Lack of Testing Hamstrings Covid-19 Fight in Asia

Impossible to trust data in most SEA countries

Indonesia has become the latest country to engage in xenophobia, closing its borders to foreigners as though they are the threat rather than its own health system inadequacies. 

It is easy for governments to look to border closures when their own Covid-19 data is so obviously far behind reality, which is the case in almost every country in Asia and especially Southeast Asia. Locking out foreigners makes a good headline for otherwise fumbling governments. But it will do deep and lasting damage to countries dependent on foreign trade and tourism.

It may yet prove true that hot climates limit the virus, in which case South and Southeast Asia may, despite their crowded cities, escape the infection rates of northern climates although at this juncture there is as yet no way to tell given the absence of large-scale testing. With cases continuing to climb in Singapore – 47 overnight – which sits just 100 km from the equator, that theory has yet to be put to the test. But let us hope so. But the statistics would be more comforting if they did the testing and tracing groundwork to come to any conclusions.

As it is, the tiny number of tests per head of population suggests that the actual total of cases could be anything from five to 100 times the official number, with some health officials putting the total far higher. According to a survey by PSA Philippines Consultancy, for instance, the Philippines needs a testing capacity of 250,000 per week. This week the Department of Health managed 1,500 per day, or 10,500 per week.  

In addition, 40 percent of tests provided to the Philippines by China have found to be faulty. Spain, the Netherlands and Turkey have rejected Chinese test kits as inaccurate. China itself has now acknowledged that it has asymptomatic cases but the number may well be a substantial underestimate as health authorities there have largely only tested those with obvious symptoms.

That doesn’t suggest there should be even more draconian measures which deprive a large sector of the population with no income and prevent migrants workers from returning to their villages. Such crude measures are political gestures that will rebound as people get rightfully angry. In Quezon City, a component of the Metro Manila conurbation, hundreds rioted overnight on April 1 to protest lack of food deliveries by authorities.

Indonesia, the Philippines and Thailand have all been very slow to develop testing and tracing, with Indonesia hardly trying. Testing and tracing are the key to getting a handle on the virus, as Singapore, Hong Kong and South Korea, which was conducting 15,000 tests per day early in the crisis, can attest. 

Lockdowns can never be fully implemented, cause unnecessary hardship and are no substitute for washing and social distancing. Officially Indonesia has only 1528 cases, Thailand 1561 (though, as Asia Sentinel reported on March 31, its king prefers to be in Germany where the case number is many times greater). The Philippines has 2084 and Cambodia just 109 and no deaths. As for Vietnam, it claims that early action and social discipline have kept cases to 203 with no deaths. That seems too good to be true.

There is a bigger problem with data globally, particularly when it comes to drawing conclusions from circumstances which are not comparable. International organization and data sources are almost as fond of headline numbers as the media. Just how misleading that can be is shown by the Covid-19 data – and the gaps therein – being spewed out. Daily counts of new cases, total cases, new deaths, total deaths are available for most of the countries of the world. Charts of cases per million people may look interesting – although by that measure the Vatican with 6 cases, or 7,491 per million people, comes top!

But cases can only be confirmed if the relevant hospital or government has both the means and the will to do so. The easiest way to have few cases is to test as little as possible. That happens anyway due to the lack of testing kits and laboratories to process them. But it can be deliberate. To get a half-instructive picture of how many might reasonably be supposed to be infected, one needs data on the number of tests. 

For many countries (China included) this is impossible to find. And that is without taking account of test accuracy. In most countries too, only those with apparent Covid-19 symptoms are tested so asymptomatic cases never come to light. Even in heavily tested countries the ratio of tests per thousand is quite low – about 70 even in South Korea.

The next bit of dubious data surrounds death rates. A death can only be ascribed to the virus if the deceased has been tested. So many could be dying of the disease who were never tested so never counted as cases. Conversely, those who died having tested positive may be said to die of the virus rather than the late stage cancer, heart or lung disease from which they were already suffering. There is a lot of leeway in this and may be one reason why mortality in Italy and Spain is so high compared with Germany or Korea.

Huge conclusions are being drawn from global data which is incomplete and of striking differences in both quality and quantity. The conclusions mostly add to panic, to rash decisions – and xenophobia.