Multiplying the tests will permit to flex the confinement - IDESA

Report Nº: 85302/04/2020

Multiplying the tests will permit to flex the confinement

Confinement to stop Covid-19 infections is a short-term strategy. It generates growing resistance in the population and depletes rapidly the State’s capacity to subsidize people for not working. By multiplying the tests, confinement could be relaxed more quickly without increasing contagion.

Two types of strategies are proposed to address the coronavirus. One is mitigation based on quarantining those infected and those close to them. The other is confinement, which consists of locking the entire population in their homes. Mitigation aims to reduce the number of new cases each day compared with the previous day and thus converge in the medium term to sensible reduction of new cases. Confinement is more ambitious because it aims directly to cut off the spread of infection.

Argentina opted for confinement. The decision may have been wise because it was made early and taking advantage of several holidays, which reduces economic losses. But confinement cannot be extended for long. In addition to the fact that the population will become increasingly fed up, the State’s ability to assist formal businesses and informal workers, who make up almost half of the workforce, is limited.

This poses a huge challenge for which it is useful to observe the progress of the disease in other countries. The experience of Korea, Italy, and Spain can be illustrative. According to the World Health Organization, in the last 14 days:

  • In Korea the average daily rate of new cases was 2% and the number of tests performed to detect the coronavirus is 6,150 x million inhabitants.
  • In Italy the average daily rate of new cases was 20% and the number of tests performed to detect the coronavirus is 3,500 x million inhabitants.
  • In Spain the average rate of new cases was 36% and the number of test performed to detect the coronavirus is 650 x million inhabitants.

These data show a high correlation between testing for coronavirus and deceleration of new cases. Beyond the fact that a multiplicity of factors operates, the relationship is not coincidental. The World Health Organization and scientific societies in epidemiology recommend that the most effective strategy to control contagion is the massive application of coronavirus testing in the population.

Tests are central to the fight against coronavirus because many people, especially children, youth, and adults of active age, are asymptomatic carriers or have mild flu symptoms. Among the elderly and chronically ill, the disease occurs critically. With the test, asymptomatic carriers can be detected, and confinement can be focused on them, freeing unaffected people to return to productive activity and normal social life. In other words, mass confinement is a costly measure generated by ignorance of who is infected. The tests allow overcoming this ignorance.

The main problem is that the logistic required for mass testing is very complex. Highly organized countries, such as the Europeans, were not able to set it up at speed needed for the pandemic. This is a credit to the Korean health system and great weakness in Argentina. Currently, the test is done only in a public institution in the city of Buenos Aires, and work is being done to do it in some other provinces. If the pace is accelerated, the confinement could be relaxed.

No doubt, the pandemic will leave many lessons. One of them is the importance of adjusting the public sector to the federal regime mandated in the Constitution. In the area of health, there is not one system, but 24 systems in charge of each of the provinces. The national State is responsible for epidemiological surveillance, but it is the provinces that are responsible for implementing health actions. These include setting up the logistics for the tests and organizing the health care capacity to absorb the increased demand the pandemic will generate. The fact that the federal State intends to replace the provinces, far from providing solutions, increases the unwanted consequences. As in other areas, federal interference in provincial functions leads to waste and, fundamentally, dilutes responsibilities.


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