Report Nº: 85617/04/2020
Coronavirus tests are an irreplaceable tool for evidence-based medicine. The government’s refusal to multiply the tests leads to unscientific decisions. Without a change in strategy, the population confinement will tend to be perpetuated with very high social, productive, and health costs.
The pandemic continues to be presented with much sensationalism. With the number of new cases in Italy declining and the pressure on its health system easing, the panic is now being sustained using images from New York. The piled coffins in hospital mortuaries seem shocking. However, New York is a city of 19 million people, where 12 thousand regularly die every month. Since the outbreak began in early March, 8 thousand people have died. Since most are over 70 years old and have pre-existing diseases, coffin accumulation likely responds more to family members’ confinement than an increase in mortality.
In line with this context of panic, the government announced a further extension of the isolation, even though Argentina shows fewer infected people in the region. The 2 thousand cases detected represent about 45 per million inhabitants. It is lower than Brazil (86) and much lower than Chile (340), Ecuador (280), Peru (160), and Uruguay (136).
What is behind this enormous difference between countries in the region? In order to find out the answers, it may help to look at the different virus detection strategies in the countries. In this regard, according to the site worldometers.info/coronavirus/ it is observed that:
These data suggest that the number of cases detected depends on the number of tests. Some countries take virus detection, such as Chile and Uruguay, seriously. They strive to perform as many tests as possible. Others, with more limited resources, such as Peru and Ecuador, are in the middle range. In Argentina and Brazil, the option is not to do many tests. Therefore, the statistics are reflecting the health policy decision not to measure the disease and not that contagion is being mastered.
The lack of information due to the scarcity of tests leads to erroneous assessments. For example, projections of deaths are distorted. International experience shows that the higher the number of tests, the lower the percentage of reported deaths in relation to the number of infected persons. Argentina has a proportion of 4.3% of deaths over reported cases, while Peru has 2.6%, Uruguay 1.5%, and Chile 1.0%. It is clear that projecting deaths with few tests, rather than a projection, is guessing.
In the medical community, there is a non-negotiable principle: to make medicine based on evidence. To have consumed 24 days of isolation without having done massive testing leads to extend the population confinement without scientific support. The confinement is extended by ignorance of the dynamics of the contagion. This leads to wrong decisions. A relentless example of the damage caused by making decisions in the dark is having prevented hospitals from continuing to function normally to prepare them for the coronavirus. The result is that, so far, hospitals are empty, doctors are out of work, and the vast majority of people who do not have coronaviruses, but have other diseases, are suffering and dying at home without medical care.
At this point, the importance and urgency of changing the strategy are evident. Instead of acting on panic and fundamentalism, evidence-based medicine must return. The multiplication of tests is the way to get out of ignorance and start making scientifically based decisions. This will also help to make prevention measures more rational. By combining the multiplication of tests with proper prevention protocols, a large part of the population can return to work without increasing the risk of contagion. The alternative is to continue being trapped in confinement, which people will stop complying pushed by unmet basic needs.