Jacky Cheong has no doubt that Macau will be able to resolve the epidemic situation and return to a zero infection rate in a short time. He says that with the exception of a few mistakes at the beginning, the authorities have been fine and that this week’s results will determine how quickly the anti-pandemic measures are lifted. On coexistence with the virus, he reiterates that it always depends on the ability of the health system to respond, and that in Macau the most vulnerable groups would be affected.
Macau has organized several rounds of mass testing since the outbreak began. These epidemic prevention measures have created a wave of discontent and doubts about their effectiveness. Jacky Cheong, professor at the Faculty of Public Health at Shanghai Jiao Tong University, says that from a preventive point of view, the current government measures – massive testing and reduction of population movement – are a two-pronged strategy.
This means that the first seeks to identify positive cases as early as possible to isolate them, as well as their close contacts; the second tries to slow the spread of the virus. “Reviewing the most recent data, we have seen a chain of transmission in the community. The delay in the first phase of mass testing meant that, for a few days, the infected and their close contacts were still active in the community”, he analyzes. The first cases were detected on June 18, and the following day at 12:00 the first round of mass testing began. However, this only ended on June 21, that is, the authorities created a 48-hour window to carry out the test.
Even so, he affirms that there has not been an explosive rise in the number of cases, proving that the measures initially implemented by the Government had an effect. The virologist also says that “the relatively low number of cases detected in the community during the 10th and 11th of July are proof that massive testing is effective. With this efficiency of the authorities, it is only a matter of time before we reach a zero infection rate.” He argues that, initially, the authorities did not want to have a major impact on the community, having adopted lighter measures at the beginning of the outbreak, starting from the two-pronged strategy.
SPACE FOR IMPROVEMENT
It is not the first time that Macau has faced an outbreak, and that is why Cheong says that the Government was able to coordinate itself and disseminate relevant information in a competent manner, especially with regard to testing. He also stresses that any measure that restricts the movement of people has an impact on their daily lives.
“When the number of cases started to grow, some mistakes [by the authorities] became obvious, including long queues for tests with a deadline of 48 hours, due to possible miscalculations. As it involves an increasing number of people, communication problems arise between departments, which can result in errors and criticism”, he says. However, he believes that compared to other places, Macau has not seen an exponential growth in cases and that the local situation remains under control. “There is room for improvement (…), but I believe that [the authorities] will make progress”, he reinforces.
GET TO ZERO
The virologist says there is no doubt about the possibility of mitigating the virus in the community. The numbers are decreasing to achieve this and reiterates that if Macau does not have infections for a week, this objective will be met. Prevention and control measures are described as solid during the first two weeks, with the effectiveness of the testing process improving significantly with the evolution of the epidemic.
“The time required for mass testing has been reduced, especially after Guangdong sent aid. If we look at the results of the last round, we can see that transmission in the community has gone down, that is, they were able to identify and isolate some of the transmission sources.” In the same vein, he points out that the increase in the number of cases has mostly taken place within the areas under medical observation, which he considers to be good news.
COEXISTENCE WITH THE VIRUS
The current outbreak is dominated by the Omicron BA.5 variant. Asked about the possible coexistence with the virus, the virologist responds that the existing strain does not determine the approach, but the economic reality and capacity of the city’s health system.
Regarding the possibility of becoming a new seasonal flu, he says that “the vaccination rate in Macau has already reached a good level, but the adoption of a coexistence approach will undoubtedly have an impact on the most vulnerable groups, such as children and the elderly. , as well as in the health system. “Now it is a question of social consensus on the best way to deal with this epidemic, without thinking about the different variants of the virus”, he clarifies.
‘TIMING’ TO LIFT RESTRICTIONS
The population’s concerns are mainly related to social distancing measures and the criteria to reduce these restrictions. The answer lies in the results of mass tests that, according to the expert, can be used as a reference. If there is a significant reduction in the number of infected people among the community, or even zero cases, he argues that there is no obstacle to the suspension of restrictions.
“The Government is carrying out these frequent tests in the hope that their results will serve as a reference for a possible reduction of restrictions”, he explains. At least until July 18, most businesses will be closed, due to the “partial lockdown” in Macau. Jacky Cheong says this factor will reduce the number of infected. However, if measures are immediately suspended without isolating positive cases, he warns of the risk of repeating the mistakes made at the beginning of the outbreak.
DIVERGENCE OF IDEOLOGIES
Chen Chien-jen, former vice president of Taiwan and a virologist with long experience in public health, published an article in which he states that “the incidence rate of a disease determines the positive predictive value”. “For this same reason, the Taiwan Center for Disease Control and Prevention decided to isolate homes and infected people in their homes [with a higher incidence rate], and use rapid tests to confirm diagnoses, however it is not an adequate solution for social groups with low incidence. ”, it reads.
Asked about the current situation in Taiwan and its possible application in Macau, Jacky Cheong explains that the main difference between the two regions is that Taiwan chose coexistence with viruses: “If the method of coexistence with the virus is adopted, the antigen tests are sufficient, along with isolation in case of infection. However, if Macau adopts the goal of “zero infection”, then more accurate data is needed. That is why it is highly important to adopt reliable, quick measures that can be used to isolate positive cases.
This requires nucleic acid tests, or a mixture of both. In this regard, we are extremely lucky to receive support from mainland China, which makes it possible to carry out mass testing at low cost.”
He argues that Macau’s situation does not compare to the incidence rate mentioned in the Taiwanese vice president’s article, as the two regions have different objectives and Taiwan’s prevention measures serve as a supervisory system. “As long as the number of positive cases does not exceed [Taiwan’s] capacity, they will accept the situation because the two regions have set different goals.” Jacky Cheong also explains that the nucleic acid testing industry in Taiwan is sparse, so it is extremely expensive to carry out large-scale testing.
