Forget CAR score. Secure medical capacity and diabetic care4
HSVG misson P.O. Box 206, Hagatna, GU 96932, USA
(01/17/2022)Did G20 learn lessons from the Delta? When the world welcomed 2022, many people were actually calling the new year “pandemic year 3.” If we have had it enough and do not want “pandemic year 4,” year 5 or year 6, let’s encourage Indonesian government step forward with its Group of 20 (G20) presidency to call for an international campaign helping people around the globe fearlessly live with the coronavirus and adopt the new normal as soon as possible. Quite a number of public health experts had advised before COVID vaccines became available that the human society was inevitably going to live with the coronavirus for a while and only sustainable measures would help everybody get through the pandemic. Unfortunately, most governments , with certain high-profile scientists and celebrities, put so much faith in lockdowns and looked forward to seeing COVID vaccines would work perfectly like a silver bullet even though, at that time, almost every vaccine developer was apparently targeting at lowering the numbers of severe patients and death victims instead of guaranteeing no infections after getting vaccinated. The Delta variant’s attack last summer was a wake-up call. Many countries, after enjoying reopening and sort of returning to normal brought by successful vaccine rollouts, experienced the Delta variant of the coronavirus caused a new wave of case surge, made hospitals overwhelmed again, and, sadly, took many people’s lives. It was the time that people started being familiar with a term called “breakthrough infections.” For example, Singapore surprisingly reported 28,901 new infections and 40 deaths in September 2021 after the vaccination rate was beyond 80%. Their COVID death number was zero in September 2020 when there was no CIVID vaccine at all. The epidemiological investigation and laboratory results concluded the changed situation was mainly caused by the Delta variant. Singapore was not the only place having a bad September last year. As of 31 August 2021, 80.43% of the residents 12 years and older were fully vaccinated, but Guam, an US island territory in the Pacific reported 47 COVID-related fatalities in September 2021. The figure was higher than the death number of 39 reported in September 2020 when no vaccine was available at that time. With almost the same land size, Guam is home of less than 200 thousand residents and Singapore has a population of 5.7 million. It means the highly-contagious Delta variant was influencing everywhere, no matter a busy and crowded city or a relaxed and rural place. In addition, obviously, vaccines alone are not suppressing the coronavirus. Europe’s experience reminded that nobody should drop his/her guard even thought the population reached a high vaccination rate. European Union has been leading its member states to keep precautions and try reopening in a gradual way. The continent has maintained a basically downward curve of infections as well as hospitalizations and deaths since its successful vaccine rollouts in association with well-managed medical capacity, even though the Delta variant did make a noticeable, but not really harmful, spike. However, it seemed that most parts of the world did not learn lessons from the Delta and implement proper measures when the Omicron came. The World Health Organization did not wait for sufficient morbidity and fatality data to be collected. Its warning message on the Omicron variant released late November last year triggered many countries’ panicked decisions of tightening COVID restrictions. It’s sad that South Africa’s variant identification efforts, which should have been appreciated, made its people punished by the almost worldwide travel ban. The wait wasn’t even long. Before last Christmas, at least three scientific researches caught the media’s attention and proved the Omicron variant may be much more contagious but it’s mostly causing mild cases. However, the chaos has hurt people. For example, Guam, which finally saw a little bit tourism recovery last November, immediately suffered from more than 5000 travel booking cancellations right after the Omicron panic widely spread. More variants will definitely come and we definitely do not want more chaos. While the Omicron has shown the new variants in the future are very likely to be less lethal and the COVID vaccines are actually promisingly reducing severe cases, plus the antiviral medicines are available, the whole world really needs a leadership that urges every jurisdiction to guide people fearlessly living with the virus by using more appropriate strategies to respond to every emerging variant. Let’s try to recall whether the system was encouraging people to get tested during the flu season to try to contain flu viruses. Were we worried so much when we experienced flu-like symptoms or got diagnosed as having flu? Wasn’t the goal of flu control to avoid severe complications and save people’s lives? The best tools helping us achieve the goal are always personal hygiene and flu vaccines although so-called “breakthrough infections” did happen to flu vaccines as well. COVID is not flu, but flu control experience could apply to COVID response, especially to the current situation of “pandemic year 3,” a year that G20 presidency returns to Asia, where people totally have no issue with wearing a mask and helped prove this measure could effectively prevent COVID spread. Indonesian government needs to work with its G20 partners and make history.(Published in The Jakarta Post on January 11, 2022) http://www.hsvg.org/hot_414422.html Did G20 learn lessons from Delta variant? 2022-01-17 2023-01-17
HSVG misson P.O. Box 206, Hagatna, GU 96932, USA http://www.hsvg.org/hot_414422.html
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(August 12, 2021)

Forget CAR score. Secure medical capacity and diabetic care


Guam island community noticed the so-called CAR (COVID-19 Area Risk) Score has increased. It seems the CAR Score is mainly attributed to the number of new infections. Given Guam’s high vaccination coverage, the hospitalization number is actually a better indicator to monitor in the post-COVID era.


The coronavirus causing COVID-19 is doubtlessly a highly contagious pathogen. Research findings from the US, the UK, Israel and other countries have proven the current vaccines are very effective in reducing transmission, severe illness and deaths, however, instead of preventing infections. That is why many breakthrough cases have been seen around the world. The number of new infections is therefore not the most appropriate indicator to monitor the pandemic, and the hospitalization number is, especially after the COVID vaccines rolled out.


So, in the Asia-Pacific, Australia and Singapore have announced their new response strategies of treating COVID like the flu. Singapore also decided to stop counting COVID cases. In Europe, the British government declared they would live with COVID like the flu even if cases keep soaring. These countries are focusing on vaccine rollouts and carefully keeping an eye on COVID hospitalizations.


In Guam, 122 COVID deaths were reported in 2020. After vaccine rollouts started last December, the death number was 12 in the first quarter of this year and six in the second quarter. The daily hospitalization number has been kept at less than 10 for several months. Obviously, successful vaccine rollouts have helped Guam reduce severe cases and deaths. What the island community now really needs to pay attention to is the hospitalization trend and whether our medical capacity is sufficient to deal with any possible increase of hospitalized patients if new variants of the coronavirus or any other emerging diseases hit our island.


In the past year, Guam residents were so frightened by the overwhelmed health care system, especially the island’s only public hospital. While we finally get a break, our island community definitely wants to see the government invest more in the hospital, especially in the intensive care unit. It is great to know Guam Memorial Hospital has established a telemedicine platform to bring the help of critical care physicians from the states, according to the hospital’s press release last week.


Every Guamanian also needs to understand that, because preventing infections is not really one of the main benefits the current COVID vaccines could offer, we should not drop our guard. Let’s live with the healthy new normal of good hygiene. People with diabetes, kidney disease, heart disease or lung disease must well manage those underlying medical conditions because they usually cause severe complications once chronic patients get infected.


Finally, another important lesson Guam has to learn from the pandemic is that a more advanced disease surveillance system, probably with help of genetic and digital technologies, is necessary for Guam. We need a system to find suspicious cases early, identify possible pathogens timely, manage infections and trace contacts efficiently when new variants of the coronavirus or any other emerging diseases come. Once again, while we finally get a break, what we should do is the preparedness for future threats.