UNDER THE MICROSCOPE
Alas, we’re now in a public health crisis with an explosive increase in COVID cases. Making the situation more difficult is that more and more health care workers (HCW) are getting infected even though the vast majority are vaccinated. This has led to an acute shortage of HCW to man our hospitals and labs. The silver lining is that because they are vaccinated and boosted, they will not get severe disease.
But let’s go to the implications of this shortage. All who are infected, whether symptomatic or not, need to isolate. Due to the 10-day isolation mandated, it has rapidly depleted our ranks. Sensibly, the IATF and DOH decided to shorten it to five days. The assumption is that the peak viral load has passed after five days and the person is no longer infectious. That should be applicable in the majority of cases but there will always be outliers. An objective way to go about this is to do antigen test which if positive indicates a high viral load thus can still be infectious. Absent that, it’s like playing Russian roulette.
The situation in COVID testing is much more dire. As med techs and supporting staff and encoders test positive, more and more labs have either closed temporarily or have limited the number of samples they will accept. Even at full capacity, we can’t accept all and sundry who want to test since this will lead to delay in testing and reporting. We’re truly being inundated by test requests and many are complaining and bad-mouthing labs on social media for not getting results out on time or rejecting their samples.
But pray tell, if you have taken care to not get exposed, which is why you want to get tested, would we be in this situation? A lot of people took risks the past holiday season with partying and reunions. There were a lot of warnings issued with the threat of Omicron already there, yet we partied like there’s no tomorrow.
Let’s get our priorities straight. If you’re asymptomatic and exposed, be responsible enough to quarantine yourself and observe for symptoms. If you can get antigen testing on the fifth day of exposure, do so. If negative, you may come out but should still be aware that you might be infected (lower sensitivity of antigen test) and refrain from high-risk activities (eating together, enclosed spaces etc., you know the drill) for another five days.
If symptomatic and can’t get RT-PCR test, get antigen tested. A positive result is just as good as a positive RT-PCR. Don’t clog the system by insisting on a RT-PCR test. Mild symptoms especially in a fully vaccinated person can be managed at home if you have a separate bedroom with toilet. Stay there until 10 days from time of symptoms or positive COVID test whichever came first. You must be asymptomatic three days before coming out of isolation.
Can’t even get antigen test? Be responsible. Consider yourself a COVID case and isolate.
For high risk individuals with advanced age and /or co-morbids who test positive, closely monitor them for signs of clinical deterioration like difficulty of breathing or low oxygen saturation. They also merit hospital admission to be closely observed. Let’s give them priority in both testing and hospital consultation.
Our labs should also prioritize patients in the emergency rooms and those for admission. Other indications as work clearance or travel are secondary and should be accepted up to the lab capacity after the hospital cases are accommodated.
Now, let’s look at certain cases of interest. Novak Djokovic, población girl and massage girl come to mind. No vacc (pun intended) Djokovic tried to enter Australia with an exemption and is still in detention. Social media is awash with debate on him. Australian immigration is standing firm on not letting him in, even considering he’s No. one tennis player in the world. Good for you, Australia!
Poblacion girl and Massage girl (nameless to not give them recognition they crave) flouted quarantine rules with the first becoming a super spreader. But at least they got caught and will be facing charges.
But what about a senator who insisted on being with his pregnant wife in the delivery room knowing he was already positive for the virus? And what about the police chief who had a birthday party in his honor and was widely seen on social media in flagrante delicto?
Nothing came out of these even with widespread condemnation in the press, TV and social media. Truly, in the Philippines, you can get away with anything if you’re influential. There’s a culture of impunity which defines the current administration and nothing says it best than when you have the Presidential Security Group getting jabbed surreptitiously with an unauthorized, smuggled vaccine.
So now, we’re riding the tiger but afraid to dismount for fear of being eaten.
And you wonder why we rank “kulelat” in pandemic response? Well, wake up and smell the garbage!