I learned yesterday that WHO also may not have much clue about what they are talking about. There was a statement by one of the senior doctors that there are not many virus transmission by asymptomatic cases.
You can imagine the uproar. Eventually WHO had to resort to saying it is a personal comment, that it was not interpreted correctly, etc
Who will trust WHO after this as an authoritative source of Covid 19 information?
Designed by Freepik
I have now learned that there are many shades of “asymptomatic”
- Pre-symptomatic – those who have yet to show symptoms but will eventually be sick with symptoms
- Mildly sick – those who are sick but don’t have obvious symptoms
- Asymptomatic – those who are sick without any symptoms
You realize that it all doesn’t really matter to the public as you will likely be infected if you have close contact with anyone of them.
I think there have been many Malaysians who have fallen sick by being in contact with such cases.
Remember that all those who tested positive are isolated. MOH doesn’t care whether you are mildly sick, or show no symptoms – their standard is the testing result.
Given the above, it means that the general public falling sick and who have not come into contact with known clusters are catching it from the various “shades of asymptomatic” cases who have not been tested and are walking around.
What to do? It is actually down to MOH
Given its current “excess” testing capacity, MOH should change its testing protocol to have a wider random testing programme so that it can catch such cases.
It will probably be less cost-effective than the current targeted testing, but why let the capacity go to waste. Especially considering that it also cost the country to treat the sick; and think of the social-economic cost of having continuous daily cases.
But I would suggest that the random test can be narrowed.
When market research companies do a survey, they don’t simply contact people randomly. They actually try to establish a profile of the population to be studied eg by age, by sex, and then devise a random survey programme where the number of people surveyed bears some relationship to the numbers in each population segment. It reduced that numbers to be surveyed yet provide some statistical accuracy.
As we already know the risk groups, it should not be too difficult for MOH to adopt this idea.
- Foreign workers living in their own quarters can be one segment
- We can leave out the domestic maids
- Those working in enforcement can be another segment
- etc
My point is that the testing strategy should change with the changing environment.
Designed by Freepik OK, I am being facetious
I also learned a bit more about Covid 19 risks to children.
First, there is the Kawasaki disease. This is a rare syndrome that affects young children and which damages the coronary artery so that as the child grows the artery doesn’t grow with them reducing the amount of blood supply to the heart.
Then there is the other PIMS (pediatric inflammatory multi-system syndrome). I understand that the Kawasaki disease is a sub-set of this and the other PIMS differs from Kawasaki in that they don't have the heart problem.
OK, I know that there is still more research to link these sicknesses to Covid 19.
But it does raise concern as we are opening up kindergartens and schools.
My grandkids are in Singapore and they just went back to school on Mon. They wear face shields as one of the SOP. Before the lockdown, the school was already taking the temperature daily of everyone who walks into the school compound.
Now they have this mask and the children are seated apart – social distancing.
You and I know that children are most likely to misbehave. So I don't know how long the novelty of wearing masks and face shields with last before they take them off when the teacher is not looking. We all know that teachers cannot have their eyes on the kids 100% of the time.
The only good (?) thing about this kids' problem is that it is very rare and given that only a small % of children get Covid 19, it is even rarer.
I came across an article citing a French report that fewer than 2 out of 100,000 children would be expected to have PIMS. There is another article saying that PIMS appears most common in children of African descent and this could be related to social or living conditions or genetic vulnerability.
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PS: This blog is for me to better understand COVID 19 as this will impact my investments. If you are also into equities, follow me at i4value.asia.
Disclaimer: I am not an epidemiologist, healthcare worker, pharmacist, or staff in the Ministry of Health, but rather is someone with a strong interest in numerical analysis. The content is an attempt to understand what is happening in the battle against COVID 19 from a data-based perspective. The opinions expressed here are based on information extracted from readily available public sources but I do not warrant its completeness or accuracy and should not be relied on as such.
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