Test, test and more tests

AFEW days ago, Ed Bartlett, the tourism minister, offered his perspective of what the global travel industry would look like when the COVID-19 pandemic passes and how Jamaica should position itself for the new reality. Don’t expect that tourists, shaped by the pandemic, will travel with abandon and choose destinations merely for their aesthetic appeal, he told this newspaper.

Expanding on the idea to the Government’s information agency, the JIS, Mr Bartlett said: “Gen-C (Generation COVID) travel encompasses building traveller confidence and what must be done by destinations, and others, to be ready for post-COVID-19 tourism. We must showcase the robust health measures that are implemented in partnerships with hotels, airlines, and the ministries of health to reassure perspective travellers.”

In other words, if the 4.2 million tourists who visited Jamaica in 2019, from whom the country grossed US$4.7 billion, are to be enticed back in the new era, they have to be assured that they would be safe from the new coronavirus. Come to think of it, this is hardly different from the assurance Jamaicans, a significant portion of whom live on the margins, would like to have so that they can get on with their lives without long lockdowns and perpetual curfews even as they adapt to physical distancing and wearing face masks for public outings.

This newspaper appreciates that this isn’t easy in the absence of a vaccine for the virus, and given that no one in Jamaica would contemplate reaching herd immunity by large chunks of the population becoming seriously ill and significant numbers, especially the elderly and the poor, dying while overwhelming the health system. Nonetheless, there are ideas and solutions that smart people can adduce to balance the health of Jamaicans while ensuring an orderly reboot of the economy. It is the kind of creative engagement we expect to be exercising the members of the subcommittee on COVID-19 resilience – chaired by the health minister, Christopher Tufton – which is part of the prime minister’s task force planning the economic recovery.

Any sustainable plan, whether as a precursor to building confidence with Mr Bartlett’s Gen-C, or more important, because of its immediate value to Jamaican citizens, must rest on knowing the penetration of COVID-19 in Jamaica. It is only with this information that the most robust strategies can be crafted. In other words, Jamaica should be testing rigorously for COVID-19 infections as well as identifying people who contracted but had overcome the virus without knowing that they had.

In recent weeks, with the acquisition of new diagnostic machines, and because of the discovery of a cluster of infections (47 per cent of all confirmed cases) related to one workplace, Jamaica has accelerated its testing .But the little over 5,200 tests it completed up to the start of this week represented only 0.19 per cent of the population, which translates to a little over 1,900 tests for every million Jamaicans. Jamaica has returned a positive-to-test rate of approximately nine per cent. The fatality rate among persons who tested positive hovers at just below two per cent, substantially below the current global average of approximately seven per cent.

THE REAL PICTURE UNKNOWN

The issue, though, is that we don’t have a full enough picture of Jamaica’s situation with regard to the spread of the virus. The protocol is to test people who have symptoms of the virus, persons who have contact with this group, and patients who seek treatment for flu-like and/or respiratory infections – all of which are also common to COVID-19. But as events at the Alorica call centre have highlighted, large numbers of people can be infected with the virus and be asymptomatic. It is Jamaica’s luck that one of nearly 200 infected employees showed symptoms – and relatively early.

The clear evidence is that countries that combined aggressive testing with other regimes, as did Iceland and South Korea early in the outbreak, were not only able to better contain the spread of the virus, but have earlier returns to economic activity. Albeit with a significantly smaller population than Jamaica’s, Iceland, with support from private researchers, has tested 13 per cent of its population. This effort was buttressed by a voluntary screening programme. Iceland also did serology tests for antibodies, checking for people who had the virus but might have been asymptomatic and didn’t pay attention because their symptoms were mild. Switzerland is about to launch a major programme of serology testing as well as a study, involving a dozen academies, to determine what, if any, immunity is developed by people who have survived the virus.

Jamaica should be doing all these things, with emphasis, especially with regard to screening, on its vulnerable populations. We imagine that there will be arguments about availability of test kits and about the cost of such an exercise. The question is, can we afford not to do it, for the sake of Jamaica’s citizens and Mr Bartlett’s Gen-C?

Also, this crisis insists on, as is implicit in Minister Bartlett’s observation, a rebuilding at the community level of the lapsed public health support systems.

The opinions on this page, except for The Editorial, do not necessarily reflect the opinions of The Gleaner.