Denying Samoans entry needless with working quarantine: expert

As long as the Government has confidence in its quarantine measures, it will make little difference whether Samoan nationals are quarantined locally, an expert on emerging infectious diseases has said.

Eight Samoan people – five patients and three caregivers en route home from India where they received hospital treatment – were returned to their last port of Fiji for a 14 day quarantine period after arriving at Apia on Sunday. 

But Dr. Michael Baker, who is a Professor at Otago University’s Department of Public Health, said while quarantining people in Samoa gives public health officials a degree more of “quality assurance,” the decisions will have similar consequences.

The decision to deny the travelers entry raised eyebrows, while five Samoan nationals sit in quarantine at the specially outfitted Faleolo Health Centre, now a quarantine facility.

While Dr. Baker said it was important to understand the rationale of the decision makers in sending the group back to Fiji, he said Samoa’s precautionary measures as outlined so far are “sensible.”

“There are advantages of quarantining people in Samoa because then you know the quality of the quarantine,” he said, and that so long as the quarantine facility is run effectively for the 14 day period, it will help avoid transmission.

The passengers, along with 11 others (non-Samoan citizens) were denied entry to Samoa at Faleolo International Airport on Sunday because they had traveled through Singapore, which has 45 cases of the novel coronavirus and proven local transmission. 

The list was last updated on Friday evening, at a time when their flight may already have departed, Leausa said. 

One of two new cases locally reported on Monday is a 37 year old man who had served quarantine orders to two travellers from Wuhan, the epicentre of the virus, Singapore’s Straits Times reports. 

As of Tuesday, Samoa is denying entry and imposing a 14-day-quarantine in a country free of sustained transmission before arriving in Samoa with medical clearance issued within three days of landing.

These countries are: China, Hong Kong, Japan, Macau, Singapore and Thailand.  

There are 21 other countries with confirmed cases of novel coronavirus, from which travellers are required medical clearance to get into Samoa within three days of landing. 

These countries are: Australia, Cambodia, Canada, Finland, France, Germany, India, Italy, Malaysia, Nepal, Philippines, Russia, South Korea, Spain, Sri Lanka, Sweden, Taiwan, United Arab Emirates, United Kingdom United States (specifically California, Washington, Arizona, Illinois, and Massachusetts) and Vietnam.

Dr. Baker said the novel coronavirus has entered a “silent transmission” phase, where it could take between four and six weeks to see local transmission in a given country. 

And because not every country has high quality surveillance and the ability to test many potential cases of the virus, there could be as many as half a million people with the virus and no ability to prove it, he said.

This makes denying entry to passengers from certain countries based on their transmission rates slightly fraught. 

“We should be very suspicious of the numbers coming from places like Thailand, which has a lot of Chinese visitors in the last month, where, as in Singapore, they have very high quality surveillance. You have to be sceptical of any reported data from anywhere," he said. 

“For relatively small, low-income countries, this is not something they have very well established yet […] so there are a lot of questions around selective entry that all countries need to think about.”

Testing is expensive and not readily available in many countries, especially in developing parts of the Asia and Pacific region: the majority of cases are proving to be a mild illness, with many infected possibly not reporting to a healthcare provider.

Rather than being stamped out like the 2003 epidemic of Severe Acute Respiratory Syndrome (S.A.R.S), Dr. Baker said this novel coronavirus may, with time, prove to join the four other coronaviruses as stick around as a mild winter illness bug.

“I think it’s heading down the trajectory of a widespread infection, it may behave like any other coronavirus that causes colds, or a mild winter illness that is very rarely fatal,” he said, noting that it is still too soon to say for sure.. 

“At the moment it is behaving like a much more severe virus than that, and the scale is still unknown. 

“Most cases will not be identified, and will never be identified because there is not enough testing available. We are seeing the severe disease and that is why we don’t know how big the base of the pyramid is.”

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