Unprepared for MERS-COV

This is my column today, April 22, 2014.

There were a number of questions that begged to be answered in the wake of the feared Middle East Respiratory Syndrome—Coronavirus epidemic that could have happened last week after a returning overseas Filipino worker tested positive - and subsequently negative-  for the virus. 

First, why didn’t the Department of Health act swiftly to require all passengers to voluntarily submit to a quarantine and testing hours after Etihad Airlines Flight EY 0424 landed in Manila last April 15?  Why did it take government a full week before issuing calls through media for the other passenges of the flight to voluntarily come forward to undergo testing and quarantine?  

When media announced that government had quarantined the Filipino nurse and the members of his family who met him at the airport and that there was ongoing search for 12 other passengers who were seated close to or around him inside the plane, one could already sense the utter lack of a comprehensive crisis management plan.  It was clear that the Health Department was winging its way through the crisis.  There was no well thought-out, properly coordinated and laid-out plan that could have been activated immediately.

A crisis management plan would have immediately invalidated the initial decision to limit the sphere of possible contagion to within a few seats of the index patient.  Why limit to only 12 passengers when the patient was within a highly pressurized cabin for almost eight hours, could have gone to the bathroom many times, and could have had close contact with other passengers before, during, and after the flight?  A plan would have provided for leaflets containing information about MERS-Cov and the numbers to call in case of possible exposure to the virus being distributed to passengers when they filed out of the Ninoy Aquino International Airport Terminal.  In fact, the government could have set up a table manned by personnel from the Department of Health at the NAIA Terminal to answer questions or give quick information to the passengers.  All of these, and many other actions, could have happened immediately and many people could have been spared from unnecessary speculation and worry.  

Because our government was not ready, it is now resorting to questionable tactics to encourage all 412 passengers of the EY 0424 to come forward for quarantine and testing—a week after they arrived in the country.  The much-delayed move has increased the possibility of local infections already happening in the event that someone among the 412 did contract MERS-CoV while on board the flight.  The 412 passengers have already come home to their families, interacted with families and friends, and even possibly gone out to public places for the Holy Week.  We’re all praying this has not happened, of course. 

I am not sure the government is morally correct should the Secretary of Health makes true his threat to release the names of all the passengers of EY0424 if they refuse to come out and submit themselves for voluntary testing and quarantine.  That would be tantamount to stigmatizing the concerned individuals publicly just because they happened to be traveling in the same plane as the Filipino nurse.  Contact tracing is unethical and breaks a patient’s right to medical confidentiality.  Of course, the state can invoke public order and safety in extreme cases as a last recourse.  I am not sure this is true in this particular case.  At any rate, doing so would validate the utter lack of empathy of certain people in this administration.

The other question that has been bugging me since the MERS-CoV issue started to spiral out of control last week was:  Why has the government been so trigger happy about disclosing everything related to the ongoing MERS-CoV issue to media including unverified reports and tentative plans and decisions?  The task of government should be to allay the fears of citizens and to downplay sensationalist reporting, not to create panic.

Something as serious and as worrisome as MERS-CoV deserve a well thought-out and—dare I say it, scientific and rational—response from government.  It’s a virus that’s airborne and easily caught.  Worse, there is no drug that treats the disease.  Any news about infections being contracted locally is bound to create panic.  And we know what happens when people panic—they lose the faculty for rational thinking.  Consequently, stigmatizing, witchhunting, and pursuing irrational courses of action become the order of the day. 

What we do know now based on what we have seen last week is that government is totally unprepared for a MERS-CoV epidemic in this country.  It’s not too late though.  We can forgive what happened last week, but am not sure we can afford a repeat of the same bungled approach.