This week Panama crept up to become the country with the highest number of new Covid-19 cases per million inhabitants. How did we get here?

The strict lock-down measures seemed to have put cases into a plateau in Panama up until the government decided to start reopening in mid-May. @MINSAPma offered advice for companies in the first two phases of re-opening, but a lot of the reopening was based on the honor system.

The issuance of thousands of salvoconductos (600k in a country of 4M) to workers who may have never actually been trained in best practices to keep themselves safe. If they got sick, contact tracing was left up to individuals until somewhat recently.

Testing is widely available, but drive-through testing without the chance of exposing yourself in clinic waiting rooms is only available to SYMPTOMATIC people who had contact with a confirmed positive person, or people who can shell out ~$100 to private hospitals.

Still, all is not lost, and we seem to have plateaued the new cases again, although we are plateaued at the most new cases per million inhabitants worldwide, so this is still not good. How can we start bending the curve downwards?

I think the strategy @MINSAPma is currently employing with mass testing in highly affected neighborhoods is a good start, and I think that has had a big impact already on slowing the spread. PPE for ALL medical workers and widespread surveillance testing could help even more.

A cheap test that could effectively catch those actively spreading the virus is ideal, as advocated for by @michaelmina_lab and @DanLarremore. Investing funds into this strategy rather than the treatment kits @MINSAPma is currently handing out would likely have a bigger impact.

Finally, several bits of bits of disheartening news this weekend. First, listening to @DanielGriffinMD talking about raising money for @floatingdoctors to help the Ngäbe indigenous group in Western Panama who are literally starving due to the pandemic. Surprising because...

No mention of this issue in mainstream news media in Panama. No calls for fund raising that I've heard of in Panama City. Instead we are hearing about the mayor of the city [illegally!] vacationing at the beach while the rest of the population is in quarantine.

If our leaders can't set an example, they should step aside. That goes for @MINSAPma officials not physically distanced in photos as well. Which brings me to my final gripe - the interview with @xsaezll for La Prensa today. https://www.prensa.com/impresa/panorama/estan-apegados-a-la-complacencia-no-a-la-ciencia/

He brings up a lot of valid issues, and I agree with most of them, BUT... The pessimism in a lot of his responses is not helping anyone living through this crisis. I especially don't agree that there's no hope for reducing cases in Panama until a vaccine is developed.

The tools are available and the public is willing to do what it takes to get things back under control. My opinion is that we need an intelligent, decisive team able to transfer scientific knowledge into practical applications. Less hand flailing and more solidarity