Covid19 & Flying Blind
I am utterly apolitical but given the Opposition’s initial knee jerk response to COVID-19, including pushing race (rights for doubles vendors) and to keep rum shops open, allow me to preface this by voicing the feeling of many citizens that we are grateful this pandemic hit us under the watch of Prime Minister Dr Keith Rowley.
An exceptional leader for our times he deserves high praise for moving fast after the first case, shutting down schools, closing borders, allowing movement only for essential living, being on it.
Currently, deaths and cases of COVID-19 are low. But there are concerns, which I now direct at the doctors and scientists of T&T leading this fight against this deadly pandemic.
A circular amidst doctors was forwarded to me written by a local public health medical doctor who compares T&T’s COVID-19 surveillance to Hawaii.
The medic makes the startling claim that T&T’s COVID-19 CFR (Case Fatality Ratio) exceeds the state of New York (5.7 per cent).
He writes: “On March 13 both islands had two positive cases and no deaths. By April 15 Hawaii tested 19,972 samples, detected 528 COVID-19 cases and had 9 deaths. T&T meanwhile tested just 1282 samples (some repeats from the same patient) with 8 deaths.”
The doctor laments that “T&T maintained unreasonably stringent testing criteria (of travel) well after the local transmission was declared by the WHO on March 26. COVID-19 testing should have been scaled up from the minute local transmission was suspected.”
The doctor had a list of peeves, some with merit. He is against forced institutional quarantine for all positive cases, while other mildly symptomatic or asymptomatic COVID cases roam freely because they have escaped detection.
CARPHA is micromanaging surveillance, and not permitting the clinical judgement of thousands of doctors on the field to use their clinical discretion to send patients for testing. The Ministry of Health and CARPHA, despite accreditation of local labs. are still policing these labs.
The public health doctor returns to the million-dollar question.
“In the absence of reliable data, how can we know when it’s safe to return to work, school, or reopen industries? How do we chart a way out of this crisis if we are flying blind?”
“We do know on April 9 a maxi taxi driver in Sangre Grande reportedly tested positive and was picked up by police officials as he plied his maxi for hire. We don’t know how many commuters were infected by him and that’s potentially catastrophic.
“We know why testing hasn’t happened beyond those associated with international travel. Not from lack of will but a global shortage related to demand. Copan, for instance, major manufacturers of swabs for COVID-19 tests, in Lombardy, Italy, was hit hard by the disease. In the absence of community testing (while we await the promised testing in health centres with the promised 4000 tests from China) the only way for us to gauge the community spread is to check either the total deaths in T&T or deaths in hospitals against last year’s numbers.
“In the silver lining, I spoke to a COVID-19 positive patient in Couva Hospital, mostly asymptomatic, who spoke glowingly of the facility and the Ministry of Health.
“From the second she stepped off the last flight from the UK, to her pick up by the ambulance personnel in full protective gear when she showed symptoms; to her quarantine in Couva where patients are continually monitored by nurses wearing multiple layers of protection; where surfaces are sanitised day and night, patients given nourishing food and given thorough medical checks with the latest equipment.
“It may be a trial run, wasted resources on asymptomatic patients (if it hits us it will hit us hard given our high rate of underlying diseases of diabetes, hypertension, cancer, obesity and heart disease) but its great news that we can do it right if the need arises.
“Reassuring when you see the burden New York hospitals face as voiced by a frontline doctor there.
“I used to tell people, ‘Come back if you have trouble breathing or if your abdominal pain gets worse,’ Now my return precautions are, ‘Come back if you’re so short of breath that you can’t finish a sentence. Or you’re coughing up more than a tablespoon of blood.’ Everyone seemed to have the virus: the heart-attack and stroke patients, the people in alcohol withdrawal.’”
We must prepare for the worst.
This is our time, citizens and the state, to be less combative, more cooperative, shed the hubris, quit pointing fingers, and even as we isolate, band together, as we fly blind.