Issue link: https://maltatoday.uberflip.com/i/1256426
PHOTO BY JAMES BIANCHI 8 maltatoday | SUNDAY • 7 JUNE 2020 INTERVIEW On Monday, Health Minister Chris Fearne announced that Malta had 'won the war on COVID-19'. This view, howev- er, does not seem to be widely shared by the medical com- munity. The Malta Association of Public Health Medicine has described the lifting of further restrictions as 'premature'. Where does the Malta College of Pathologists stand on this? Have we really 'won the war'? The use of the phrase 'won the war' was a very unfortunate one, and has given the mistaken impression that this is over. It is not. We have certainly won a major battle, if one wants to use a similar analogy; and so far, we must consider this a relative suc- cess. However, this is a 'world war'; and until such time as the virus is around in other parts of the world, not only Malta, we still have to be on high alert. The College of Pathologists agrees that we are not yet out of the woods. The virus is cer- tainly still present in Malta, and we agree with our medical col- leagues that too many restric- tions have been lifted, too quick- ly. We would have been more cautious and continue to lift restrictions in a more controlled manner. Regardless of whether the dan- ger is fully behind us or not, the figures do show that Malta has been far more successful than other countries in containing this virus. What are the factors behind this success? Why do you think Malta did not suffer the same fate as countries such as Italy, Spain, etc? Our success has not been a for- tuitous one. Thanks to a huge concerted effort by our own ex- perts in virology and infection control, our colleague experts in public health, the health minis- try, all front liners and not least of all, the public, Malta acted fast and effectively with meas- ures put in place before the virus even got here. The relentless testing and trac- ing, with a high testing rate, has played a major role in limiting the spread of the virus. Putting vulnerable people out of harm's way was also a crucial factor. All this has had a major impact on how we controlled the situation and has greatly mitigated the ef- fect of the virus. One need only look at the countries you mention, together with others like the UK and the US, to see the devastating conse- quences because things took too long to happen. Both the Health Minister and Superintendent of Public Health Charmaine Gauci cited statis- tical evidence to justify the easing of restrictions, includ- ing that 'the rate of infection is now below 0.5, meaning each infected person passes it on to less than one other'. Doesn't this also mean that the virus is still spreading, albeit at a lower rate… so it may still pose a dan- ger to vulnerable people who contract it? The answer is yes. The virus is still here and may still pose a threat, albeit to a lesser degree. All it takes is for one infected person in a crowd to get the ball rolling again. We need to be sen- sible and careful at all times. We cannot let our guard down. Another justification is that pro- longed lockdown would have health consequences of its own: both physical and mental. Has there been any evidence of worsening public health during the lockdown? I spoke to a psychologist col- league today, who tells me that the impact on mental health has been a major issue. There is fear, there is loneliness, there have been marital problems, economic problems, and oth- ers. These have all contributed, in varying degrees, to mental health problems. I believe this issue has been well discussed by experts in the field. Apart from the fact that men- tal ill-health can affect phys- ical health, one of the collat- eral damages, if you like, of controlling the pandemic is that our physical health has not tak- en centre-stage. With everything fully focused on COVID-19, other diseases have not been given priority as can be expected. This scenario is not peculiar to Malta and has been reported in many coun- tries now. We know that we have had sev- eral deaths from heart attacks because patients were afraid to come to hospital. We calculate that between mid-March and end May, at least 150 cancers that would normally be diag- nosed routinely, are only now starting to come to light. This will obviously impact prognosis. These are only two examples. There are many others. Hope- fully people with symptoms will now make sure they seek med- ical help. We encourage people not to neglect themselves. As of Wednesday, restrictions of vulnerable categories (eg, over 65) will be lifted. What is your message to those people who will once again be free to leave their homes, but may still be afraid of infection? Once restrictions are lifted, one has to be even more careful than before. Much more. The vulner- able people staying at home were at an extremely low risk of get- ting infected. Now that they can go out, we cannot stress enough the PROPER (in capitals on pur- With 'victory' declared in the war on COVID-19, there is a widespread perception that the danger is behind us. But Dr JAMES DEGAETANO, President of the Malta College of Pathologists, warns that our initial success does not mean that the crisis is fully over Not out of the woods yet Raphael Vassallo rvassallo@mediatoday.com.mt