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Leire Labaka, Researcher of the Aon Foundation's Disaster Chair at Tecnun-University of Navarra

The health crisis: result misinterpretation and lack of information

Wed, 06 May 2020 15:32:00 +0000 Published in North of Castilla

The most repeated phrase in the news since the beginning of the pandemic has been "We don't know", which shows that we have not prepared, and therefore, we have not been able to make quick and accurate decisions.

The core topic is to study data, metadata and information and analyze how the lack of complete capture and analysis of the data affects the understanding of the spread of the coronavirus and, consequently, the decisions surrounding it.

We have witnessed three types of governmental reactions to fight this disease. The first, exemplified by South Korea and Germany, was the massive testing in order to have information on which to base their decisions. Countries such as Spain and Italy had an attitude of wishful thinking, assuming, without supporting information, that the impact was not so serious. They reacted late and this delayed the response, forcing them to take drastic measures, such as total isolation. The third was irresponsible denial despite the evidence in other countries. Brazil and the US delayed the measures, justifying themselves on the grounds of economic side effects. Now they are reacting with extreme measures, under constant pressure to put more emphasis on Economics, relaxing social isolation, again, without relying on reliable information.

To face unknown challenges, it is necessary to be prepared and to have the scientific capacity to develop knowledge on the fly. In this century there have been other pandemics to learn from, such as H1N1 and SARS, Ebola or dengue. These experiences are not always enough for authorities to know how to manage new and unfamiliar situations.

Several scientists announced the possibility of the spread of COVID-19, but few governments acted promptly and none fully prepared for this possibility. Moreover, lessons from recent epidemics told the opposite: a pandemic can be identified and controlled during its early stages. Viruses such as SARS-CoV and MERS, targeting very serious diseases, but with a very low issue of cases (8,439 and 2,519 total cases with fees mortality of 9.6% and 34.3%, respectively), and both pandemics could be contained. These facts conveyed the false impression that we did not have to take the necessary measures from the beginning.

When COVID 19 was identified in China, no one foresaw the magnitude of the problem. This virus spread more easily and rapidly than its predecessors, SARS and MERS. All three have the mode of transmission in common, but the authorities did not apply that knowledge to support decision-making regarding the infrastructure needed to deal with the crisis.

This pandemic forces us to manage a new status from a social and infrastructural point of view. The most novel aspect is quarantine as an instrument to "flatten" the propagation curve and avoid sanitary collapse. It is a drastic alternative, with social and economic side effects. But was there another option? Yes, as long as we had more accurate information about those infected. By massively testing, the government could have isolated only the positives, keeping the rest in their daily activities.

The data published in the news generate confusion and give rise to misleading interpretations. When they talk about issue of infected people they are referring to issue of people who tested positive for a test at some point in time, which has a quite different meaning than the total number of infected people. Initially, only people with symptoms and the medical staff were tested. It is therefore not surprising that the mortality rate was so high, in some countries as high as 10%.

Thinking about the immediate future, we still cannot find concrete answers because we do not have enough information. Assuming that the virus does not mutate and that the antibodies last a reasonable period of time to develop a vaccine, the best status is that of a person who becomes infected, reacts by producing antibodies, is cured, is immune and cannot infect others. That person would be able to return to normal activities without fear, although it is not certain when.

If this were applied to everyone, including the portion of the population that has not been infected, the pandemic would be controlled and sporadic cases would be quickly identified and treated accordingly. Successful treatment would accelerate this result and reduce deaths.

It is difficult to predict what the world will be like when the crisis is over. Whatever happens, it is to be hoped that the attitude of governments towards science will change. Public and private investments should be directed to the science and research that really matters for a sustainable world. Preparing for climate change, natural disasters, pandemics and a more equitable and less unjust world must be a priority to avoid a catastrophic future.