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The fallacy of mandatory COVID-19 tests

Since the outbreak of COVID-19 infection, Kuwait had taken a number of precautionary measures to prevent the entry of the virus to the country. But once it was discovered that a number of citizens who had traveled to Iran in past weeks had been infected with the virus, the Ministry of Health and relevant authorities moved from a precautionary to a containment phase.

Airports and land borders introduced thermal scanning machines and citizens found to be infected were quickly whisked off to special quarantine facilities. Kuwait also banned the entry of people from nearly half-a-dozen countries where the infection was known to have spread widely.

Latest report from the Ministry of Health indicates that a total of 56 people have been infected with COVID-19 so far, and that all the patients quarantined are in stable condition. Two of those initially suspected of the virus have since been released following their 14-day quarantine period.

It is understandable that Kuwait is concerned about the health and safety of citizens and would like to prevent COVID-19 infection from spreading in the country. In line with recommendations made by the World Health Organization (WHO) and other relevant regional health entities, Kuwait introduced a slew of necessary and welcome steps to prevent the spread of the disease. 

These preventive measures have obviously been working. The highly specific nature of those infected in Kuwait — with nearly all of those quarantined being citizens who had recently visited Iran or had come in contact with people who traveled to that country — shows that the deterrent actions taken have had a positive impact in limiting the number of cases in Kuwait.

Then, on Tuesday, the Directorate General of Civil Aviation (DGCA) issued a bizarre notification stating that starting next Sunday, 8 March, citizens from 10 countries would be denied entry into Kuwait, unless they produce a medical fitness certificate attesting that they were free of the COVID-19 infection. 

This new decision is certainly not among the measures recommended by the WHO. What makes the DGCA notification perplexing is the arbitrary nature of picking on citizens from just 10 countries to produce these certificates. In addition to the countries from which citizens were earlier banned entry, there are more than 65 countries and territories worldwide where the virus has spread. So why were just 10 countries chosen, and especially, why Bangladesh, which has so far not had even a single case of infection?

The answer could be that most of the countries named have a large number of expatriates living in Kuwait, and the authorities could not afford to test each of them individually. So in their infinite wisdom, the DGCA decided to move the onus of testing to the country of origin. 

However, this move then raises another question; what is the guarantee that the certificates produced from these countries would be bonafide? When people are willing to pay the equivalent of thousands of dinars to obtain a work visa to Kuwait, it is not inconceivable that they would be willing to pay some more to get a medical clearance certificate. 

Probably anticipating this, the DGCA circular made clear that the certificates would have to be issued by medical facilities approved by the Embassy of Kuwait in the respective countries, or in the absence of an embassy, by accredited medical facilities in the country. This is no doubt a smart move on the part of the DGCA. 

Within 24-hours of the notification from the aviation authorities, Kuwait’s consulate in Mumbai promptly came up with a list of more than 120 ‘approved’ medical facilities in India that would carry out the tests. 

It would take the widest stretch of imagination to believe that the embassy individually verified and approved these 120 facilities on their capability to diligently and accurately carry out the required tests. In the most likely scenario, the consulate subcontracted the work to someone outside, or called for and received the names from facilities that claimed they could carry out the test. 

Incidentally, the RT-PCR (real time Reverse Transcriptase -Polymerase Chain Reaction) test that Kuwait authorities have called for, is a highly specific test carried out and evaluated in specialized labs. It is highly doubtful whether many of the names that made it into the consulate’s ‘approved’ list have the facilities or capability to conduct these tests. At least some of the names that made it into the consulate’s ‘approved’ list are nothing more than a one-man operation working out of a dingy room.

Moreover, there is nothing conclusive about the RT-PCR tests. Recently, four patients who were quarantined in China were discharged after two consecutive RT-PCR tests showed they were free of infection. However, a further test conducted after about 10 days, showed that all four were infected with the virus. 

In all probability, the RT-PCR tests mandated by Kuwait will not only cause inconvenience to people who had gone on vacation or were hoping to come on new visas, it will also burden health systems in countries that are already struggling to comply with the WHO recommended precautionary and containment measures. At best, the tests will help a few unscrupulous people to make a lot of money.

 

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