Parasram: T&T needs ‘learned behaviours’ not ‘lockdown’; lab lags meant one week wait for positive results

Chief Medical Officer Dr Roshan Parasram said ‘learned behaviours’ rather than state-ordered ‘lockdowns’ are Trinidad and Tobago’s best chance of successfully seeing off the Covid-19 virus.

At present, the twin island republic falls into the World Health Organisations’ (WHO) second highest category for the movement of the novel coronavirus, which is cluster spread. The four groupings, from lowest to highest, are ‘no spread’, ‘sporadic’, ‘cluster’ and ‘community’.

Photo: Spectators flouted public health regulations to watch T10 cricket in Charlieville on 5 August 2020.
The TTPS shut down the event.
(via TTPS)

“About a week ago, we moved from sporadic to cluster: meaning that we have conglomerations of local cases or imported cases in a specific geographic location and/or linked to each other,” said Parasram, at this morning’s Ministry of Health virtual press conference. “[…] Community means there is extremely widespread spread throughout the entire country meaning that you can go to any locality in the country and possibly be at the same risk of developing Covid.

“That is not the case at this point.”

Today, the Ministry of Health confirmed 18 ‘new cases’ of Covid-19 with one imported from a person who travelled home via Nigeria, Egypt, London and Barbados. Another six persons were linked to ‘recently positive Covid-19 patients’ while 11 were ‘pending epidemiological investigation’.

It means that there will be 100 patients hospitalised with the novel coronavirus by the end of the day.

Trinidad and Tobago has had 243 positive cases since the onset of the pandemic while there have been 90 infections within our borders over the last 20 days—and 69 in the last eight days.

Parasram stressed that the 18 cases announced this morning were from samples taken over an eight day period and ‘not representative of the positive cases over the last 24 hours only’.

Photo: Ministry of Health CMO Dr Roshan Parasram.

“What has resulted in that sort of reporting […] is that from the beginning of the set up of the University of the West Indies (UWI) lab, we had agreed for quality assurance [and] quality control that any positives would be sent to the Trinidad Public Health lab and thereafter to the Caribbean Public Health Agency (Carpha) for confirmation,” said the CMO. “What was happening is once we got positives, they were batched by the Trinidad Public Health lab [before being sent to Carpha]…

“[So there was a] lag of seven days in terms of the reporting, which gives a sort of an artifactual epidemiological picture of what is actually happening.”

The lag in confirmation of positive Covid-19 samples means that, in theory, someone who was swabbed for the coronavirus on 31 July would not have discovered they were positive until almost eight days later. During that period, persons are asked to self-quarantine but it is up to the respective persons to comply.

Crucially, as numerous callers have told Wired868, the primary contacts of such persons who are awaiting results continue to interact with the public as normal—if not the tested persons themselves.

Parasram did not say whether the Ministry of Health is confident of reducing the delay in test results. However, he stressed that simple health measures like wearing masks and adhering to physical distancing and proper sanitisation protocols can do wonders and allowed some countries to totally open up their societies with negligible caseloads.

Photo: A mother and daughter head home from the bakery in Penal on 23 April 2020.
(Copyright Ghansham Mohammed/GhanShyam Photography/Wired868)

Dr Saed Rahaman, director of Veterinary Public Health, suggested that the country’s ‘marked increase’ in Covid-19 cases were as a result of a ‘false sense of security’ due to the low infections between May and early July.

He noted that, based on surveillance by the ministry, the financial and banking sector offered excellent compliance to new health measures while large supermarkets were ‘good’. However, many other businesses have not been implementing guidelines consistently; and it created a scenario where the disease could flourish again.

“We need to understand as a population that our largest strategic weapon in the defeat of this virus is our behaviour,” said Rahaman. “Behavioural changes, even if it is made by most, can be completely sabotaged by just a few who choose to disobey the rules.

“Every individual needs to understand their direct impact on this pandemic.”

Dr Maryam Richards, Principal Medical Officer – Institutions, said the parallel health care system is near half capacity at present with 415 hospitals bed available. The country welcomes home 102 nationals from USA today, who will be quarantined at the Paria Hotel.

Photo: A taxi driver in San Fernando waits for passengers during the Covid-19 pandemic on 23 April 2020.
(Copyright Ghansham Mohammed/GhanShyam Photography/Wired868)

Parasram also pointed to the changing trends in the virus on our shores. For the first wave (11 March to 26 April), the patients were 41.4% male and 58.6% female while the median age was 55. The largest infected age group was 55-65.

However, at present, there is a higher rate of infections in children and persons in their 20s, 30s and 40s, while there is a reversal in the sex of Covid-19 patients, which now stands at 58.1% male and 41.9% female. The median age for patients in the second wave is 33 while the highest infected age groupings are 36-40 (men) and 41-45 (women).

At present, doctors believe this change is due to lifestyle choices as younger persons flock to bars and ‘limes’.

Parasram does not believe that the roll-back of civil liberties and another lockdown is the answer. Trinidad and Tobago citizens, he said, must learn how to live safely—despite the disease in its midst—until a vaccine is available in a year or two.

“The primary goal at this time remains to get persons to take personal responsibility for their behaviour,” said the CMO. “[…] We can’t be punitive every time we see a few cases come up from here, there and everywhere and close everything in society.

“[…] Without the behaviour change, even if we roll back, there will still be clusters and some level of spread in the country [as soon as restrictions are lifted again].”

Trinidad and Tobago vs Covid-19 (in numbers)

Local infections of Covid-19 in first wave (27 March to 26 April)

  • 50 cases in 31 days.

Local infections of Covid-19 in second wave (20 July to 8 August)

  • 90 cases in 20 days.

The Ministry of Health reminds members of the public to:

  • Wear a mask over your nose and mouth when you go out in public;
  • Keep your distance from others (six feet);
  • Stay home if you are ill;
  • Clean then sanitise surfaces, such as tabletops, door knobs and cell phones;
  • Wash your hands often with soap and water or use an alcohol-based sanitiser;
  • Cough into a tissue or into the crook of your elbow;
  • Avoid touching your face.
Photo: Persons practice physical distancing in Manila.

Persons are urged to call Covid-19 hotline numbers: 877-WELL, 87-SWRHA or 877-3742 (Trinidad) and 800-HEAL (Tobago) if they feel unwell; or they can report a possible breach of Covid-19 regulations by calling 555, or sending messages—inclusive of photographs and videos—to the Police App or via Whats App to 482-GARY.

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