Starting from March and especially during the past few days, many experts have been saying that full-scale screening for COVID-19 is not necessary. Nonetheless, the Kaohsiung City Government on Thursday last week decided that about 4,000 doctors and nurses in Kaohsiung should be tested for the virus.
Thankfully, following some protests, the city government agreed to make the tests voluntary.
However, this issue raises a number of points.
FALSE RESULTS
The first point is that any kind of test would produce some false negative and false positive results, which often have to do with the way samples are collected.
Of course there would be relatively few false negatives and false positives if screening is performed on people who are strongly suspected of being infected. In other words, there would be a relatively high rate of accuracy.
However, there would be more false negatives and false positives if screening is performed on a large number of people who show no symptoms.
If this were to happen at a time such as now, when doctors and nurses are under heavy pressure at work, it would surely create a situation in which they and the people around them cannot work, and where some of those who are really sick with COVID-19 feel safe to go on working, which would make it more likely for them to infect other people.
UNIVERSAL TESTING
The second point is that if doctors and nurses are assumed to be a high-risk group who needs to be screened, then obviously other hospital staff and their family members are no less at risk.
If that is so, should they not all be screened, too?
FUTURE UNKNOWN
The third point is that screening only shows a person’s situation on the day of the test. It cannot show what would happen any number of days later.
It is just as if someone has a lung computed tomography scan in January that does not reveal any sign of lung cancer — it does not mean that lung carcinogenesis would not occur in the same person in June.
So, if authorities want to know whether doctors and nurses are in normal health, they would have to test them every day, otherwise it would be pointless — but that would be impossible.
LOCKDOWNS
Some people have suggested locking cities down or at least holding lockdown drills, but the central government’s disease control experts say there is definitely no need to consider such measures now, as the outbreak has not yet spread out of control.
Doing so could actually have the undesirable effect of causing fear and social unrest.
EXPERT OPINION
Given the existence of the Central Epidemic Command Center, it should have full powers to direct and coordinate the disease-control policies and decisions adopted at various levels of government nationwide.
Politicians would do better to calm down, stop thinking of themselves as experts and desist from making outlandish decisions on the grounds of taking pre-emptive measures.
Officials must bear in mind that the recent COVID-19 outbreak on a navy ship occurred precisely as a result of the Ministry of National Defense placing itself outside the authority of the center.
Jeremy Wang is a retired family physician.
Translated by Julian Clegg
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