The COVID-19 crisis demands a coherent, unified approach

Given the recent surge in contagions, and the widespread perception that the situation is sliding out of control…  the time has surely come to re-visit our national approach to the COVID-19 crisis in its entirety

From the outset, Malta’s national health strategy to counter the COVID-19 pandemic was always to try and ‘flatten the curve’: in other words, to slow down the rate of transmission of the virus as much as possible, so that the number of ITU admissions is never overwhelmed by too many cases at once.

As strategies go, it proved highly successful – albeit at a significant economic cost - when it came to dealing with the first wave, from March to July. Sadly, however, Malta was less successful at coping with the second wave:  partly because the same successful strategy could not be prolonged indefinitely; but partly also because the government’s first response, back in March, was to declare a national health emergency: thus transferring executive power directly the Superintendence of Public Health.

It cannot escape notice, then, that Malta’s earlier success could be attributed directly to decisions taken with the backing of sound scientific advice.

From July onwards, on the other hand – after the ill-fated boast that ‘we had won the war on COVID-19’ – the government’s approach has been somewhat less reassuring.

Though Prime Minister Robert Abela is on record claiming that his policies were drawn up in consultation with medical experts, the reality we have experienced then has been, at best, haphazard and erratic.

Government has so far been entirely reactive to each new twist and turn of the crisis. To give but one example: the new health and safety regulations published last week – after a sudden spike of over 200 cases in one day – had to almost immediately be withdrawn and reconsidered… after large groups of revellers gathered at St George’s Lido, in defiance of social distancing measures, after the forced closure of all Paceville bars and clubs by 11pm.

Even without the hindsight of that event, it should have been easy to predict that an 11pm curfew could only ever have resulted in large numbers of (mostly drunk) people aggregating in the same place, at the same time; and ironically, this is the sort of behaviour that the new measures were supposed to discourage in the first place.

Meanwhile, all bars have now been shut down completely until December: whereupon, presumably, the situation will be reviewed ahead of the Christmas season. But without entering the merits of whether this is indeed the correct approach… the effect of all this inconsistency – coupled with the unfortunate mixed messages when it comes to enforcement - is taking a toll of its own.

From a situation where the vast majority was ready and willing to subject itself to the discipline demanded by the Public Health Authorities… people now seem to be growing more distrustful and sceptical, in the face of what looks like a series of hurried, and sometimes contradictory knee-jerk responses.

Much more worryingly, the medical community in general is now almost unanimous in declaring that the original strategy – the all-important need to flatten the curve – is increasingly in danger of failing.

In an interview last week, MUMN president Paul Pace declared that there were not enough qualified nurses to man the number of ventilator beds currently in place at Mater Dei; and that the nursing sector suffers from endemic shortages, made worse by international competition for TCNs (Third Country Nationals).

This bleak scenario has since been corroborated by both the Medical  Association of Malta, and the Malta College of Pathologists: who also added that the available ITU beds are filling up, and – as can be separately confirmed anyway – the death toll is rising, and may yet rise further.

Faced with all this, the government’s response can no longer be a series of disjointed emergency measures, that always seem to keep changing. Given the recent surge in contagions, and the widespread perception that the situation is sliding out of control…  the time has surely come to re-visit our national approach to the COVID-19 crisis in its entirety.

This newspaper therefore strongly supports the calls from Malta College of Pathologists to institute a council of experts, representing all the relevant medical fields - public health, infection control, virology, epidemiology, metal health, etc. – who, in conjunction with other major stakeholders (e.g., the Police, and other sectors involved on the enforcement side of things) – should consult government with a view to formulating a single, coherent national strategy to curb the spread of COVID-19.

Only then would government be able to back its claim, that its approach really is based on the best possible scientific advice.

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