Prepare for more cases as global pandemic numbers rise

As global cases numbers of the novel coronavirus rise, the chances of it getting to Samoa get higher and higher, and the country needs to prepare to deal with that, microbiologist from the University of Auckland Dr. Siousxie Wiles has said.

With Samoa no longer willing to leave citizens stranded on foreign soil, especially as situations abroad grow more frightening, the country is going to see cases of COVID-19 slip through the border and will be able to manage them.

Her comments come as Samoa records its first case of COVID-19 since the virus was first announced as a pandemic early this year, in a sailor who was repatriated from Italy via Dubai and Auckland.

Dr. Wiles said the case is unsurprising considering the sailor's travel history, and said Dubai is a common route for cases that have tested positive in quarantine in New Zealand too.

All passengers are required to have a negative test for COVID-19 within three days of travel to Samoa, but Dr. Wiles said these have never been a guarantee of safety.

“If [the case] was negative then and tested positive now it will either be an infection that was incubating or an infection that happened since the negative test,” she explained.

“The really important thing about the negative test before arrival is that they do not rule out infection.”

Samoa’s sailor had a negative test on arrival, and tested positive after their routine P.C.R. test on Wednesday on the fifth day of quarantine. 

Two follow up tests to confirm his status returned negative, and now the Government is sending swabs to New Zealand for confirmation and will test him once more on Saturday. 

“The P.C.R. test is incredibly reliable,” Dr. Wiles said.

“We have done over a million tests in New Zealand and we haven’t had any real false positives, that is not somebody who has either had a historical infection or who is infected.”

Director General of Health Leausa Dr. Take Naseri is sending swabs to New Zealand to confirm the status of the two negative tests, whether they were “false negatives.”

Dr. Wiles said a false negative can either come from a test that does not collect enough viral material because it is done so early in the life cycle of the virus, or if the swab was conducted incorrectly.

“The good thing is this is a returning traveller and they are not in the community. That is a really crucial thing,” she said.

The sailor who tested positive was in quarantine with a roommate, who has also been taken into isolation at the hospital for closer monitoring. The roommate has not tested positive for COVID-19, but Dr. Wiles said if one roommate did, it is highly likely the other will within ten days or so.

“We have had that happen in New Zealand where people have been double-bunking and I don’t think that will be done here again because definitely if one person in the room, because they are in such close quarters, they are much more likely to transmit the virus.”

With the case caught at the border before it had to chance to spread the virus around the community, Samoa can be alert to its border protocols and use the opportunity to tighten any loose areas, she added, as has happened in New Zealand over the year.

She said it is not likely to have to require people to isolate in managed quarantine for four weeks instead of two, but echoed the Samoan Government in saying people who do leave quarantine should act extremely cautiously for the two weeks after.

They should avoid large gatherings and report any symptoms of unwellness to the authorities, in case they happen to be a rare case of an extremely long incubation period.

In New Zealand, Dr. Wiles has been advocating for a follow-up test one week after release from quarantine.

But keeping people out of the country or locked away is not manageable, she said.

“The really important thing is for the public not to panic but to feel like it’s under control but that they have some role in this,” she said.

“People have a right to come home, especially as things are getting quite frightening overseas.

“Testing will pick up some cases so they won’t fly but it’s not a guarantee at all, so be prepared for people to come through and test positive in a few days’ time.”

If the public is vigilant about social distancing, mask-wearing, handwashing, and making records of their movements to potentially help with contact tracing, a case breaking free of the border can be stopped before it becomes a cluster.

"If these flights are going to continue the public need to start becoming a little bit more aware that the virus is increasing around the world. There are countries that are not controlling it well at all. 

"The chances of somebody coming back positive are basically increasing every day. That means having really good processes in place around the border but it all means there are everyday things everyone else can do to ensure that if a case comes through that it doesn’t turn into a big cluster.

“That is the way we are going to need to live for the next year or so,” Dr. Wiles said.

Johns Hopkins University data reports there have been 55.6 million cases of the virus so far and 1.34 million people have died.

The United States is reporting 11.6 million cases.

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