Two and a half weeks after the first suspected case of coronavirus here, 13 days after the World Health Organization (WHO) decreed a global pandemic of COVID-19 and 10 since the governor Wanda Vázquez Garced it ordered to suspend all non-essential activities, the tests to detect the disease were still dropped yesterday, and the data that would help to understand the magnitude of the threat were still scarce and opaque.
The absence of basic information blinds the pandemic here to both the public and the medical and scientific community, as well as the government itself. Uncertainty reigns, moreover, at a time when the governor is evaluating whether to extend the curfew and the suspension of non-essential activities beyond the expiration of her executive order on Monday, March 30.
Yesterday, Vázquez Garced received from the medical work team that advises him in the management of this crisis the recommendation that he extend the curfew and forced closure for two weeks, one of the members of the organization, the infectologist, told El Nuevo Día. Humberto Guiot.
“We are still in the phase of infection when we understand that there are asymptomatic carriers who are the engine of the infection and who are the ones who can carry the infection to other people. This is the time to stop the exponential growth that could emerge. We still have to emphasize social distancing ”Guiot noted.
It was not possible to confirm last night whether the president would accept the recommendation of the special working group. Michelle De la Cruz, deputy press secretary of La Fortaleza, only said that “when the final decision is made, she (the governor) will announce it.”
However, this newspaper learned that the governor is preparing to follow the advice of the “task force”, but it would be a different curfew than the current one. “It would be more flexible in some areas and stricter in others,” said one source.
At the commercial level, some lines would be made more flexible so that certain businesses, which now remain closed, can open. Instead, the curfew would be stricter with respect to crowds of people and the conditions in which some public employees work. “There are still many people on the street, and that has to be corrected to minimize the risk of contagion,” added the source.
Insufficient evidence and information
Until yesterday, only 582 tests were known in Puerto Rico, 224 of these carried out by organizations outside the Department of Health, such as the Veterans Hospital and private laboratories.
On Tuesday, the agency conducted 78 tests, the highest amount in one day, but still far from what is considered optimal to have a clear idea of how the new coronavirus has behaved here, which until yesterday afternoon it had infected 462,000 people, and killed 20,853 in the world.
In Puerto Rico, 51 positive cases were known yesterday. But, beyond the age and the region in which they are served, the government does not give more information. It has not reported, for example, in which towns the infected live, how they are believed to have contracted the virus, if they are hospitalized or if their contacts were tracked, so that these people take the necessary precautions to prevent further follow-up. spreading the virus.
At some point, it was considered essential to know whether the infected had traveled or had contact with travelers. The government has not released again how many of those infected meet these criteria or were the subject of community infections, which are those that occur between people who have not left the island or been in known contact with someone who had been outside.
The medical and scientific community is alarmed at the government’s lack of transparency on this critical issue.
“This is like us driving a car with our eyes closed. At a given moment, if we do not have the ability to see, that we will not have it until there is evidence, we can hit a wall or go off a cliff, “said Dr. José Rodríguez Orengo, professor at the Medical Sciences Campus of the University of Puerto Rico (UPR) and advisor to the Public Health Trust, a quasi-public body attached to the Science, Technology and Research Trust.
The subject of the tests is critical. Experts consider that each day that passes without them being available is a time when the virus can be spreading around the island without knowing exactly how.
The 582 tests done here until yesterday assumes that 18 have been performed for every 100,000 inhabitants.
The two countries considered the global standard in the fight against the coronavirus, South Korea and Germany, have made 647 per 100,000 inhabitants, the first, and 585, the second. The United States, whose cases yesterday exceeded 60,000 and which is facing a major crisis with this pandemic, had until yesterday done 90 tests for every 100,000 inhabitants.
200,000 tests are coming
To make matters worse, the tests that have been done in Puerto Rico have a bias, since almost exclusively people with symptoms are examined, so they do not give an idea of the real panorama of a disease that in most cases It does not present symptoms, said the infectologist Ángeles Rodríguez, who was an epidemiologist of the State between 2000 and 2003.
“The Department of Health is in a delicate position because there is no abundance of evidence either for us or for anyone,” he said.
A week ago, the governor said she had ordered the purchase of 200,000 rapid tests. Dr. Guiot said that the first 1,500 of these tests, purchased in an Asian country that he could not specify, should arrive between today and tomorrow, and that the rest will arrive in the week of March 30 to April 4.
Dr. Guiot said that the team, along with government officials, are working to offer more detailed information on those infected with coronavirus, including the villages of origin of the patients, in the near future.
“It is not that the information was hidden, it is that it was not available when we started working,” said the doctor.
He added that the “task force” is reinforcing the process of tracing patient contacts. “One of the reasons the ‘task force’ was activated was to strengthen areas in which support had to be given,” he said.
Dr. Rodríguez is also not sure that the Department of Health is effectively doing contact tracing for those infected because she barely has a “skeleton” of the job she would need.
“I don’t think there is much direction on that. I know of a positive case in a hospital that had to trace contacts. That is not for the hospital, “said Rodríguez.
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