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Arrivals screenings may be missing cases

Arrivals screenings may be missing cases

Thursday 16 July 2020

Arrivals screenings may be missing cases

Thursday 16 July 2020


A local GP has shared concerns that some covid cases could be missed at the border because the most effective type of test is not being used.

Following the recent reopening of the borders, Dr Mark Wilbourn of Windsor Medical Practice and the Oxygen Therapy Centre charity had this to say...

"As an island we have been incredibly successful at ‘flattening the curve’.

This was achieved primarily through the hard work of GPs across the island working together in a new way to support secondary care services.

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Pictured: "In many cases, GPs gave up normal working practices to staff an Urgent Treatment Centre (UTC) at our hospital."

In many cases, GPs gave up normal working practices to staff an Urgent Treatment Centre (UTC) at our hospital.

Unfortunately, we have been too successful in flattening the curve and the vast majority - about 93%-95% - of our population remain at risk from covid-19 infection.

It is perhaps surprising that with closed borders the infection has lingered on in our community. Now that our ports have opened we can expect people to bring the infection from other countries and we have already seen this.

The best test for covid-19 is something called Broncho-Alveolar Lavage (BAL). This highly unpleasant and technically challenging procedure hardly misses any cases of infection, but it is impractical to apply to a large number of people.

Consequently, we have to use lesser alternatives, like nose or throat swabs.

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Pictured: "Nose swabs, if conducted correctly, only miss one out of three infected people and throat swabs miss two out of three infected people."

Nose swabs, if conducted correctly, only miss one out of three infected people and throat swabs miss two out of three infected people.

Assuming that screening at the ports uses nasal swabs, correctly performed, two identified cases result in one missed case, who is free to spread corona virus here.

These people are more likely to exhibit behaviour which spreads the infection, because they caught it on their travels.

We know that 15 contacts of one positive screened arrival have been asked to isolate for two weeks. It is not possible to ask the contacts of a covid-19 positive, test negative person, to isolate.

If arrival screening was sub-optimal and screening missed six cases, then 90 contacts missed out on being told to self-isolate.

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Pictured: Missing six cases on arrival could mean missing out on telling 90 contacts to isolate.

We have seen that Clipper arrivals struggled to get the screening that they expected.

In around two weeks, we might see if the gamble of opening ports was a good or bad decision.

Let us hope the UTC's replacement is able to protect us if another peak results from this decision and HCS have maintained good relationships with those who might help."

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