Jamaica’s ability to test for the COVID-19 virus is good news. What we now wait to hear now is how this new capacity will be utilised, or more correctly, the philosophy behind the testing.

Put another way, while this capability to, in larger numbers, and at a faster pace, diagnoses who may have contracted the virus, and therefore require specific attention, there ought to be larger strategic issues at play. Increased testing should be part of a matrix where the Government mobilises, and makes use of, the broad range of talents in the society in planning a national response to all phases of the COVID-19 crisis.

The acquisition of the new machine by the National Public Health Laboratory (NPHL) is opportune. This happened in the midst of the discovery of a cluster of COVID-19 cases, which up to last Saturday numbered 167 or approximately 55 per cent of all confirmed cases, attributed to the Portmore, St Catherine, branch of the business process outsourcing (BPO) company, Alorica. Jamaica now enters, what health officials believe to be, the community spread phase of the epidemic. If expectations hold, the demand for testing will probably be more than what was possible with the previous 200-a-day capacity of the National Influenza Laboratory, if it ran flat out.

Significantly, the 351 tests reported to have been completed for the 24-hour reporting period were approximately 53 per cent more than what would have been possible before the installation of the machine at the NPHL.

Indeed, before the new machine, Jamaica had completed 1,936 tests, which was less than half of one per cent of the population. Put differently, Jamaica had tested approximately 712 persons per million residents. At the time, 233, or 12 per cent of the persons tested, had the virus.

Since then, the number of tests increased to 2,868, or a jump of 48 per cent. Confirmed infections moved 31 per cent to 305.

The authorities were also contact-tracing more than several hundred persons. Clearly, the machine at the NPHL is making the process faster, and more efficient.

The larger story behind these numbers remains relatively sketchy, although this could change quickly if there was more aggressive testing, including for antibodies to tell if persons have been infected by coronavirus, without showing symptoms.

In the absence of a vaccine for the virus, and with no known drugs with specific efficacy against

COVID-19, governments around the world have sought to slow the spread of infections by shutting off regions, as Jamaica did with St Catherine, and telling non-essential workers and vulnerable people to stay at home. These moves, though, have slowed economic activity to a trickle, leading to projections for three per cent decline in global output in 2020. The fallout for Jamaica, by most estimates, could be significantly deeper.

LARGE-SCALE TESTING

The debate, especially in developed economies, is how to emerge from these shutdowns and kickstart economies. Most epidemiologists, and other experts, say that these decisions should be guided by the results of aggressive testing for the virus, similar in scale to what has taken place in countries such as South Korea and Germany. Large-scale testing provides policymakers with demographic data that can them help to make informed decisions about regions, sectors that can reopen, the pace and sequencing of the relaxation, and profiles of persons who may be immediately re-engaged.

In a relatively poor country like Jamaica, while testing is critical to mapping the spread of the virus and of the turns it may take, there are questions about the access to, and affordability of reagents required to do so, on a massive scale. The situation is complicated by the social and economic realities of large segments of the population, such as the more than 17 per cent of Jamaicans who live below the official poverty line, and the many more who also scrape by and hustle daily for their existence. These circumstances are exacerbated for many by their sparse, often dilapidated and overcrowded homes, with few amenities.

This delicate balancing act requires the use of all available tools –such as an aggressive enforcement of the mandatory wearing of face masks in public places, as well as the guidance on physical and regular distancing and regular handwashing – capable of slowing the spread of the virus, as well as the involvement of critical stakeholders so that Government policy has the benefit of a broad range of ideas, beyond what exists in the administration.

These actions must be underpinned by clear, energetic, and culturally appropriate education and mobilisation campaigns.

With respect to the national partnership demanded by these circumstances, it would make sense, even at this stage, to establish sectoral task forces, to map plans for confronting and surviving the immediate crisis, and for thriving in the post-COVID-19 future.