The World Health Organisation: “You can’t fight a virus if you don’t know where it is,”
The most important measure to contain the Covid-19 epidemic in Spain is to increase the diagnostic tests for the coronavirus, according to specialists in infectious diseases and public health.
Prioritizing the early diagnosis of cases is what has enabled South Korea to contain the epidemic despite having registered more than 7,500 cases since February 20. In Spain, by contrast, lax detection criteria have allowed an undetermined number of undiagnosed cases, favouring the spread of the coronavirus.
Korea has contained the epidemic thanks to early detection, which has allowed the chains of contagion to be cut.
“You can’t fight a virus if you don’t know where it is,” the director-general of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, warned yesterday at a Covid-19 working meeting in Geneva. “This requires robust surveillance to find, isolate, test and treat all cases, to cut the transmission chains.”
South Korea has conducted four Covid-19 tests per 1,000 population in the past three weeks, according to a study by Oxford University’s Our World in Datacenter based on official data and updated yesterday. Italy, which has also opted to strengthen its capacity to detect the coronavirus in recent weeks, is the second country that has done the most: one for every 1,000 inhabitants.
“It is totally insufficient!” Exclaims Oriol Mitjà , from the Germans Trias I Pujol Hospital in Badalona. This detection rate allows the identification of Covid-19 cases that have clear symptoms and require hospital care, but it is not enough to detect all cases in a country that is already the sixth in the world in the number of affected. Consequently, there are coronavirus carriers who have no way of knowing if they have been infected and who can transmit the infection to others.
This has favoured evidence of community transmission of the coronavirus in several communities, including Catalonia. Since it is not known how many undiagnosed cases there are, it is not possible to determine to what extent community transmission is widespread.
To clarify this, the number of diagnostic tests would have to be significantly expanded. “There is no excuse for saying we can’t do it,” Maria van Kerkhove, technical director of the WHO Health Emergencies Program, said Wednesday at a press conference announcing that Covid-19 has already become a pandemic.
“You have to make sure that hospitals and laboratories are ready. You have to be as aggressive as possible to reach the early cases. By doing this, we are saving lives, “said Van Kerkhove, who cited the South Korean experience as” a good example [that] demonstrates the ability to reverse the situation. “
Four scientific societies in Spain (those of Internal Medicine, Emergencies, Intensive Care and Infectious Diseases) have urged the Ministry of Health to increase diagnostic tests to “guarantee the early identification of as many cases as possible.”
In Catalonia, if a person suspects that they have contracted the coronavirus, the Health Department recommends that they answer a three-question questionnaire online to indicate if they should call 061.
They are asked if they have been in an area affected by the coronavirus if you have been in contact with a person with Covid-19 and what symptoms you have. If you only have symptoms that could be from Covid-19, but you don’t know if you’ve been in contact with a carrier of the virus, a message tells you “Don’t worry, it looks like you don’t have the SARS-CoV-2 coronavirus.”
With this questionnaire, the citizen is ruled out to take the coronavirus test in one of the ten laboratories that perform it for public health. Nor can it be done in a private center, since there is no laboratory authorized to do it this way. By not checking for the coronavirus, it is not recommended that you isolate yourself. In case you have it, it becomes a possible source of contagion for other people.
“Testing is crucial to understand the prevalence of the disease, to provide timely treatment to those affected, to understand how the disease evolves and to ensure that measures are taken to slow the spread of the disease,” writes Esteban Ortiz-Ospina, Researcher at the Our World in Datacenter, in the study in which he presents his results. “When infected people don’t know they are infected, they may not stay home and then go on to infect other people.”