Take dire COVID-19 warnings seriously

WHEN DR Alverston Bailey posits arguments on public health, we take him seriously. Policymakers, too, as well as the public, should. Not only is Dr Bailey a respected physician, who has served as president of the Medical Association of Jamaica, he is a professor of occupational health and safety at the University of Technology, Jamaica (UTech). He speaks with authority.

Dr Bailey last week gave a chilling warning about the trajectory of Jamaica’s COVID-19 epidemic, suggesting that the recent, sharp, upward spiral in infections is the tip of the iceberg. “The real spike is going to come in October,” he told this newspaper. “By then we will have a similar situation to what happened in New York.”

The spectre of New York invoked by Dr Bailey is not of the New York of today, but a mirror, on a relative scale, of what was happening in that American state of 19.4 million people in the months of March and April, when COVID-19 cases reached over 10,000 on some days. At the time, New York’s hospitals were overwhelmed; its medical staff were burnt out; and COVID-19 patients were dying by the hundreds, to reach over 32,500 by the end of last week. Happily, the state’s daily cases of the virus are now a small fraction of three months ago.

GOING IN OPPOSITE DIRECTION

Jamaica is going in the opposite direction, as our Government reopened the island’s borders and seeks to rekindle the economy. That is happening, we believe, with an insufficiently rigorous mobilisation of the population, and enforcement of the rules, to sustain earlier successes at holding the coronavirus at bay. It has not helped that the political parties have held rallies and motorcades, campaigning for this week’s general election, and that restrictions on fêtes and big public gatherings were relaxed at the beginning of August for the Emancipation and Independence holidays.

In the fortnight up to Saturday, Jamaica recorded 1,107 new COVID-19 cases, bringing the number to 2,113 since the first one was confirmed on March 10. In other words, the cases have doubled in two weeks. Further, the positivity rate for the virus, or the percentage of the people who are proven to have the virus from the number of tests done, is now 3.7 per cent, up from 2.4 per cent at the middle of August. That is a rise of 1.3 points, or 54 per cent.

These statistics, and the alarm sounded by Dr Bailey, are petrifying, especially when considered against the backdrop of some of his other observations, as well as those of other health sector professionals. For instance, Dr Bailey said that allocated COVID-19 beds at the University Hospital of the West Indies (UHWI), the island’s largest, were beginning to feel the pressure. “What is going to happen to smaller hospitals when the spike, which is moving vertically, reaches the end of October?” he asked.

There were 78 COVID-19 patients in hospitals up to Saturday.

NOT ENOUGH TRAINED STAFF

Add to that the statement by the UHWI’s CEO, Kevin Allen, that the hospital has 36 functional ventilators – which are often important in the treatment of critically ill COVID-19 patients – but not enough trained staff to operate them around the clock. Or, that the hospital has only 30 per cent of the 160 intensive care units that it requires. Internal medicine doctors at the same hospital have complained about their workload with an influx of coronavirus cases, which the management has said will be addressed by assigning other specialists to help. Additionally, the nurses union reported that at least 10 of its members have tested positive for the virus, while 50 are in quarantine. This further stresses an already-burdened health system.

We agree with Prime Minister Andrew Holness, as he reiterated in the election debate, last Saturday, that given Jamaica’s economic and social circumstances, a strict, long-term lockdown could not be sustained. “We must go on with our society … (and) our economy”.

But opening, in our context, has to be accompanied by compensatory actions.

Frequent sanitisation, maintaining recommended physical distance and the wearing of masks in public places are the most efficacious way to slow the spread of the virus. They, however, are not robustly enforced. Masks are patchily used on public transport. Yet, few, if any, buses or taxis are pulled over by the police to enforce the regulations. Neither is there an aggressive promotion of the wearing of masks in communities and public markets, or other places where large numbers of people congregate.

The authorities may ameliorate some of the difficulties in the health system, but the bulk of the problems will remain, at least in the short to medium term. Low-hanging fruits are, however, there for the picking. Which, in some circumstances, will require tough trade-offs, including with the private sector.

Perhaps after the distraction of the election, whoever forms the government may get around to this kind of mass mobilisation.