Issue link: https://maltatoday.uberflip.com/i/1243341
PHOTO BY JAMES BIANCHI 8 maltatoday | SUNDAY • 3 MAY 2020 INTERVIEW In a recent interview, the Prime Minister said that "It would be imprudent to remove re- strictions all at once." Instead, government is contemplating a more gradual transition. How- ever, some have argued that it may be premature to consider lifting any restrictions at all, at this stage. Do you agree with those concerns? Any government, wherever it be, must base its decisions re- garding when to lift restrictions, and at what pace, according to the local situation: both econom- ic and from the public health point of view. Obviously, as a doctor, my primary concern is public health, but I also recognise the economic cost of the current position we are in. The question to be asked must be whether it is worth risking all the sacrifices we have made so far in order to open up the coun- try too fast, and to then regret having done so and start all over again with partial lockdown, and with an even greater economic cost in the long term. We must be cautious, open up less risky activities first, and modify how we practice others. We have to test the waters, and ensure the steps already taken do not result in the deterioration of Malta's COVID-19 picture; and then move on, but only when we are sure it is safe to do so. Malta has so far adopted a con- tainment (as opposed to 'herd immunity') strategy: which im- plies that the vast majority has so far been unexposed to the virus. Isn't there a danger that, by easing restrictions now, we may be inviting a 'second wave' of new cases? Firstly, the herd immunity con- cept is based on the supposition that the Sars-Cov-2 virus (the re- al name for the COVID-19 virus) will not mutate in the future. If it does, it would render previous immunity through exposure to the virus useless, just as happens with seasonal influenza. So I cer- tainly do not advocate it. The human cost of that approach is too huge to be justified: especial- ly when the strategy is based on supposition, not fact. Now, as regards the contain- ment approach. Malta is in a relatively strong position, if we use the fact that we are an island nation, and can easily control our borders, to our advantage. This we can do by shutting down any local infection through aggressive contact tracing, and strict quarantining of those with the infection and their immedi- ate contacts, and by keeping our ports and airports closed to pas- senger traffic until the current pandemic is over. We will then be able to open Malta – but only internally – sooner rather than later, giving much needed relief to a large section of our economy. Evidence to date suggests that patients who recover from COV- ID-10 may still have a chance of re-contracting the disease. If that is the case: doesn't it also mean that the virus is here to stay regardless? I have answered part of this question in the previous one. The fact is, nobody really knows. COVID-19 is a new illness. The virus may mutate into a milder form that will spread wider but cause less harm; but it may do the opposite. We do not know if the reported re-infections were due to people being really previ- ously cured, or whether they only had false negative tests that sub- sequently proved positive. The only reliable way to know is by testing for antibodies. Only to- day (29 April) it was announced that the EU has approved an an- tibody test that is 99% accurate; but it only tests for previous ex- posure to the virus, not current active infections. That is still in the pipeline. Until we can reliably assess the situation, decisions – even by ex- perts - will be based partially on speculation and calculated risk rather than hard fact; a situation that has been a feature of the en- tire world-wide handling of this crisis thus far. Meanwhile, the hopes of a long-term partial lockdown are pinned on the successful devel- opment of a vaccine. Does the fact that COVID-19 may be re- Is Malta relaxing its COVID-19 restrictions too early? Former PD chairman Dr ANTHONY BUTTIGIEG argues that any hurried decisions taken today may risk undoing all the positive results achieved so far Too much, too early? Raphael Vassallo rvassallo@mediatoday.com.mt Until we can reliably assess the situation, decisions, even by experts, will be based partially on speculation and calculated risk rather than hard facts; a situation that has been a feature in the world-wide handling of this crisis thus far