Issue link: https://maltatoday.uberflip.com/i/1281593
2 maltatoday | SUNDAY • 23 AUGUST 2020 NEWS JAMES DEBONO FOR Dr Chris Barbara, Mal- ta's most prominent virologist, Malta's high rate of swab tests is something we should be proud of. "It is the key to Malta's suc- cessful containment of the dis- ease during the first wave and probably the key to recovery from the second wave," Barbara says. Recalling advice given by the World Health Organisation, at the onset of the pandemic – "swab, swab, swab" – Barbara says a significant financial in- vestment and round-the-clock work of health workers has al- lowed Malta to follow this ad- vice to the letter. Malta has now achieved the third-highest swab- bing rate in Europe after Lux- embourg and Denmark. And the number of tests reached an all- time high this week, increasing from 500 in the beginning April to over 3,000 now. Barbara praises his eight-per- son team, describing them and other health officials involved in contact-tracing as "heroes en- gaged in the frontline in keeping the virus at bay". Earlier last week, the hotelier Michael Zammit Tabona, no a stranger to controversy with comments that recently cost him his resident-ambassador- ship for Finland, railed against over-testing of COVID-19 cases for detecting a higher rate of in- fected people. But Barbara's logic in defending high swabbing rates is impecca- ble: "The more swabs you take today, the more infected people you detect and isolate from the community. This is why swab- bing is not a statistical census to measure the people infected by COVID-19 but an effective tool in reducing numbers. For the more people you swab now, the less cases of COVID-19 you will have in the next weeks, sim- ply because you would have re- moved more infected fish from the pool, which would otherwise have infected more fish." This is why swabbing alone is not enough. It has to be accom- panied by contact-tracing to test and isolate those who potential- ly have come in contact with the people found positive for the virus. The more infected people are removed from the pool the less the chances of infection for other fish swimming in the same pool. Chris Barbara again uses a fish- ing analogy for swabbing, com- paring to catching fish with a net. "When someone is found positive, you would not have just caught one person in the net, you would have caught all the potentially infected persons in his or her circle. The more peo- ple you isolate, the less infected fish there are swimming in the pool. In this way the numbers start decreasing." Barbara admits that the task was easier during the first wave of COVID-19 when Malta closed its ports and airports, in a way that no new infected fish could find themselves in the pool. At that time people were also strict- ly adhering to social distancing, minimising the risk of infection amongst those still swimming in a pool, which had been isolated from the rest of the world. "We had reduced active cases to just two, by removing near- ly all the infected fish from the pool. We were so close to be- coming COVID-free! "But the opening of airports and the relaxation of social dis- tancing meant that a few con- taminated fish managed to get through in to the pool, managing to contaminate many more fish in a way that the situation deteri- orated rapidly in just a few days." But swabbing, together with mitigation measures like limiting entry to the country to people certified COVID-free, is the key to reducing the numbers again. Barbara acknowledges that in the short term, conducting more tests now means detecting more cases of infections. "Temporarily you will detect more cases, but this means that in the long term you will find less cases. It is true that on one par- ticular day we had 72 cases. But this meant that all these people and their immediate circle were quarantined and thus stopped from infecting others. If we had not swabbed all these people our hospital will be already flooded by infected people and more vul- nerable people would have been exposed to infection…." Swabs also serve to protect the most vulnerable. "For example, Malta is one of the few countries where everyone who is to be op- erated at Mater Dei Hospital, is tested," Barbara says. Barbara is cautiously optimistic that the large number of swabs, coupled with more restrictions on travel from abroad and trans- mission hotspots like clubs, will result in a decrease in num- bers. "I hope that we will even- tually start detecting less cases which means that there will be less contaminated 'fish in the pool'." Fish in a pond: swab now, less COVID-19 later Virologist Chris Barbara (centre): high rate of swabbing is key to Malta's successful containment Cases 1577 Active 666 Recoveries 901 Deaths 10 Swabs 171,103 LATEST COVID-19 www.maltatoday.com.mt/covid19 Trumpian logic: the US president complained about over-testing revealing more infections In a display of true Trumpian logic, hotelier Michael Zammit Tabona suggested Malta stops 'over-testing' for COVID-19 because its high rate of swabbing had driven down the economy. But experts disagree: swabbing's higher detection is key to reduce COVID-19 cases by removing the infected from circulation Daily tests per 1,000 inhabitants Luxembourg 5.25 Denmark 2.92 Malta 2.84 UK 2.03 Greece 1.95 Belgium 1.73 Portugal 1.36 France 1.15 Lithuania 1.09 Germany 0.98 "When someone is found positive, you catch all the potentially infected persons in his or her circle. The more people you isolate, the less infected fish there are swimming in the pool"