An infectious disease physician working at the University of the Philippines, Manila answered important questions about the COVID-19 after the government confirmed the local transmission of the virus in the country.
On a Facebook post, Dr. Edsel Maurice Salvana answered five questions related to the COVID 19.
According to Dr. Salvana, the netizens should not assume that there was already a “sustained community transmission” in the country despite the new cases being reported in the Philippines.
He also denied that the Department of Health (DOH) underreported the cases of COVID-19, saying that the agency is updating the public as fast as possible.
Dr. Salvana also explained that it’s normal for any country to miss some cases of COVID-19, citing that even the United States government also has missed.
The expert said that DOH’s daily reporting of new cases means that they’re continuing testing the possible carriers of the virus.
He also said that each COVID-19 test costs the government 5,000-8,000 pesos and some of the kits are still having errors.
The expert said that the best thing that the Filipinos can do is to distance themselves in crowded places and follow the instructions from the government.
You can read his whole post below:
Deeper breath. Four new cases in the Philippines. Let’s dissect what this means for us.
1. Does this mean there is sustained community transmission?
No it doesn’t. Two of the four new patients had travel history, while the other two had contact with a confirmed case. There is still a clear epidemiologic exposure and so hopefully we still have a chance to control with quarantine and contact tracing.
2. Is DOH underreporting cases?
If you look at the timeframe between testing and reporting, it is no more that 24 to 48 hours. DOH is reporting as soon as it can, with some leadtime for contact tracing so that people can quarantine themselves as soon as possible. So there is no underreporting. The more relevant question is are we missing cases.
3. Are we missing cases?
The best surveillance systems in the world miss cases. The US CDC have tracked cases with no travel history after cryptic community transmission over 3 to 6 weeks. There are WHO protocols that we follow. We have two surveillance systems. The first one is the one that identifies PUIs and PUMs based on travel or contact with a known case. A second one, SARI, looks for unexplained pneumonias and clusters of pneumonia in the community. This is how DOH picked up case #5 out of the 10. This was due to the excellent clinical judgement of a private infectious disease physician who decided to test based on SARI priniciples.
The fact that DOH DETECTED the 10 cases means that TESTING IS BEING DONE. More than 700 people have been screened according to established WHO protocols. Due diligence is being observed.
4. But why don’t we test more if we are concerned of missing cases?
Each test costs the government (aka you) 5,000 to 8,000 pesos. Testing is complicated and not many places are capable of doing the test well. Even the CDC in the USA had a major error in their test. Capacity is being expanded. A Filipino kit is being validated. These are all happening as we speak. However we still need to prioritize testing to the most probable because we cannot test everyone at this time.
5. What happens next?
Based on the Chinese experience, the only thing that seems to have a major impact on transmission is social distancing. We do not want to wait until we have a case load as high as Wuhan because even they had a hard time controlling and they have much more resources than we have. We need to think of preemptive social distancing now if we want to have a chance to contain. If this happens. PLEASE follow instructions and understand that a sacrifice is being asked of everyone FOR THE GREATER GOOD. Now is the time to help each other by putting our individual impulses aside and being proactive.
The post of Dr. Salvana already reached 1,700 reactions and 2,200 shares on social media.
As of writing, DOH already reported ten new cases of COVID in the Philippines.