Editorial: The Enemy We Cannot See

IT is hard to fight any battle – but it is harder still to fight an enemy you cannot see.

The battle against COVID-19 is, of course, unlike many physical battles, and yet it shares similarities in how we defeat it. We must know where it is. We must know its strength. We must know the number we are facing.

Do we really know for sure how many cases of COVID-19 we are dealing with? According to three international research groups, our confirmed numbers are much lower than the likely number of cases. One group said that on a day in August, when we recorded only double-digit numbers of new cases, the actual number was likely to be 14 times higher than that.

The researchers draw their estimates from a number of sources – they consider confirmed cases, confirmed deaths, testing rates and knowledge about epidemics themselves.

The numbers are shocking. In March, on a day when just four cases were confirmed, Imperial College London estimates we had 453 cases. Another group, IHME, estimates there were 118 cases.

Now part of this is understandable because of the nature of COVID-19 itself. It is estimated by the World Health Organisation that around four in every five cases of COVID-19 are mild or asymptomatic. What that means is that people are not experiencing symptoms. If you don’t have symptoms, you don’t call the doctor, you probably don’t take a test, you don’t show up on the list of confirmed cases. You can, however, keep spreading the virus.

Asymptomatic people would be detected if they took a test, however, so the question becomes whether enough testing is being done to find people who don’t know they have the virus – and prevent them from spreading it unwittingly.

These questions have been raised with Bahamian experts – but testing numbers have overall remained low.

Back in May, advisor Dr Merceline Dahl-Regis said that The Bahamas does “not have the capacity to do mass testing”, while in July she acknowledged: “Many have asked about mass testing. Mass testing is most helpful at identifying cases where there is community spread. Testing will identify a case but this must be accompanied by contact tracing, testing of contacts”, isolation and quarantine.

To date, as of last night, 20,261 tests have been completed in total since the start of the pandemic. That includes multiple tests of the same people – and a common part of the process of ensuring a patient has recovered from COVID-19 and can leave quarantine is a retest. Even if that was entirely separate patients, that would represent about five percent of the total population over the whole time of the virus.

Perhaps this is our strategy, the way we think is best to tackle the virus. Or perhaps this is what we are forced into because of the lack of availability of supplies or testing capacity. Perhaps we can’t get enough lab space to test in the numbers we need.

Whatever the reasons for our approach, you can only fight the enemy you see, and if these researchers are right, there is a vast swathe of the battlefield we cannot see anything on. We can’t engage COVID-19 if we aren’t tracking it.

The solution could easily be said to be get more test kits, hire more labs – but we are not the only ones in that market. How plausible it is to do that is an entirely different question. If it is possible to do more, then absolutely we should, but if we cannot then we are left with the same weapons to use in this fight: wear your masks, keep your distance, wash your hands. Keep doing those, for all our sakes.

Back to work - safely

It’s getting to the sharp end of things for many businesses whose doors have been closed down so long that they are having to make tough decisions about how to keep going.

One of those businesses is Fusion Superplex, the cinema complex, that says it may have to terminate staff and restructure finances if it cannot open again by early November.

The company is making its own assessments about how to open safely – with a capacity reduced to about 30 percent of maximum, and the cinema is eager to make the most of movies coming out at the end of the year.

Of course, it has to be safe – and the goal to bring in customers and money must not trump safety. Some locations have been ingenious with their thinking about how to approach matters safely – drive-in movies have made a comeback in a number of areas, for example, allowing people to watch the film and share only the space in their car.

But when it is safe, we hope businesses do get the green light to cautiously return to the market. It is good for the business, it is good for the government coffers – Fusion was already on a payment plan for NIB and those NIB funds could do with replenishing.

We long for a return to normal – but only when it’s safe.


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