It feels as if we pressed the pause button that we never thought we had. Currently most countries are just passing the surge or are in the containment phase of this epidemic which has hooked our lives.
The main issue with this viral epidemic is that we have lots of grey areas in our knowledge about its biology that is rendering us hesitant in what to do next. For example, we don’t know whether acquiring herd immunity for COVID-19 is of any use. Is the immunity we get from this viral exposure long lasting? Will this virus mutate in the near future and therefore keep haunting us for an unknown period of time? Will a vaccine work?
However, with almost six months experience of this infection, the world has gathered some facts on which one can make educated decisions for the future. We need to build our future on facts and not fear, as otherwise we will falter.
Facts will direct us to lighten the lockdown measures in order to resume our lives, the degree of which varies according to the level of lockdown one had put in place originally. So what do we know so far?
We have a clearly defined section of our population who are more at risk to succumb from the infection. These include the elderly population and those individuals suffering from certain chronic diseases. Therefore it’s quite logical that if one protects the vulnerable, one would be decreasing the mortality rate from COVID-19 and at the same time eliminating the potential hospital overcrowding.
If we look at the local scenario, where we’ve controlled the first ripple of the infection admirably, according to our health department we’ve only used at maximum two intensive care beds at one time from the 100 that have been made available.
There’s a higher risk of dying from the side effects of the management of COVID-19 than the infection itself- Franco Mercieca
The vast majority of people who contract the infection have no significant risk of succumbing to the disease.
I am not going to bore you with statistics but it is quite clear that the vast majority of those who die from COVID-19 infection are elderly, as the main brunt of the epidemic has been felt at old people’s homes.
A recent Stanford University antibody study estimated that the mortality rate is around 0.1 to 0.2 per cent. This has been our experience locally as well where the unfortunate deaths were all of a very vulnerable age and the majority of our positive individuals were either asymptomatic or minimally so.
The lockdown measures are flattening the curves for all with a variable degree of success. This obviously implies that we’re limiting the spread of the infection to lower levels and therefore prolonging the duration of the epidemic. The concept of ‘herd immunity’ is not new but has been known for decades.
In fact herd immunity is the main purpose of widespread immunisation in other viral infections like measles, mumps and rubella, to assist in population immunity. It stands to reason that if in this infection the principle of herd immunity holds, then lockdown measures are only delaying the time that most of us will get infected.
If one disputes the importance of herd immunity on the theory that COVID-19 immunity does not last very long, then it basically means that we will keep getting infected with this virus and its mutant versions forever and that a vaccine will not have any effect in its natural history.
It means that it would be behaving like the common cold virus which one can contract more than once in a winter and therefore behaving like other coronaviruses that have flu-like symptoms and short-lived immunity.
Having an epidemic does not mean that people will not die of other pathologies, namely chest infections, heart attacks, strokes and cancer, to mention a few. Critical care of these conditions are being ignored worldwide, with devastating results, in order to accommodate COVID-19 patients and for fear of its spread. Unfortunately most countries have stopped ‘non-essential’ investigations and treatments and therefore we are not diagnosing and treating life-threatening conditions. As a result many patients during this period would have missed their only chance of treatment which has resulted in either death or long term permanent disability.
Therefore, a more focused strategy should be the favoured approach. We need to keep protecting our vulnerable section of the population while persisting with the intensive testing and contact tracing of all those infected.
However, one should allow a gradual decrease in social distancing which would allow us to get through this debacle as expediently as possible. To me it seems that there’s a higher risk of dying from the side effects of the management of COVID-19 than the infection itself.
Therefore we need courageous politicians who ignore the panic and decide on facts. There is no right decision but only the least wrong.
We have to diminish the fear factor and work incessantly on the trust factor.
Franco Mercieca is a former parliamentary secretary for the elderly.