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Non-essential workers ordered home from 30 March; Gov’t addresses blanks on first Covid-19 death

Prime Minister Dr Keith Rowley advised today that only ‘essential workers’ should report to work between 30 March and 15 April. For the rest, the message was: stay at home.

However, Rowley stressed, on multiple occasions, that he was not proposing a state of emergency, and he criticised a Trinidad Express editorial that called for a ‘14-day  lockdown’.

Photo: A billboard is installed on an apartment building in Cape Town, South Africa on 25 March 2020 before the country of 57 million people goes on a nationwide lockdown for 21 days to fight the spread of the new coronavirus.
(Copyright AP Photo/Nardus Engelbrecht)

“We are not declaring a state of emergency,” said Rowley. “We are asking people to stay at home… I am describing it as: ‘essentials’ to come out and ‘non-essentials’ to stay at home.”

Rowley gave examples of essential workers as those employed with T&TEC, WASA, TSTT, Customs, Immigration and the food and market sector. The government promised to publish an exhaustive list of essential workers by tomorrow.

The prime minister suggested that there were already laws that permitted lawmen to break up gatherings and those would be enforced with the help of the Defence Force.

“We are relying on the advice of our [medical] experts […] on the basis of scientific analysis,” said Rowley, as he sought to justify the government’s decisions.

Rowley pointed to the country’s first Covid-19 related death yesterday as another indication of the serious nature of the pandemic.

“This singular death is a marker for all of us,” he said, “because we are all exposed together.”

The Prime Minister also knocked opposition leader Kamla Persad-Bissessar for confirming the patient’s death before the Ministry of Health issued a statement.

Photo: Prime Minister Dr Keith Rowley.
(Copyright Parliament.org)

“It wouldn’t be Trinidad and Tobago if it didn’t go like this,” said Rowley. “First we were anxious for our first virus arrival, […] then after that we were anxious for the first death—the town crier went out and made the announcement of the first death.

“Now we are anxious for a state of emergency. We have not declared a state of emergency or any lockdown. What I have declared is an upgrade of the stay at home [request].”

However, more than 24 hours after the landmark tragedy, the government has still given almost no information beyond the obvious—that a patient has died.

In the Q&A segment, Express reporter Ria Taitt pointed to information about the deceased patient that the Health Ministry has so far not confirmed or denied.

Taitt: […] The person who came into the country on 5 February and presented with symptoms on 13 March, which is five weeks later. So that appears to give the lie to the theory that we didn’t have any domestic…

Parasram (interrupted): First of all, the information that you have, you should not have had in the first place. The confirmation you got was circulating from someone’s private notes that was sent out through Facebook. It was a breach in doctor/patient confidentiality. I have already spoken to the CEO to find out how that breach occurred.

Photo: Ministry of Health CMO Dr Roshan Parasram.

It should not be out in the public domain. It is too much information… All the information that we have, I would have gotten from the doctors who saw the patients… That is actually from the notes. We have said something is imported or note based on the notes of the doctor that saw them. I don’t know that is what is circulating. I have not looked at that in detail.

In the first instance we have asked our physicians to say it was imported enough from whichever hospital […] and they have given us that guidance from the first instance. So we are basing our imported or not imported […] based on the doctors who see the case and send it to the lab. And the lab generates that to us. And that is how we make our determination.

Taitt: What you said hasn’t really…

Parasram (interrupted): I understand what you’re saying but, as I say, we have to look based on the information that is circulating around there are […] a number of terms we can use epidemiologically. It is an imported case which is a broad term that encompasses a lot of things. I don’t want to go into details about an individual patient at this level. But we can discuss it afterwards if you like.

Rowley: Doctor, for my own edification, can I ask: this 14 days; how definitive is that?

Parasram: It is not. And I would say the research out of China even has said they are outliers in all of this. And as Dr Rampaul clearly pointed out, it is a new virus. All of us are working with 14 days. We are hoping to God that it is right… But there are outliers in every viral disease…

Taitt: So you’re saying you are not certain…

Parasram: No. I am not saying we are not certain. All the cases we have listed as imported have come from the physicians and epidemiologists. They are telling us so in every single case.

Photo: A doctor operates a Covid-19 test kit.

Taitt: […] What are the procedures [or] protocols for announcing the death of a person…

Parasram: I don’t know if the death of a person should be public interest matter in the first place.

Taitt: But given the situation, it is not as if it was a heart attack he got. It is an infectious…

Parasram (interrupted): I know. But our policy and procedure is the family and relatives need to be informed first. That is key. When this occurred we would have taken all the necessary steps to communicate with the family. Some of the family is abroad. I don’t want to give out too much information.

It takes a significant amount of time to reach out to them. They not only have to receive the information, they have to be counselled, they have to bring in certain vital pieces of information to us, for example identification, etc… Could you imagine if your relative has passed away […] and you find out by looking at the press? How would you feel?

Taitt: The gap between the actual event and the confirmation of the ministry was so wide that…

Parasram: I don’t think the gap was wide at all.

Taitt: It creates an opportunity for the opposition leader and everybody else to get that information. Nature abhors a vacuum and if there is an information vacuum, [it might be filled] by someone who is not the authorised person. So that’s all I am saying.

Parasram: Everything is variable. It depends on how long it may take to contact a relative… It has to be guided by when relatives are informed and comfortable first before we send anything out.

Photo: A Covid-19 patient is evacuated from the Mulhouse civil hospital, France on 23 March 2020. The Grand Est region is now the epicenter of the outbreak in France, which has buried the third most virus victims in Europe, after Italy and Spain.
(AP Photo/Jean-Francois Badias)

Guardian reporter: We know that the patient died around midday and we had confirmation from close members to the family that the family found out soon after the death. So again it begs the question: why such a long period of time?

Parasram: [Dr Michelle Trotman and I] both followed the process. I don’t know how the information would have leaked out… We have to follow our process.

Guardian: […] Wouldn’t the death of a patient [in these circumstances] constitute public interest?

Parasram: […] We have taken the position to report to the population twice a day, which I think is more than adequate… I don’t think we need to go beyond that.

Guardian: When we look to our neighbours in Jamaica, they are getting more detailed information. The public is seeing this and wondering why we don’t have it. Information like the exact amount of people who are in isolation, those are at home…

Parasram: […] Every country will determine what is relevant and what is not. We are guided by WHO’s guidelines as well. And we think that the information we are providing now is sufficient. If of course that changes and we add certain perimeters on, we will continue to do this as needs be.

Taitt: Prime minister, another leg to the same question. The vacuum…

Rowley (interrupted): Let me just say something here. I have you all here in front of me and I don’t intend to spend valuable time dealing with the irresponsibility of the opposition leader. Dr Parasram has held his position. There is a protocol for the announcement of the deceased in the health system. That protocol is not to be breached…

If there are people who believe they want to be the national ghoul or the national town crier, let them do that. We have other things to do. Any other questions?

Photo: Prime Minister Dr Keith Rowley.
(Copyright Shaun Rambaran/forge.co.tt)

Earlier in the press conference, Rowley also revealed that the Ministry of Finance had made TT$157 million available to the Ministry of Health.

Deyalsingh said this money will be spent on consumables (gloves, surgical caps, etc), human resource capacity (consultants, house officers, nursing assistants, etc), infrastructure (building isolation rooms, areas for self-quarantine for staff, etc) and equipment (cardiac monitors, ventilators, heart-rate monitors, etc).

The Eastern Regional Health Authority (ERHA), which includes Balandra, is due TT$2.6 million from that figure with TT$16.6 due to the North West RHA and TT$4.5 to the South West RHA. The ‘lion’s share’, which was not specified, will go to the North Central Regional Health Authority.

Tobago’s medical structure will be resourced separately.

“This is going to cover the first months of this marathon,” said Deyalsingh.

At the time of the press conference, Deyalsingh reported 407 samples with 61 positive reports of which 44 were from the Costa Favolosa cruise ship. By evening, that figure had climbed to 65 positives from 415 tests.

Three additional persons from the cruise tested positive along with another new ‘imported case’.

Testing of the 3,711 passengers on the Diamond Princess cruise, which was ‘the source of the largest outbreak outside of China during the initial stages of the pandemic’, revealed an infection rate of roughly 20 per cent.

Photo: The ill-fated Costa Favolosa cruise ship.

Yet, the infection rate for the 73 Trinidad and Tobago passengers on the Costa Favolosa now stands at 64 per cent, which is more than three times as high.

Wired868 asked a spokesperson at the Ministry of Health the following questions:

Have we investigated whether passengers on the cruise from other countries [were] infected at that rate? Is it possible that a small or even significant portion of [the passengers] are being infected while in quarantine?

There was no response up to the time of publication.

As far as the measures on the ground go, Dr Marlon Rampaul, infectious disease specialist at Caura Hospital, endorsed measures taken by the government.

“It gives us the opportunity to try and mitigate the spread of the disease,” said Rampaul. “We are investigating any evidence of community spread…”

Rowley stressed that the government—at the risk of the ‘implosion’ of the Budget—were putting measures in place to deal with a surge, if necessary. He called on the public to keep faith in his government and to avoid being ‘misled’ by the ‘embarrassing’ behaviour of the opposition leader and her ‘cohorts’.

“If we are as disciplined about this situation as we were in Panorama for Carnival,” said Rowley. “We will succeed.”

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