By Graham Nowland
The COVID-19 WA case at Perth Airport reported yesterday potentially has deep implications. Had it not been for the rapid finger-prick blood test and other mass screening measures, announced as expanded by Rio Tinto yesterday, this FIFO worker would have boarded the plane. After flying up to the Pilbara he might have infected at least some of his co-workers at the massive iron ore operations there.
It is worth briefly revisiting the news item. The virtually immediate results from blanket finger-prick blood tests, of all returning shift workers, revealed eight had suspicious anti-bodies. The eight were then tested again for the virus itself. This revealed one had COVID-19.
The employee had been to Bali, recounted Premier Mark McGowan, in a now familiar tone of slight exasperation. Yes, he had completed the compulsory 14 days isolation. Yes, he was apparently clear. Yes he was headed back to work.
Now this is an asymptomatic case though the word was never mentioned. Some reporters tried to form focusing questions. The premier’s attack on the worker’s irresponsibility in flying off to Bali in the middle of a pandemic seemed to distract them.
He also brushed off questions about Rio’s blood test for antibodies, used on some 1200 employees by then. He noted that ‘our test’ for the virus was the one that actually identified this COVID-19 case.
There seems to be a political avoidance of the asymptomatic case issue in spite of mounting concerns globally. Also in spite of Annika Blau’s well researched article on 4th April on the ABC Perth News website. The World Health Organisation has claimed such cases are rare and the Federal Health Department advice to clinicians repeats this. The reporter presented some of the growing evidence which suggest WHO, and our national government, might be wrong.
Over the last six or so weeks some reliable sources have affirmed the existence of asymptomatic COVID-19 cases. Now this week Reuters reported that medical officers on the aircraft carrier USS Theodore Roosevelt had so far tested 94% of its crew. More than half of 600 sailors who tested positive showed no symptoms. The implication is that young, healthy-looking sailors on this active warship were, until identified in mass tests, potentially stealth transmitters.
Also less than a week ago the venerable and conservative medical journal, Lancet in Britain, wrote:
‘There is a powerful case in support of mass testing of both symptomatic and asymptomatic HCWs (Health Care workers) to reduce the risk of nosocomial (originating in a hospital ) transmission.’
This is because many fully protected front line health care workers in Britain are self-isolating unnecessarily when, for example, they suspect a breakdown in protection. Lancet argues strongly that mass testing will reveal any asymptomatic cases and allow the others to return to the front line.
Casting around Britain and the world for evidence, the article states: ‘The number of asymptomatic cases of COVID-19 is significant.’ The writer hedges a lot which spoils the effect but does commit when evidence is overwhelming and solid.
The best example centres on another ship. Vessels on long ocean voyages seem to generate conditions that intensely cultivate the virus while also facilitating the gathering of hard evidence about what happens. This kind of account seems to be as good as laboratory testing as far as Lancet is concerned. The one chosen rendered a similar result to the American aircraft carrier.
‘In a study of COVID-19 symptomatic and asymptomatic infection on the Diamond Princess cruise ship, 328 of the 634 positive cases (51·7%) were asymptomatic at the time of testing’ Lancet states unequivocally.’
Both news items appeared not long before Rio Tinto flushed out the asymptomatic case at Perth airport. Yet no one at Premier McGowan’s press conference uttered the word ‘asymptomatic’ in either a statement or a question.
Also no one suggested Rio Tinto’s mass testing initiative might be applied more widely, although one reporter tried hard to get Mark McGowan into that target area. He diverted her with the point that ‘our tests’ (meaning the government’s viral ones) were better than Rio Tinto’s blood test for antibodies. Yet Rio’s rapid mass blood testing rung the alarm and helped stop a COVID infected worker boarding the plane north.
Whatever the governments do and say they have to be careful. But in not doing any mass testing, perhaps using both types of test in combination and looking for asymptomatic cases, they might be flying half-blind. Rio’s screening success, the USS Theodore Roosevelt case, the Diamond Princess, even conservative British doctors; all now suggest that refined mass testing wherever possible might be important. It might be the only way to get deeper and more authentic information about exactly how this complex, subtle and devastating disease transmits.
Graham Nowland is an ex-staff news reporter/photographer on world-leading shipping paper, Lloyds List DCN. Graham was also a regular freelance feature writer for West Australian, Sunday Times, and Brisbane Courier-Mail and many others.
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