Public Health Ministry mishandled first COVID-19 case

Dear Editor,

Never has it been more apparent the unacceptable levels of callousness and incompetence in Guyana’s modern healthcare system, than with the post and pre-events surrounding the discovery of ‘Patient Zero’ in the first confirmed case of the deadly Novel Coronavirus (COVID-19) on Guyana’s shores.

The ruckus that ensued with the family before and after the death of Guyana’s first victim and the baffling health authority decisions that followed, only leaves gaping questions as to whether Business and Accounts Degree holder, Volda A. Lawrence and the Health Ministry she runs, were ever prepared to handle this disease with the seriousness it deserves.

To frame the issue, the Centers for Disease Control (CDC) describes COVID-19 as a respiratory disease. It is deadly. It is aggressive and contagious. It is a pandemic of global proportions because there is little to no pre-existing immunity against the virus. It is spreading worldwide. We had two months to prepare.

Notwithstanding the fact that ‘Patient Zero’ and other members of her family entered Guyana from New York–an area crawling with a COVID-19 outbreak–we learnt through the press that the case was first suspected by a private hospital, which has since quarantined a number of its staff.

The now dead woman was then referred to the Georgetown Public Hospital Corporation (GPHC) for COVID-19 testing and based on reports, it was only after authorities at the GPHC were informed of the woman’s travel history, that COVID19 tests were ordered on a fluid sample taken from her body after she died.

What are the policies or chain of command if any, for local private hospitals without COVID-19 testing facilities to communicate its concerns to the GPHC after referring patients? In addition, what prevented the private hospital in this scenario from reporting its suspicions to the GPHC or even the Health Ministry?

In Epidemiology, the branch of medicine which is concerned with the incidence, distribution, and possible control of diseases and other factors relating to health, the discovery and tracking of ‘Patient Zero,’ is a landmark factor regarding disease control. As global infection rates and first-world death tolls in Italy, USA, Canada and other European counties rise, images and videos of health authorities grappling to contain the virus now flood our screens. Europe is now considered the new epicentre of this aggressive and infectious virus with its origin in the Wuhan district of China.

A predicament faced by Italy in particular, was that health authorities were unable to identify ‘Patient Zero,’ early on, hence, an effective strategy to map and track the spread of the virus using data about its local origins proved challenging.

In Guyana, health authorities had the privilege of knowing exactly who ‘Patient Zero’ was, where she lived,

ties had fully internalized the magnitude of the threat that COVID-19 posed. It had decided to put its proverbial cards on the table. What the CDC had to say was termed a “guidance announcement.” It was specifically – and daringly in the context of America – cautioning against “large events and mass gatherings that include conferences, festivals, parades, concerts, sporting events, weddings, and other types of assemblies.” That, mind you, included, NBA games. In America you do not cancel NBA games without some earth-shattering reason without risking some kind of national pushback. People, whether Americans or Guyanese, activate instincts linked to self-preservation when the circumstances so dictate, or at least appear to do so; and even as we in Guyana were ‘invading’ our distribution outlets in search of disinfectants that had, in the twinkling of an eye, become hard-to-get items, America was pressing its President, no less, into service to urge against hoarding and panic buying. This surely was not America, the ‘land of plenty’ with a reputation for virtually unbreakable supply chains. In parts of California grocery stores were virtually emptied after (according to one media report) “panicked shoppers swept through, stocking up on supplies.” No, not California but some beleaguered supply outlet somewhere in coastal Guyana or some other similarly-appointed Third World nation. But then the irrefutable truth was being reinforced by widespread US media reports that Americans had descended upon their groceries with such ferocity that it had necessitated an urgent exchange between the President of the United States and food industry executives to discuss how the food supply chain was ‘holding up.” And this, we must remind ourselves, was America! One media report asserted that grocers had been “limiting purchases per customer of hand sanitizers,

when she arrived in Guyana, where she came from, her immediate family, and to some extent her whereabouts up unto death.

Why then were the relatives of this landmark first case not placed into mandatory state quarantine?

Why then given the relatives of ‘Patient Zero’ were people who did not inform GPHC that they were referred for a COVID-19 test, and who denied both at the hospital and on social media that their relative had the virus, were they were entrusted with self-quarantine?

There are reports that the day after his wife passed away, the husband of ‘Patient Zero’ and his son–who has since tested positive for COVID-19– visited the US Embassy to complain to officials about the wife’s death. There are further reports that a sick child from the home was sent to school and also makes frequent runs to the shop.

Were these persons ever under any surveillance? Who did this man, his son and the child come into contact with? How did they travel? Where else did they go?

Visits to the Good Hope ECD, home last week by a social media user after the death of ‘Patient Zero’, furnished us with video evidence showing no signs of high-level quarantine or security presence at the home. Rather, the family were entertaining guests and preparing for a ‘wake’ with neighbours walking in and out of the yard.

toilet paper and other high-demand products”. Pure propaganda, one might think! Not really. It required intervention at the very highest level to pronounce on panic buying. “You don’t have to buy so much. There’s no need for anybody in the country to hoard essential food supplies,” the President of the most powerful country in the world had been asked to assure a jittery nation where, out of a sense of consummate fear, Americans were reportedly “buying three-to-five times what they normally buy.” They had, it seemed, been pushed to a wall by their fears of what COVID-19 could do. Enter Donald Trump, again, to urge the country’s ‘top grocers’ to ensure that the shelves were stocked with necessities so that Americans can “feel calm and safe,” a national security exhortation if ever there was one. It could well have been Guyana, one might think, where we have had historic experience of ‘food insecurity’ and its disruptive consequences. Even now, (and among developing countries we are by no means alone) we may not yet have experienced that extreme sense of worry that has already been manifesting itself in aberrant consumer behaviour elsewhere. But then we have seen it all before. What the American experience is telling us is that when issues of self-preservation, whether real or imagined arise, are perceived to be the ‘bottom line,’ people’s responses are not really all that different, after all.

In essence, a family who should have been in mandatory state quarantine went about their daily lives, travelled, entertained guests at their home, held a wake and in the process, possibly exposed hundreds of Guyanese to this deadly and aggressive virus.

We know for a fact that those at risk of dying and getting the sickest from COVID-19 are the elderly, older adults and people who have serious chronic medical conditions like Heart Disease, Diabetes & Lung disease. We are not short of that in Guyana.

Volda Lawrence & her Health Ministry ‘dropped the ball’ with COVID-19, and there is no excuse why that happened other than pure incompetence, carelessness, callousness and an inability to grasp the seriousness of this virus and the economic implications it would have should an outbreak happen in Guyana.

Important roles like the Minister of Health should never be appointments based on political merit, rather, should be an established leader with the background and track record to understand the importance and seriousness of disease control and response, including what logistic measures ought to be in place based on data models and forecasting.

Guyana is now in trouble as the latest figures of our confirmed COVID-19 cases according to the Health Ministry is now four, inclusive of the one death with possibly hundreds of Guyanese now having unnecessary exposure to the virus because of this one family and the inability of health authorities to take action when they had the chance.

Yours faithfully, Ron O. D’Avilar