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  • By Vincent Taijeron Akimoto, MD

The weakest link


Frightened voices cry into a quiet city darkened by the fear of coronavirus. Lonely, searching voices meet across the black urban canyons formed by high-rise skyscrapers that now serve as quarantine prisons.

“Wuhan jiayou!” A child-like voice whimpers from a balcony into the somber starless night.

“Wuhan jiayou!” one voice first calls back, “Don’t give up!” Then another, “Hang in there!” And another “Stay strong!” Then, the whole night echoes with encouraging voices and faces lit up by the blue light of smartphone monitors.

Jiayou is an expression of inspiration and optimism that came to world-wide consciousness during the 2008 Beijing Olympics when enthusiastic Chinese sports fans would cheer loudly for their fellow countrymen.

Now, 11 million suffocating Wuhan souls are entering their fourth terrifying, mind-numbing, infuriating week isolated and quarantined from the rest of the world. Their story has been drowned by the numbers: more than 40,000 infected, 28 countries around the world affected, more than 900 people dead. In an attempt to contain the cruel, murderous virus, China issued the largest quarantine in human history, locking down an estimated 45 million people.

The Chinese government has been praised for its strong, heavy-handed actions in the face of the emerging pandemic. Simultaneously, an unprecedented level of collective anger toward bureaucratic government officials has been witnessed worldwide on Chinese social media.

In a breathtaking revelation of vulnerability, President Xi Jinping admitted that the Wuhan epidemic is "a major test of China's system and capacity for governance".

Earlier, Xi’s ruling party humbly acknowledged "shortcomings and difficulties" including the early withholding of information from the public and the initial slow government reaction when the virus was first detected. Apparently anxious about losing tourist revenue from a ruined Chinese New Year celebration, fearful local Wuhan politicians tried to hide the situation from Xi even as courageous medical doctors alerted the world to the new virus.

One of those doctors was Li Wenliang, who was arrested by Wuhan police for spreading "rumors" about a deadly epidemic earlier last month.

He had warned his classmates in a private WeChat message about a SARS-like virus spreading in Wuhan. Dr. Li himself became infected after treating a glaucoma patient who at the time was not aware that he had already been infected with the deadly virus.

Hailed as a national hero, Dr. Li tragically died last week due to the infection.

With the doctor’s martyrdom, the social contract between China's citizens and its leaders is now being threatened. While the world's largest nation struggles with this new reality, smaller governments like Guam are likely even more vulnerable to the political consequences of a badly managed local epidemic because of inherently weaker medical and hospital systems.

In Hubei, China with 50 million people in the coronavirus killing zone, doctors believe that the number of deaths and infections are undercounted because hospitals and laboratories are under severe strain to test for the virus. Many sick residents in Hubei say that they have been turned away by overwhelmed hospitals, which lack test kits and beds for patients. The same hospital disaster exists now on Guam even without the terror of the coronavirus.

Closer to home, world health experts are increasingly suspicious that Indonesia and Thailand are failing to detect their true number of infected patients due to lack of proper testing and medical surveillance. This suspicion enflames global anxiety that the coronavirus may be spreading undetected in weak countries, potentially adding fuel to this incendiary epidemic that threatens to enflame to whole planet.

Dr. Maria Van Kerkhove, head of the World Health Organization's emerging diseases unit, said that the agency has set up a referral system where countries that don't have the capacity to run diagnostic tests can send samples to 15 labs located in different regions around the world. Officials are looking for more "countries that have the molecular capacity" to run tests, she said.

Guam has that molecular capacity to run the necessary tests to quickly diagnose coronavirus and other emerging infectious diseases including bioterror agents. The tests require dedicated, hard-working healthcare professionals competently operating sophisticated molecular biology equipment and protocols. Sometimes called "molecular photocopying," the polymerase chain reaction (PCR) is a fast and inexpensive technique used to "amplify" - copy - small segments of DNA. Laboratory studies of these isolated pieces of DNA are now being used to confirm the clinical suspicion of coronavirus infection.

As the ancient Chamoru probably once said, you can’t fight what you can’t see and you can’t see what you don’t look for. For the sake of the Pacific island region and the health of the world, Guam needs to establish itself as a sentinel laboratory facility to participate in the global network of medical scientists now courageously fighting this menace to humanity.

As the mushroom cloud of global pandemic rises on the Chinese horizon, Guam has a too weak island medical system manifested by overcrowded emergency rooms; a broken public hospital declared unsafe by national accreditation inspectors; and a destroyed Public Health laboratory decimated by a fire caused by deferred maintenance and selfish political patronage.

In order for our island community to finally have a healthcare system that doesn’t give us all nightmares, GovGuam needs to quit stealing money from sick children and dying patients at the Guam Memorial Hospital. Cut the bloated administrative payroll like Saipan has just done. Tax the banks, hotels, and insurance companies like any sane capitalist nation should do. Give the $60 million Tourist Attraction Fund to Lester Carlson to pay down the GovGuam deficit.

The government of Guam needs to look itself in the grown-up mirror of self-accountability. No one is going to come to save us. We need to help ourselves. We need to help each other. In the face of the existential threat of the Coronavirus, GovGuam must finally put service before self.

 
 

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