An opinion letter was published in Marianas Business Journal on September 7, 2020 (Guam time).
While most people around the world are still worried about
the rising number of COVID-19 cases, the analysis based on statistics of
EuroMOMO, The European Mortality Monitoring Activity, has actually shown that
COVID-19 did not cause more deaths than the mortality rate projection for 2020,
especially in countries that responded well.
EuroMOMO is the official body monitoring EU member states’
mortality data. Their analysis in the end of April, when the pandemic still
looked bad in Europe, has already shown the deaths from COVID-19 did not make
the total mortality be over the projected normal range in Germany, Austria,
Greece, Norway, Finland and Denmark. Even in Sweden, with a controversial
“no-lockdown” strategy, its death toll number was still under the extremely
high excess mortality.
COVID-19 became a frightening killing bug of the new decade
right after it was emerging in China mainly because the coronavirus is in the
same family with SARS and MERS. However, the comparison of case fatality rate
(CFR), which is the ratio of deaths from a certain disease to the total number
of people diagnosed with this disease for a certain period of time, actually
showed SARS had a CFR of around 10%, MERS killed 34%, and a collaboration of
Hong Kong University and Harvard University in February estimated the CFR of
COVID-19 would be around 1.4%. The latest data from Singapore, 27 deaths out of
55,938 cases found by its aggressive testing and contact tracing protocols,
indicated a CFR of 0.48%, which is getting closer to a seasonal flu’s CFR 0.1%.
The key is absolutely to well respond to the pandemic with
proper strategies. When Singapore government decided to reopen the country
after a two-month lockdown on June 2, the city state, with 6 million residents,
had reported over 35,000 COVID-19 cases and 24 deaths. As of August 14, its
total confirmed cases were over 55,000, which means 20,000 increase after
reopening, but Singaporeans have switched their focus to watching
hospitalization rate, instead of paying too much attention to daily testing results,
and the death toll therefore increased 3 only during the period.
On the same day, August 14, when Guam’s cumulative COVID-19
cases reached 500, there were 8 patients who were hospitalized. This number was
actually four times higher than the hospitalization rate two weeks ago, which
was 2 hospitalized patients only on July 31. It has even jumped to 45 on August
31. It's two times higher than the record-high hospitalization rate during
Guam's first lockdown, which was 21 hospitalized COVID-19 patients on April 6
when the confirmed cases were just over 100.
The increase certainly needs to be taken seriously. However,
do not forget the hospitalization number did go down to zero on July 23 after
the island lifted the restrictions on Mother’s Day. There is no doubt that the
majority of Guam residents have been doing their part to avoid infections and
severe illness and Guam’s medical community has done a great job to treat
patients and save lives in the past several months although many people have
been thinking the medical capacity on Guam is relatively weak. Obviously, It is
very important that we keep living the healthy new normal and our government
keeps supporting our medical heroes to help our island get through it together.
The new normal is not a guess, or a theory only. A number of
solid research findings have actually proved that there are effective
protection measures helping people live with the coronavirus in the long run.
For example, a research article published on June 11 in the Proceedings of the
National Academy of Science analyzed data from three epicenters - Wuhan
(China), Italy and New York City - and proved that mandated face covering
“alone” significantly reduced the number of COVID -19 infections. The researchers
concluded that this inexpensive practice, in conjunction with simultaneous
social distancing, quarantine, and contact tracing, represents the most likely
fighting opportunity to stop the COVID-19 pandemic.
There are, of course, studies showing lockdowns help as well.
However, the excess death analysis based on EuroMOMO’s data, mentioned earlier,
proved that the strictness of a country’s lockdown measures had little
associations with its fatality of COVID-19. These analysis concluded that it’s
better to respond quickly, with proper testing and tracing protocols, rather
than relying on strict lockdowns.
The biggest myth about lockdown is to believe it is the only
solution when the epidemic gets worse. In fact, lockdown is a measure to lock
the seriously-affected area in order to protect people in other areas. When
SARS hit Taiwan 17 years ago, the health authority there locked a hospital
where a serious nosocomial infection occurred to protect the community
outsides. When Wuhan became a miserable epicenter of China in January, Chinese
government issued a lockdown order in Wuhan to avoid the coronavirus’ further
spreading to other cities and provinces. The price the whole world had
paid for the chaotic restrictions was the collapse of supply-chains
happening in the second quarter. It sadly led to many frontline medical
personnel being forced to fight the coronavirus without personal protective
equipment (PPE).
When new cases are emerging, it is time everybody should be
told that there are not any “coronavirus free” places in the world and we are
inevitably going to live with the coronavirus for a while. Only a sustainable
strategy can help us carry on together.
The US CDC Morbidity & Mortality Weekly Report on July 24
emphasized, again, that older adults and those with chronic obstructive
pulmonary disease, heart disease, diabetes, chronic kidney disease, or obesity
are at higher risk for severe COVID-19-associated illness. An estimated
prevalence of any of five underlying medical conditions, mentioned above, among
US adults was 47.2%. The percentage could be higher in more rural areas like
Guam, especially of diabetes and obesity.
The most relevant measure is therefore to protect the
vulnerable, including the elderly and people with those underlying medical
conditions, from the risk for severe illness, and watch those who ignore
response advice and continue high-risk behaviors. Don’t forget the coronavirus
has such a highly contagious nature and the aggressive testing and contact
tracing policies will definitely dig more infections. Paying too much attention
to daily testing results is just causing panic and very likely to result in a
chaotic response.
