To test or not to test


Too many people are finding themselves conflicted over the question of whether it is preferable to stay quietly at home and not let on that you might have covid19, or run the risk of contracting it while at a health centre and having to be locked down somewhere for a couple of weeks.

The current official TT figures for affected individuals are increasing daily, but experts suspect that the real infection rate in the general population is several times higher.

It is a good call, since not everybody is keen to subject themselves to a test and then perhaps be forced to go to a health facility.

Many people I know have been feeling cold-ish and wondered if it might be Sahara dust, a cold, a non-covid flu or some sort of mild seasonal infection. Some have been tested and received negative results and others have had positive ones. All of the latter have confined themselves to their homes and a regime of self-prescribed medical care.

The big problem with not being tested is that it deprives the State of tracking those with whom we have been in contact and thereby encouraging the community spread that seems to have no bounds at the moment.

The opposition party has criticised the government repeatedly for the low level of testing. Some blame the current infection spike on it, and with some reason.

Now that our public health authorities have seen the wisdom of not wasting resources by putting everyone in state quarantine facilities, regardless of how casual their contact with a covid-positive person; and now that most people are allowed to self-quarantine at home, more people may be likely to subject themselves to the test, provided they could afford the very expensive private facilities or had the time to queue up for hours at a public one.

It is with hindsight that we can criticise the government’s draconian handling of the virus at the outset.

We should remember that the entire world panicked when the virus was rampaging through the population, country by country, in its potent early stages, killing thousands of older and sick people, decimating frontline health workers.

The advice changed daily. For example, it has taken months for masks to be judged safe.

The World Health Organization (WHO) has also been criticised for the changing advice it gave to countries, which has very much dictated the national policies followed. Fortunately, over the last seven months scientists have come to know much more about the highly infectious and opportunistic virus that has been mutating, presenting itself like a hydra-headed monster. If any reader remembers their Greek mythology, they would recall that even the supposedly immortal hydra was eventually overcome, but it was not easy.

Only Sweden did the counterintuitive thing which was the opposite of early WHO advice, and it has not worked. The country never completely locked down. From early on, the government simply told citizens to work remotely where possible, wash their hands frequently, observe social distancing, stay home if they had symptoms and self-isolate if they developed them. It tested only those with severe symptoms.

As a result nearly 6,000 people, mainly the old and disadvantaged, died, a higher rate than every other Scandinavian country.

Sweden clearly made individual citizens responsible for their well-being, a policy, it would seem, designed for healthy, middle-class, young and middle-aged people only – people who could stay at home in relative comfort and who ran reduced risk of death.

Swedish scientists believed that the more people who got it, the more immune the population would be, an approach known as herd immunity. According to the Journal of the Royal Society of Medicine, predictions were that 40 per cent of people in the capital city would develop immunity, but only 15 per cent did, the reason being that only very severe cases develop immunity.

Also troubling is the fact that higher levels of virulent infection and mortality have persisted in Sweden beyond the few critical weeks of neighbouring countries.

It is fanciful, therefore, that Sweden is being lauded as the exemplar for flattening its curve before everyone else, when the human cost has been so high.

The final word on immunity is still awaited, so scientists may want eventually to test widely for immunity, especially after a vaccine becomes available, but in the meantime we have to test for infection and early diagnosis.

It’s a cautionary tale for those amongst us who do not want to be tested when symptomatic. By not facilitating contact tracing, we are doing a huge disservice to others and even ourselves, as we could become reinfected. We should be pressing our health ministry for more quick, safe, affordable and thorough testing.

The government was not transparent about why so little testing was done at the beginning of the pandemic.

Perhaps there was a shortage of kits, but provided we can access them, it is a much cheaper option than the loss of tax revenue and the psychological damage, and personal and financial ruination of even a partial lockdown.


"To test or not to test"

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