A sign of things to come

Yesterday’s news of a sudden surge in new COVID-19 transmissions– with 52 new cases, bringing the total up to 293 - is a clear sign that Malta’s fight with the coronavirus pandemic has only just begun in earnest.

Apart from representing by far the highest number of cases detected in a single day, the nature of individual cases suggests that a level of community spread is underway. One of the new cases concerns an elderly person resident at a retirement home, who has now been isolated. Patients who were in the same ward, and staff members who may have come in contact with them, have also been placed in quarantine.

Nonetheless, Health Minister Chris Fearne insisted that yesterday’s sudden increase was to be expected; and that the figures, in themselves, do not represent any significant cause for alarm. For this reason, no new restrictive measures were announced.

All the same, it is now essential that government prepares the public for what is yet to come: a spike in cases, that can only be kept manageable through clear, unequivocal procedures for self-isolation on a national level.

These have to be fair measures which apply to everyone equally; but which are also clearly intended at minimising the risk of local transmission. From this perspective, it does not bode well that the government has allowed over 6,000 hunters to roam the countryside, in what could be a potential rendezvous of the local hunting fraternity. Such measures can only dent the government’s credibility when it comes to laying down quarantine rules for the rest of us to follow.

Having said that, the latest increase cases only reaffirms a stronger call for the Public Health Superintendent – who has now been granted emergency powers at law - not to be hesitant with measures that can ensure an effective lockdown, and keep local infections down as much as possible.

Malta’s rate of testing is indeed commendable: with 825 tests carried out over the last 24 hours, bringing the total to more than 11,000 since the start of the pandemic in March.

A recent study, published in the British Medical Journal, suggested that 78% of people with COVID-19 exhibit no symptoms at all. Those findings are in line with research from an Italian village at the epicentre of the outbreak, Vo’Euganeo, 50 km west of Venice, showing that 50%-75% were asymptomatic, but represented “a formidable source” of contagion.

A recent Icelandic study also confirmed that around 50% of those who tested positive to COVID-19 were asymptomatic cases. This is consonant with WHO’s estimates that “80% of infections are mild or asymptomatic, 15% are severe infections and 5% are critical infections”.

The implication is that a large majority of cases will most likely remain undetected. Ultimately, only widespread testing could give us a better picture of the number of people who have had COVID-19, and what social distancing measures may have to be mandatorily enforced to keep the rate of local transmission down.

The Superintendent should also encourage people to voluntarily track their movements with a special application, complete with full safeguards on data protection. An app that track people’s movements could help identify and isolate anyone who has come into contact with an infected person.

This kind of contact-tracing technology is indeed controversial, especially since many of us would not accept such levels of surveillance. But if proper data protection safeguards are in place, there are valid reasons to believe people would be motivated to use the technology to help end the pandemic.

This would involve using a smartphone app to track people’s movements and automatically notifying them if they have come in contact with someone known to have caught the virus. It would then encourage them to immediately self-isolate and prevent further contamination.

The location-tracking aspect of the app could be enhanced by enabling users to check in to locations such as shops, public transport stations or workplaces; and to allow government provide more information for health services, and even food or medicine deliveries during self-isolation.

Naturally, such measures are not without their risks; and it is clear that the information collected would have to be destroyed after a certain amount of time.

But if it is to be successful, the fight against COVID-19 has to be a collective effort… in which all of us will be expected to make sacrifices.