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Locking the barn after the horse...

18 mars 2021, 09:45

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Introduction: The current outbreaks of Covid-19 should not have occurred, but it was a disaster in the making, and it represents a clear failure of the Health Protectorate Agency to take pro-active steps in protecting the Nation on two separate occasions as shown by the red stars in the adjoining graph. It is pertinent to ask why we keep making the same mistakes and to invoke a sense of responsibility from the concerned authorities. I consider six areas for corrective actions.

Incorporating genuine scientific advice: My scientific advice starting in January 2020 were simple to practice: close the borders in January 2020 itself, test asymptomatic subjects and wear masks. In March 2021, at the beginning of the current outbreak when we only had 4 cases, I again sounded the alarm bell and advised on imposing an immediate hard nationwide lockdown for 7 days to significantly break the chain of transmission. This pandemic is new, and it requires experience, expertise and competency in the areas of virology, epidemiology, public and international health to manage it. Relying on a select few with virtually limited or no experience is a clear-cut recipe for disaster, and disaster we are witnessing twice already.

Avoid bickering and belittling the voice of science: In 2020, I was labelled as a gibbering jabbering, frustrated scientist and was portrayed as being anti-patriotic by some, while others branded my advice as fake news. In contrast, some basking in the monopoly of authority affords themselves of arrogance clad in ignorance when they publicly denounce wearing a mask and boast that this country is covid-safe, conveying a false sense of security and misleading the population. My heed of high probability of a second epidemic was equally scoffed upon. Where are we today? Who has led us into this precipice? Who should be scoffed at today?

Do not follow WHO blindy: When we lack expertise, we turn to an international agency for advice or hide behind their umbrella. But turning to WHO is like putting the wolf garbed in lamb skin to guard the sheep. WHO has faltered and erred the world into serious errors: I classified the outbreak as a public health emergency of international concerns and subsequently classified the outbreak as a pandemic; WHO was a week late in doing so in both instances, with dire consequences for the world including us.

At a local level, WHO has been promising us vaccine for 10% of our population by mid-February, where is the promised vaccine? Following WHO dogmatically is akin to sacrificial lambs being led to the altar, today we find ourselves caught unguarded in the midst of a second epidemic with not even 10% of the population immunized and we are totally vulnerable like an unarmed ship being attacked by fighter jet at sea.

Practising a coherent public health policy: Despite all we have learnt in preceding 12 months, it is unacceptable to have a botched-up public response during the current epidemic by making the patently wrong hypothesis and going after patient zero instead of instituting classic outbreak control measures to quell the outbreaks at the outset, especially when we know we have a high probability of covid variants existing in our territory. We have moved back and forth with the vaccine and made U-turns with the AstraZeneca vaccine; how can this inspire confidence in a world where fake news has become the norm rather than the exception?

A time to wake up: We must brace for jumpy ride, with frequent episodes, because the virus is now endemic in our population as we could not eradicate it at the beginning stages, and we have not vaccinated a critical mass of population. We know in epidemiology any number of estimated cases has to be multiplied by a factor of 10 or even 100 to adjust for incomplete surveillance and limitation of the test. We should not forget that the very WHO we have followed so dogmatically had predicted that “under a no-effective scenario, some 1 million of the 1.2 million population of the island could be infected symptomatically or asymptomatically”. We must stop hiding our heads in the sand like ostriches believing the danger has passed, we never were Covid-safe and now we join the rank of Italy, France and others who failed to take timely precautions and we must pay the health and socio-economic tolls.